1. The roots of a skin cancer may extend beyond the visible portion of the tumor, like the tip of an iceberg. If these roots are not removed, the cancer will recur.
2. The visible portion of the skin cancer is surgically removed.
3. After the tissue is removed, it is color coded with a dye and divided into sections and a map is drawn.
4. The surgeon carefully examines the undersurface and edges of the tissue under the microscope to ensure all the skin cancer is out.
5. If all the cancer is not out, the surgeon marks the exact area on the map where the cancer persists, and returns to the patient to remove another layer of skin, but only from precisely where the cancer cells remain. This way no more tissue than absolutely necessary is taken out.
The removal process stops when there is no longer any evidence of cancer remaining. At this point, the surgeon will close the wound with the least scarring and best cosmetic result possible.