Mohs micrographic surgery is a specialized technique for the removal of skin cancer that combines surgery with real-time histologic margin evaluation. The procedure was first developed in the 1930s by Dr. Frederic Mohs and has evolved over the last century into the gold standard treatment for most types of skin cancer.
This meticulous, multi-step process removes cancer with a small (1-2mm) margin, followed immediately by 100% histologic margin assessment. Any microscopic cancer “roots” are identified, mapped, and tracked, allowing Dr. Spring to precisely remove the positive margin with minimal disruption to the surrounding healthy skin. The process is repeated until cancer-free tissue is reached (“clear margins”). Mohs surgery allows for the highest certainty of cancer removal, with the smallest defect, resulting in smaller scars and superior cosmetic outcomes. It is the treatment of choice for cosmetically sensitive areas such as the face, ears, nose, and scalp. Mohs surgery is also recommended for skin cancer on the hands, feet, and shins, for tumors that are aggressive, large, or recurrent, or when tissue conservation is critical.
Mohs surgery is performed as an outpatient procedure under local anesthesia in our comfortable Mohs suites at Capital Skin and Laser. The visible skin cancer is removed along with a thin layer of surrounding tissue, which is carefully mapped and processed in our state-of-the-art onsite histology lab. Dr. Spring examines each layer under a microscope. If cancer cells are detected at the margins, additional layers are removed only where cancer remains, repeating the process until the skin cancer is completely cleared.
Once the cancer is completely removed, repair of the surgical site is performed using advanced reconstructive techniques to optimize healing and cosmetic results.
As the wound heals, the scar will continue to remodel over time.
highest cure rate of skin cancer.
Allows examination of 100% of the tumor.
CURE RATE For basal cell and squamous cell carcinomas.
Recommended for aggressive tumors preservation of tissue.
Mohs micrographic surgery offers the highest cure rates of any skin cancer treatment while preserving the maximum amount of healthy tissue. Mohs surgery allows examination of 100% of the tumor margin in real time, allowing your surgeon to map, track, and follow your cancer, removing the tumor layer by layer until only cancer-free tissue remains. This precise, methodical approach achieves cure rates up to 99% for basal cell and squamous cell carcinomas, while minimizing scarring and optimizing cosmetic outcomes. Mohs surgery is ideal for areas where tissue conservation is critical, such as the face, ears, neck, hands, and other cosmetically or functionally important sites. Mohs surgery is also recommended for aggressive tumor subtypes, recurrent cancers, or large cancers.
Mohs surgery offers the highest cure rate of skin cancer (up to 99%); however, no treatment can guarantee zero chance of recurrence, and continued surveillance remains an important part of your long-term care.
Studies have shown that once you develop skin cancer, you are at a higher risk for developing other skin cancers in the future. We recommend full-body skin examinations with a dermatologist at least once a year, or more frequently if advised based on your individual risk. Patients should also seek prompt evaluation for any new, changing, or non-healing spots of concern between scheduled visits. Regular follow-ups allow for early detection and treatment, providing the best opportunity for long-term skin health and peace of mind.
Mohs surgery is both a cancer treatment and a reconstructive procedure, requiring precision, judgment, and advanced surgical skill. Fellowship training in Mohs micrographic surgery represents the highest level of specialization in skin cancer surgery and reconstruction.
A fellowship-trained Mohs surgeon has completed an additional year of intensive, hands-on training beyond dermatology residency, focusing exclusively on skin cancer removal, microscopic margin analysis, and complex reconstruction. These surgeons earn their membership to the American College of Mohs Surgery (ACMS), a highly selective professional organization with rigorous training and ethical standards.
It is important for patients to understand that board-certification or “advanced training” in Mohs surgery is not the same as fellowship training. Fellowship training in an ACMS-approved program requires formal, supervised surgical experience, extensive case volume, and mastery of both cancer clearance and reconstruction–standards that go beyond examination-based certification alone.
Mohs surgery at Capital Skin and Laser in Columbia, South Carolina, is performed by Dr. Leah Spring. Dr. Spring completed fellowships in both Mohs Micrographic Surgery & Cutaneous Oncology, as well as Cosmetic Dermatologic Surgery, and is double-board certified in both Dermatology and Mohs Micrographic Surgery. This level of expertise ensures our patients the highest cure rates while preserving as much healthy skin as possible, with reconstruction thoughtfully designed to optimize both function and cosmetic outcome.
Explore before-and-after images that highlight outcomes from real patients treated in our practice. Each result reflects an individualized treatment plan developed by a board-certified dermatology team, with a focus on safety, skin health, and natural-looking improvement.
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“Dr. Spring was just fabulous to deal with. She listened intently and had a great personality to boot. I’m almost 82 years old, and my initial visit with her was one of the best experiences I have EVER had with any physician. I feel privileged to have her as my doctor, and I highly recommend her!!!”
“Dr. Spring was amazing. She explained everything thoroughly and respected my concerns.”
“Dr. Spring and her staff were upbeat, attentive, and caring. They saw my anxiety prior to my procedure and took an extra moment to talk through it with me, which made me feel like they care about me as a whole person. I’ve never felt anxious prior to treatment before so this extra step really hit home.”
“Kudos to Dr. Spring. She has the Eye of an Eagle, the Heart of a Lion, yet the Hand of a Woman! Best surgeon ever!”
When you’ve been diagnosed with skin cancer, your choice of surgeon matters. Schedule a consultation with Dr. Leah Spring for the highest level of skin cancer treatment, paired with a refined, aesthetics-focused reconstruction.
At Capital Skin and Laser, our team understands the word “cancer” can be scary and Mohs surgery can feel intimidating. Therefore, your comfort, understanding, and peace of mind are our priority from your first visit through recovery. Every patient is cared for with the same attention and respect we would offer our own family. Our approach is meticulous, kind, and designed to deliver exceptional care while preserving your natural appearance–so you can move forward with confidence.
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