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One of the questions I hear most often before surgery is:“What exactly is going to happen there?”  People fear the unknown more than the surgery itself.So here is a precise description of a typical Mohs surgery day.

Before You Arrive

No fasting is required. You may eat, drink coffee, and drive.It’s important not to forget your regular medications, and if you usually take medications during the day, bring them with you.

Wear comfortable clothing with buttons - not shirts that need to be pulled over the head.If the surgery is near the eye, wear clothes that won’t matter if they get stained with a bit of blood.

It’s recommended to have someone accompany you and drive you home.

Arrival and Preparation - 15–45 minutes

Upon arriving at the Mohs unit, you begin with administrative intake and registration.Then a nurse calls you in, takes vital signs, reviews your medical history, and explains how the day will proceed - where the waiting room is, where the operating room is, and what to expect.

After this, you wait in the waiting area until it’s your turn.When your turn arrives, you enter the operating room and meet the doctor, who explains what will happen and answers any last questions.

Only then do you sign the informed consent in the doctor’s presence.At this stage, the OR nurse helps you onto the surgical bed and positions you comfortably.

The doctor joins you, confirms the exact location of the lesion together with you, and documents it with a photograph.

Then the surgical area is disinfected, and local anesthesia is injected.

The injection is usually the most uncomfortable moment - and even that is generally mild.

Once the anesthesia is in, pain disappears immediately, followed by loss of sensation to touch and temperature.

Stage One - Excision and Microscopic Examination: 45–90 minutes

The doctor disinfects the area again, more thoroughly, and the surgery begins.

The tumor is peeled away, and a first layer of tissue beneath it is removed.

The wound is treated to stop bleeding, and both the wound and the removed tissue are photographed for documentation and mapping.

The wound is then covered with a sterile dressing.

Meanwhile, the tissue is taken to the lab next to the operating room, where the technician processes it and prepares it for microscopic examination.

You return to the waiting room, applying gentle pressure on the dressing for several minutes.

During this time, the doctor examines the tissue under the microscope, looking for tumor margins.

Patients may use this time to go to a nearby café to eat or drink (a sandwich and water are also provided in the waiting room).

If the margins are clear, the tumor has been fully removed and you proceed to closure.

If cancer cells remain, the doctor maps their exact location and you return to the operating room for removal of the next layer - precisely where the remaining tumor was identified.

Additional Stages - If Needed

About 80% of cases are completed in one stage.

More complex cases may require two, three, or more stages - each adding 45–90 minutes depending on the tumor’s size and complexity.

Closure - 20–45 minutes

Once clear margins are achieved, the wound is closed with a focus on optimal cosmetic results.

Most wounds are closed with simple sutures; some are left to heal naturally without stitches, depending on size and location.

More complex cases may require flap reconstruction, grafts, or other techniques.

Going Home

At the end of surgery, the area is disinfected again, photographed, and covered with a dressing meant to stay in place for up to three days.

The nurse instructs you and your companion on care until suture removal.

The doctor provides a summary letter, prescriptions if needed, and detailed instructions, and reviews the healing process and what to expect.

Most patients can drive home themselves and even return to work the next day.

Sick leave is provided according to individual needs.

7–14 Days Later

You return for suture removal at the scheduled time.

The healing is assessed, questions are answered, and expectations are reviewed.

In the vast majority of cases, that’s the end - no hospitalization, no general anesthesia, no weeks of recovery.In a small minority of cases, more aggressive tumors require further evaluation or additional treatment.

The doctor will guide you, explain, provide referrals, and continue follow‑up as needed.

For questions before surgery:  WhatsApp: 050‑5633002  Email: 5633033@gmail.com

When patients come to me holding a pathology report, the word “cancer” has already triggered fear. At that stage, most of them don’t really read what’s written - they just see the word and stop.

So let’s talk about the two most common types of tumors I operate on: BCC and SCC.

Yes - both are skin cancers.

No - they are not the same.

First: BCC — Basal Cell Carcinoma

This is by far the most common tumor. About 8 out of 10 cases I see are BCC.It is a slow‑growing tumor. It almost never spreads to other organs.

But - it does invade deeply.

A small BCC on the nose can, over years, reach the cartilage.

On the eyelid - it can extend into the eye socket and even into nerves.In some cases, this tumor can infiltrate surrounding tissue with almost no external sign other than a slight change in skin color or texture.

