BCC surgery is the surgical removal of basal cell carcinoma, the most common type of skin cancer. If you searched “BBC surgery,” you were likely looking for information on BCC, which stands for basal cell carcinoma. Surgery is considered the best treatment for this cancer, and the goal is straightforward: remove every cancer cell while preserving as much healthy skin as possible. Several surgical techniques exist, and the right one depends on the tumor’s size, location, and whether it has been treated before.
Standard Surgical Excision
The most common approach is standard surgical excision. A surgeon numbs the area with local anesthesia, then cuts out the visible tumor along with a surrounding margin of healthy-looking skin. That margin acts as a safety buffer, increasing the odds that no cancer cells are left behind. The removed tissue is sent to a pathology lab, where it’s examined under a microscope to confirm the edges are cancer-free.
For tumors that haven’t been previously treated, standard excision works well in most cases. Five-year recurrence rates for primary basal cell carcinomas treated this way range from about 2.5% to 4.1%, meaning the vast majority of patients are cured with a single procedure. Recurrent tumors (ones that have come back after earlier treatment) are trickier, with five-year recurrence rates climbing as high as 12%.
Mohs Micrographic Surgery
Mohs surgery is a more precise technique reserved for higher-risk situations: tumors on the face, ears, eyelids, nose, hands, feet, or genitals, where saving every millimeter of healthy tissue matters for function and appearance. It’s also the preferred method for tumors that have recurred after previous treatment.
The procedure works in stages. After numbing the area, the surgeon scrapes away any visible tumor, then removes a very thin layer of tissue around and beneath the wound. That layer is cut at a 45-degree angle, pressed flat, frozen, sliced, dyed for orientation, and examined under a microscope. Unlike standard pathology, which only samples small cross-sections of the tissue, Mohs processing allows virtually 100% of the outer and deep margins to be checked in a single pass.
If cancer cells are found in a specific area of the margin, the surgeon consults a detailed map of the tissue and goes back to remove only that section. The process repeats, layer by layer, until no cancer remains. Each round of tissue processing takes roughly 15 to 30 minutes, so the entire procedure can last several hours depending on how deep or widespread the tumor is. Once the margins are clear, the wound is closed with stitches, a skin flap, a graft, or sometimes left to heal on its own.
Curettage and Electrodesiccation
For superficial basal cell carcinomas confined to the top layer of skin, a simpler office procedure called curettage and electrodesiccation is sometimes used. The doctor scrapes the tumor away with a sharp, looped instrument called a curette, then applies an electric needle to destroy any remaining cancer cells at the base. This scrape-and-burn cycle is typically repeated once or twice during the same visit. It’s quick and effective for small, low-risk tumors, but it’s not appropriate for deeper or more aggressive cancers.
How to Prepare
Preparation for BCC surgery is relatively simple. You can eat a light meal beforehand, since these procedures use local anesthesia rather than general sedation. Stop taking over-the-counter blood thinners like ibuprofen, aspirin, or naproxen at least 10 days before your scheduled surgery. If you take a prescription blood thinner, let your surgical team know when you schedule the procedure, as they’ll typically have you continue it. On the morning of surgery, wash the affected area with antibacterial soap. Wear a loose, button-front shirt so you can change into a gown easily without pulling fabric over a fresh wound.
Recovery and Healing Timeline
Most BCC surgery recovery is straightforward. You’ll leave with a bandage over the surgical site and instructions for keeping the wound clean and moist as it heals. Stitches are usually removed at a follow-up appointment within one to two weeks, depending on the location.
The wound itself heals in stages. Initial tenderness and swelling settle within the first week or two. A visible scar is normal, especially after Mohs surgery or excision on the face, but it flattens and fades significantly over the following months. Full maturation of the scar can take up to a year. Your surgeon may recommend silicone sheets, gentle massage, or sun protection to help the scar heal as inconspicuously as possible.
Cost and Insurance Coverage
Because basal cell carcinoma is a cancer diagnosis, BCC surgery is considered medically necessary and is covered by most health insurance plans, including Medicare. The cost varies by technique. A standard excision on the face with pathology typically runs in the range of $130 to $330 through Medicare reimbursement. Mohs surgery costs more, averaging around $420 for the first stage and about $300 for each additional stage, making the total two to three times higher than standard excision. That premium reflects the real-time microscopic analysis built into the procedure.
A coalition of 70 physicians reviewed over 200 clinical scenarios and found that 83% of them met the criteria for Mohs surgery to be deemed “appropriate,” so insurance approval for Mohs is common when the tumor’s location or characteristics warrant it. If your surgeon recommends Mohs, it’s worth confirming coverage with your insurer beforehand, but denial for a medically indicated case is uncommon.
Choosing the Right Approach
The choice between techniques comes down to a few factors: where the tumor is, how large it is, whether it’s been treated before, and how aggressive it looks under the microscope. Tumors on the trunk or limbs that are small and haven’t recurred are usually handled well with standard excision or curettage. Tumors on the face, near the eyes, on the ears, or in other cosmetically or functionally sensitive areas generally call for Mohs surgery to minimize tissue loss. Recurrent tumors also benefit from Mohs, since the scar tissue from prior treatment can make it harder to identify cancer margins with the naked eye.
Regardless of method, BCC surgery has excellent cure rates. The overall five-year recurrence rate across techniques is around 3.4% for primary tumors and 5.1% for recurrent ones. After treatment, regular skin checks with a dermatologist are important, since having one basal cell carcinoma increases the likelihood of developing another in the future.