What is Mohs Surgery?
Cancer can be a frightening word, but for those diagnosed with skin cancer, Mohs surgery at Sonterra Dermatology - San Antonio could be the remedy. Mohs surgery is a procedure that carefully and precisely removes skin cancer tumors. The objective of this process is to take as little of your healthy skin tissue as possible while still maintaining an optimal success rate for skin cancer treatment. This surgical procedure is used to remove squamous and basal cell carcinomas, melanomas, along with other, lesser-known kinds of tumors. Dr. James R. Neiner, MD, FAAD FACMS begins this treatment by slowly and carefully removing the malignant cells one layer at a time. After each layer, he will inspect the cell makeup of the skin tissue to determine if any cancer remains. Reach out to our San Antonio, TX office now to plan an evaluation.
Am I a Candidate for MOHS Surgery?
The Mohs surgery procedure is primarily utilized to treat the two most common kinds of skin cancer, including squamous cell carcinoma and basal cell carcinoma, as well as a wide variety of other skin cancer subtypes. If you are suffering from melanoma or a different kind of uncommon skin cancer, an appointment will help determine if you're a good candidate for Mohs surgery. Along with the type of skin cancer you have, there are also other qualifying standards that may make you a good candidate for Mohs surgery.
Mohs surgery is the ideal choice if your cancer has a high risk of recurring or when it has already returned after undergoing treatment. The cancer cells must also be located in sensitive locations, like the eyes, ears, mouth, or nose. Skin cancer cells that are big, aggressive, and contain boundaries that are hard to specify are also better treated with Mohs surgery.
Who is the MOHS provider?
Dr. James Neiner is a board-certified dermatologist and dermatologic surgeon (Mohs surgeon) with more than twelve years of experience in the treatment of skin cancer. He is based in San Antonio, Texas, where he also served as an active duty Lieutenant Colonel in the United States Army. He was also a Mohs surgeon and staff dermatologist on faculty at the San Antonio Uniformed Services Health Education Consortium (SAUSHEC) and served as both the associate program director and interim program director for the dermatology residency. He also served as an assistant professor for the F. Edward Hebert School of Medicine in Bethesda, MD as well as an active clinical assistant professor for UT Health dermatology. Dr. Neiner earned his medical degree in 2006 from the F. Edward Hebert School of Medicine. After graduating, he completed his residency in dermatology at SAUSHEC in 2010. In 2013 he was selected for advanced Mohs training in a fellowship in Mohs Surgery in Macon, GA, under the supervision of Dr. David Kent. Dr. Kent, who is recognized as one of the best skin cancer doctors in the country, has performed more than 30,000 Mohs surgical procedures. Dr. Kent is also one of a select number of program directors charged with training other dermatologists in Mohs surgery and reconstructive surgery accredited through the American College of Mohs Surgery. Dr. Neiner joined the American College of Mohs surgery in 2013. He continuously works on dermatology research with multiple publications in the Journal of the American Academy of Dermatology, CUTIS, the Dermatology Online Journal and the Dermatologic Surgery Journal. He has also earned the designation as Fellow of the American College of Mohs Surgery.
How Is MOHS Surgery Performed?
During this procedure, Dr. Neiner will generally use local anesthetics to numb the affected area prior to incisions being created for removal. The incisions can be compared to a map (like a clock face) and are designed to correspond with the orientation of your skin that had been removed. The excised layer is suspended, processed, and examined under the microscope. If additional cancer follicles are detected, they are marked on the corresponding map and the procedure is repeated. The method continues until a clean coating with no residual cancer is reached. The amount of layers eliminated and the period of the procedure depends on the phase of the cancer and how long it was present. The conclusion of this procedure will leave a wound. Healing solutions vary, from easy sutures to close the wound to more complex reconstructive (plastic) surgery for bigger wounds.
Mohs Surgery Reviews
I've been with Sonterra Dermatology for a while and have always had some sort of mole to be removed because of my skin history. I went in for my first MOHS procedure on my face right under my eye last year and never felt more reassured. Dr. Neiner is spectacular, he was honest and enjoyable. A year later my scar is barely there after my procedure. I am grateful for him and the staff for being on top of everything. Thank you :)
Great from the start of my inital call to book as a new patient. Went in for a biopsy, went back in for shingles then back again for MOHS surgery. I am currently healing. I've got a scheduled follow up and will continue to to visit Sonterra Dermatology for future concerns. No long wait times, friendly, professional, caring, quick to respond.
Dr Neiner is the best dermatologist. He makes you feel comfortable & is very knowledgeable . He gives his opinion on what choices you can make. He performed Mohs surgery I couldn’t be happier with the outcome. I’ve been to several dermatologists here in San Antonio & he is the best by far.
The care I received at Sonterra Dermatology was outstanding. The promptness of the appointment and the efficiency of the staff makes the experience a 10 out of 10. I completed Mohs surgery with Dr. Neiner and will not go to anyone else in the future. I can't thank them enough.
Very nice office. Staff were pleasant and very professional. Minimal wait time took place. Dr Garcia is superb! Dr Metzinger is outstanding! Both have great, very pleasing “bedside manners.” Excellent experience in a first rate practice! I’ve now had three MOHS procedures for basal cell cancers on my face. I’m very pleased with the results; both Dr Neiner and Dr Owen are very professional and friendly, and they are highly skilled. Greg, the nurse, was outstanding as well. This is a superb medical practice. And, Dr Neiner is superb in dealing with skin cancer.Wonderful and efficient practice. Saw Dr Neiner again today for another skin cancer. He’s the best!! Great skin cancer specialist.As always, excellent and very efficient care again today. It’s amazing how nice the staff are; very patient oriented. Great medical practice!!08/13/25Back to see Dr Neiner and his nurse(Greg) again today for skin cancer follow up. Two more biopsies were done. As always, this is an outstanding practice. Everyone is cordial and nice; wait times are very short; and quality of care is superb!! Very pleasant environment!Greg is a very nice, attentive person. Dr Neiner is a wonderful skin cancer specialist and superb MOHS surgeon. Following the healing process, one can hardly detect that facial surgery had been done! To me, MOHS by him is preferable to IG-SRT, which is much more time consuming for treatment of basal cell cancer.09/06/2025MOHS surgery by Dr Neiner yesterday went very well, as always. Greg was very helpful also. They are superb!! No problems 30 hours post op
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What Results Can I Expect from Mohs Surgery?
Mohs surgery is completed on an outpatient basis with patients able to drive home after their surgery. Due to the specialized process used during Mohs surgery, please expect to be at our office for an extended period of time, as it may take multiple stages or steps to complete your procedure. Our office is equipped with Patient Accessible Wifi, so feel free to bring an electronic device, or bring your favorite book / reading material. Even though the site may be heavily bandaged, it is possible to resume routine non-strenuous activities the following day. This rules out any active exercise or tasks for up to two weeks. If sutures were used, they'll be taken out in 7 – 10 days. Scarring will vary, depending on the process. The achievement rate of removing the cancerous cells from the treated site is extremely high when treating basal cell carcinoma, squamous cell carcinoma, and melanomas, receiving up to a 97% - 99% cure rate.
Seek Superior Care
When confronting a skin cancer diagnosis, it is imperative to do thorough research and locate an experienced Mohs surgeon who's a great match for your requirements and needs. Success rates of this procedure are directly connected to your physician's skill and experience. To learn more about the experience, training, and success rates of Dr. Neiner, call Sonterra Dermatology - San Antonio now to schedule a consultation.