Classic sign:  A shiny pink sore that keeps returning, bleeds, doesn’t heal, and slowly grows.

Sometimes it can be brown or black in parts, and it often appears in places where the patient assumes it came from trauma (glasses, scratches, etc.).

Second: SCC — Squamous Cell Carcinoma

This tumor is less common and behaves differently.

SCC can spread - to lymph nodes, and in rare cases to distant organs.Not always, not with high probability, but this is a major difference from BCC.

In some cases, this tumor is dangerous and even life‑threatening.

There are several subtypes - some more aggressive, some less, some deep, some superficial.

Classic sign:  A rough, scaly lesion - sometimes ulcerated, sometimes fleshy and nodular - usually on sun‑exposed areas: face, ears, lips, hands.

Why Mohs Surgery Is the Preferred Treatment for Both?

Because in Mohs surgery, unlike standard excision, we examine all tumor margins immediately under the microscope.

We don’t take “wide margins” as a safety measure - we take exactly what is needed, confirm that everything is clear, and then close.

Result:  Maximum cure rates with minimal damage to healthy tissue.

Bottom Line

For BCC - it’s important to treat, maybe slightly less urgent, but we do not wait.

For SCC - we definitely do not wait. Treatment should be done promptly and thoroughly.

If you received a report with one of these names - contact us.

We’ll explain exactly what’s going on and what the next step is.

When I performed my first mole surgery in the early 2000s, I arrived at the operating room with a protocol, equipment, theoretical knowledge acquired during my training in San Diego, and clinical experience acquired during my extensive plastic surgery residency. What I didn't know yet was what only surgery after surgery teaches.

Ten thousand surgeries later, I can say that much of what I know today is not found in any textbook.

What the data doesn't tell:
A 99% cure rate in Mohs surgery for BCC tumors — that's a real number. But behind every percentage are people. A 72-year-old man who came in with a "small pimple on his nose" that turned out to be a tumor that had penetrated the cartilage. A 58-year-old woman who postponed surgery for a year and a half "because it didn't seem important." A 17-year-old boy whose tumor was discovered during a routine checkup.
Every case taught me something.

What surprises patients the most:
Most of them think that Mohs surgery is “major surgery.” They come with anxiety, with someone accompanying them, with questions about general anesthesia.
In reality: Most surgeries are performed under local anesthesia only, in the clinic's operating room. You arrive in the morning, return home at noon. The scar, in most cases, is almost invisible after six months.

What still worries me
Patients who arrive too late.
Not too late in the dramatic sense — but too late in the sense of "I knew something was wrong a year ago, but I thought..., I waited until..." Every month of waiting with BCC or SCC on the face is another millimeter of growth, another tissue that will have to be removed, another risk of complications and aesthetic damage that will be difficult to repair.

If you have a lesion that doesn't heal, a wound that recurs, a spot that changes — come. Even if it turns out to be completely benign in the end. A visit that rules out a tumor is better than a visit that proves you've been nurturing a large and dangerous tumor.

What hasn't changed:
Every surgery, from the first one until now, begins at that moment: when I explain to the patient about the surgery and what's going to happen and I see the anxiety go down their face. That hasn't changed. That won't change.

For questions or to schedule an appointment: WhatsApp/SMS to 050-5633002 or email to 5633033@gmail.com

Too often, my patients come to me not as their first stop, but as their final station after months of exhausting uncertainty. This is the story of a young patient who recently came to me - and it illustrates exactly why Mohs surgery is not just a medical procedure, but peace of mind. 

The First Stop: Months of Waiting It all began with a small lesion on her facial skin. From there, a “snowball” of medical bureaucracy started rolling: two months waiting for an overbooked dermatologist, a quick referral for a biopsy with a plastic surgeon, and then another nerve‑wracking month waiting for the pathology results. The news: positive. A tumor. Surgery required. 

The Second Stop: The Hospital She was referred to a leading hospital’s plastic surgery department. Again - waiting for appointments, pre‑operative tests, and finally, the long‑awaited surgery. Nearly five months after the initial discovery, the lesion was excised. The cosmetic result was good, and she finally breathed a sigh of relief. She thought the story was behind her. 

The Third Stop: The Disappointment at Follow‑Up At her follow‑up visit, the devastating news arrived: 

“The margins are not clear. The tumor is still active.” 

Exhausted and anxious, the young patient was referred to me for complete excision using Mohs surgery. 

