How does the MOHS surgeon know to take two layers at one time?

I had MOHS surgery in March 2016 for a basal cell on my left cheek. During the procedure, one of the nurses said that he'd taken two layers all at once (which I understand to mean two stages at once). Why wouldn't my surgeon take one layer and check this one, then take a second layer (stage 2) separately? How does the surgeon know to take two layers at one time? (I tried to attach a photo but it wouldn't upload.)

Doctor Answers 2


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he would know and therefore shouldn't take 2 layers or stages at once. He may have taken two pieces for one stage which is ok.

Dr Malouf

Fort Worth Dermatologist
4.7 out of 5 stars 87 reviews

Taking Two Layers: What Gives

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That's a difficult question to answer. You are right. Generally, you would take one stage and then check the results and if necessary take another. Maybe the assistant meant that the piece of tissue was bisected or cut in half. In that case it would still only be one stage. Maybe there was obvious tumor when the surgeon cut through the tissue and he/she took another specimen, but again that would likely be considered one stage. Best option... talk to the surgeon directly about the situation and see what their explanation is.

Andrew Kaufman, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 16 reviews

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