Mohs Surgery Instructions and Information

What is Mohs surgery?

You have been diagnosed with a skin cancer. Due to the location of cancer, the best treatment option for you is Mohs Micrographic Surgery. This procedure has a 99% cure rate for lesions on the face, neck, and recurrent cancers on the body.

What happens the day of surgery?

Your appointment will be scheduled early in the day. You will be given local anesthesia around the lesion; this is done with each layer. Once it is numb, visible cancer and a thin layer of tissue will be removed. This tissue is carefully mapped and coded by the surgeon and taken to the lab where the tissue will be processed. You will then have a temporary bandage and be seated back in the waiting room. The surgical procedure only takes about 10-15 minutes. However, it takes a minimum of 1-2 hours to prepare, process, and examine the tissue. Several surgical stages and microscope examinations may be required. Although there is no way to predict before surgery how many stages will be necessary, most cancers are removed in 3 stages or less. You may want to bring reading material and a snack to occupy your time while waiting between stages. You are asked not to leave the office at any time until the surgical procedures are finished. Unfortunately, we do not know how long this procedure will take; it varies from patient to patient, so we ask that you be prepared to spend all day with us. After the cancer is removed, you will then be sent to a plastic surgeon for the repair of the wound. We coordinate with a plastic surgeon, Dr. Raniere.

Will the surgery leave a scar?

YES!  Any form of treatment will leave a scar. Our main goal is to remove cancer first. However, because Mohs surgery removes as little normal tissue as possible, scarring is minimized.

Will I have pain after the surgery?

If there is discomfort, Tylenol is often all that is necessary for relief. A prescription for stronger pain medication will be written if necessary.

Pre-surgery instructions

One to two weeks prior to the surgery please stop taking Aspirin, blood thinners or over the counter pain relief medication. All pain meds OTC act as a blood thinner and increase bleeding and bruising during the procedure. If OTC pain meds are needed, Tylenol is ok.

Also, discontinue any vitamins or herbal supplements, as certain products will increase bleeding or bruising. Examples: Vit E, Ginkgo, Garlic.

If you are taking any prescription blood thinners (Coumadin, Plavix or Xarelto) check with the physician who has prescribed them to make sure you can discontinue meds one to two weeks prior to surgery. Please let us know on the day of the procedure if you are unable to discontinue any of these medications.

Avoid alcoholic beverages for at least 24 hours before surgery as this can increase bleeding as well.

Try to stop smoking prior to and after the procedure. Smoking will increase your risk of complications and interfere with the normal wound healing process. We want you to recover as quickly as possible.

If you have any artificial joints, (hips, knees, etc) please let us know a couple day in advance. We will call in a preop antibiotic to a pharmacy of your choice.

The morning of surgery

Eat your normal breakfast. Please do not wear any makeup or jewelry. Avoid using moisturizers on the surgical areas on the day of surgery.

Take your usual medications the day of surgery except for any blood thinners mentioned above.

Be prompt, plan to arrive 15 minutes prior to your procedure. If you are late, this may cause you to be rescheduled.

After surgery

Usually one or two visits are needed. Post-surgical/wound care instructions will be given the day of the surgery.

If you should have any questions prior to your procedure, please call our office at 770-460-8988.