Why Mohs Surgery Is Your “Insurance Policy” 

With Mohs, we don’t guess. Unlike standard surgery - where the pathology report arrives days later - here everything happens in real time: 100% Margin Examination I examine the tissue under the microscope while the patient is still in the clinic. 

Complete Certainty We finish the surgery only when I can confirm with 100% certainty that the margins are clear. 

Optimal Cosmetic Outcome We remove only diseased tissue and preserve as much healthy skin as possible - crucial in the facial area. 

This patient is now past it. She left the clinic not only healthy, but with the absolute certainty that this time - it is truly over.

Meet Avraham, a veteran farmer from the Arava who spent most of his life under the strong Israeli sun. Avraham isn’t the type to run to a doctor for every scratch or bandage; he’s used to hard work and believes that “the body knows how to handle itself.” But when you work in the fields under direct sunlight for decades, the skin has a long memory - and it doesn’t always forgive. Let’s see how the exact same story can end in two completely different ways. It all depends on one simple thing: when he decided to stop everything and come to our clinic.

Scenario A: “It’s probably just a small wound” (Late Detection)

It all started with a small, insignificant scab on the side of his nose. “It’s probably just from my glasses,” Avraham thought as he loaded another crate of peppers. He was too busy during the peak season, then came the holidays and family… and in the end, eight months passed.

The small wound had become a nuisance; it started bleeding occasionally, stopped healing, and the skin around it became stiff and tight. Avraham arrived at the clinic and admitted he had completely forgotten the warnings about non‑healing wounds.

During the examination, it was already clear that this was a serious - and not small - tumor. We scheduled an urgent surgery.

When we finally met in the operating room, it became clear that the “wound” was only the tip of the iceberg. The tumor had already sent deep, hidden “roots” into the supporting cartilage of the nose - just like weeds burrowing deep into the soil.

What did this mean for the surgery?  Instead of a short procedure, we went through a long, exhausting day. Five stages of Mohs surgery were required - each time removing a layer, examining it under the microscope, and discovering that the tumor was still there, hiding deeper.

Outcome and recovery:  Because of the deep cartilage damage, Avraham needed a complex facial reconstruction (a forehead flap to the nose). This meant pain, complex dressings, and a significant impact on his quality of life for many months. He also had to undergo a series of radiation treatments to ensure no cancer cells remained.

Scenario B: “I came because that’s what we scheduled” (Early Detection)

This time, Avraham came for his routine check‑up every six months, exactly as we had planned at his previous visit. He even felt a bit embarrassed to “waste my time” over a tiny, almost invisible spot on his nostril - but during my careful examination, I immediately recognized the early signs that something abnormal was beginning to develop.

The good news?  Because he didn’t wait, we caught the tumor at a very early stage - still “sleeping” on the surface of the skin, without having had time to spread inward.

What did this mean for the surgery?  Everything went smoothly. In a precise Mohs procedure, we achieved clear margins in the very first stage. The tumor was removed completely without damaging the cartilage or the structure of the nose.

Outcome and recovery:  Avraham went home with delicate stitches and a small dressing. He returned to the fields and his full routine after just a few days - no chronic pain, no radiation treatments, and no facial deformity. Everything went back to normal quickly and most importantly, with complete peace of mind.

My Bottom Line

Friends, when it comes to the face and neck, every millimeter is a world unto itself. The distance between the skin and vital structures is practically zero. Early detection is not a “bonus” - it is what turns a painful, complicated medical drama into a simple, aesthetic, and quick treatment.

Don’t say “it will go away on its own,” and don’t wait for the wound to grow. If you see something new, bleeding, or just unusual - get checked early. It can save far more than your smile.

And beyond that, structured follow‑up at appropriate intervals - based on your personal risk level (your doctor will determine the recommended frequency) - allows early detection of lesions you may not have noticed, catching them before they become a serious problem.

Avi Meller 1953–2025Mohs surgery is considered today the gold‑standard technique for removing malignant skin tumors in the facial area — and not by chance. It enables complete and precise removal of cancer while preserving as much healthy tissue as possible. The story of sports broadcaster Avi Meller, who faced a recurrence of a tumor that was not fully removed and ultimately became an aggressive, life‑threatening disease, illustrates how critical the choice of the right treatment method can be — for one’s health and even for one’s life.

Mohs Surgery: Why Is It So Important, Especially on the Face?

Skin cancer is the most common cancer in the world — and particularly in Israel. Israel is a sun‑drenched country with inviting beaches and a population that includes many fair‑skinned immigrants with lifestyle habits that lead to high exposure to UV radiation. It is important to emphasize that darker‑skinned individuals are also at risk, especially because many mistakenly believe they are “protected” and cannot develop skin cancer.Many malignant lesions appear in exposed areas, especially the face: nose, eyelids, ears, lips, temples, and the hairline. These are areas where:

• The skin is thin and delicate, allowing tumors to penetrate quickly.
• There is very little room for error — every millimeter of tissue matters functionally and aesthetically.
• The risk of recurrence is higher if all cancer cells are not removed.

This is where Mohs surgery comes in — a unique surgical technique in which the tumor is removed in thin layers, and each layer is examined under a microscope in real time. Only if cancer cells are found does the surgeon continue removing additional tissue. This ensures complete tumor removal with minimal damage to healthy tissue.

What Makes Mohs Surgery the Most Precise Method?

Mohs surgery combines surgery and pathology at the same moment. Unlike standard excision, where the tumor is removed “approximately” with wide margins:

• 100% of the margins — both peripheral and deep — are examined.
• The surgeon identifies exactly where cancer cells remain and removes tissue only from that area.
• Healthy skin is maximally preserved, resulting in smaller scars and easier recovery.
• Cure rates reach 97–99% for certain tumors.

On the face, where every millimeter matters, this is not just an aesthetic issue — it is a matter of medical success and improved chances of full recovery.

Avi Meller’s Case: What Happens When a Tumor Is Not Fully Removed?

It was recently reported that sports broadcaster Avi Meller faced a recurrence of facial skin cancer after the original tumor was not completely removed. The disease returned with distant metastases and required difficult chemotherapy and radiation treatments.Cancer cells left behind can continue growing beneath the surface — sometimes months or years after surgery.When a tumor recurs:

• It tends to be more aggressive.
• It may invade deeper tissues, nerves, or blood vessels.
• A simple surgery is often no longer enough.
• Additional treatments such as radiation or chemotherapy may be required — longer, harsher, and accompanied by significant side effects.

Meller’s story is a painful reminder that skin cancer is not “small” or “simple.” Inaccurate treatment can lead to a far more complex medical journey.

Why Is Mohs Surgery Especially Important on the Face?

1. Maximum precision in a sensitive area  The face contains delicate structures — nerves, muscles, cartilage, tear ducts, eyelids, and more. Unnecessary damage can cause functional problems, not just cosmetic ones.2. Preserving a natural appearance  Mohs surgery allows optimal reconstruction with smaller scars and precise placement of incisions.3. Preventing recurrence  Complete removal the first time significantly reduces the risk of the cancer returning.4. Handling complex tumors  Recurrent tumors, tumors with unclear borders, or tumors in difficult locations are particularly suited for Mohs surgery.

Who Should Consider Mohs Surgery?

Not every skin cancer requires Mohs, but it is preferred in cases such as:

• Facial basal cell carcinoma (BCC)
• Squamous cell carcinoma (SCC)
• Recurrent tumors
• Tumors with unclear borders
• Tumors in areas where tissue preservation is crucial
• Younger patients seeking optimal cosmetic results

What Happens If Mohs Surgery Is Not Chosen?

In standard excision, the tumor is removed with relatively wide margins. The problem:

• Not all margins are examined, so cancer cells may remain.
• If the tumor returns, it may be larger, deeper, and more dangerous.
• A more extensive surgery may be needed, sometimes with additional treatments.
• Cosmetic results may be inferior.

In other words: saving time or cost initially may lead to a far more complex treatment later.

A Message to the Public: Do Not Compromise on Treatment Quality

Avi Meller’s story is not just personal — it is an important lesson for anyone facing a suspicious facial lesion. Skin cancer is common, but when treated correctly, it is usually fully curable.Choosing Mohs surgery can be the difference between:A short, focused treatment  andA long, painful, complicated medical journeyEspecially on the face, where even a small mistake can become a big problem.

In Summary

Mohs surgery is not “just another surgery.” It is the most precise method for removing malignant skin tumors from the face, offering a rare combination of:

• Microscopic accuracy
• Very high cure rates
• Preservation of appearance and function
• Prevention of recurrence

Avi Meller’s story reminds us how important it is to choose the right treatment the first time. When it comes to skin cancer, there is no room for compromise.