MOHS Surgery


WHAT IS MOHS SURGERY?

Mohs surgery was initially developed by Dr. Fredrich Mohs. It is a surgery that allows a skilled dermatologic surgeon to remove a skin cancer, layer by layer microscopically examining each section. This allows complete removal of the cancer, sparing the maximum amount of healthy skin.

It provides the highest cure rate for removal of skin cancer (97-99%). Mohs surgery is performed with local anesthetic only.

HOW SHOULD I PREPARE FOR MOHS SURGERY?

  • Plan to spend the day with us.
  • Bring a light lunch.
  • Bring a book, iPad, magazine, light jacket.
  • Please do not bring children.

SHOULD I CONTINUE MY MEDICATION?

  • Take any regular medication prescribed by your physician. Discontinue any non-prescribed agents, such as aspirin, ibuprofen, Aleve, herbal supplements, vitamin E, fish oil, ginko, garlic for 14 days prior to surgery.
  • Continue taking any blood thinning agents that your doctor prescribed, including Plavix, aspirin, Coumadin.
  • Avoid alcoholic beverages two days before and after surgery.

WHAT HAPPENS ON THE DAY OF MOHS SURGERY?

A medical history will be obtained, and you will sign an informed consent. Your regular medications will be checked, and any questions you have will be answered prior to surgery.

STEP 1: The skin around the cancer will be anesthetized (numbed), and the visible skin cancer will be removed.

STEP 2: A thin layer beyond the visible cancer will be surgically removed, processed, stained and examined microscopically. A bandage will be applied to the site, and you will be returned to a waiting area until this is completed. (This usually takes an hour to an hour and a half).

STEP 3: If cancer cells are still present, the above procedure will be repeated, taking tissue only from the site where the cancer cells remain.

Once the skin cancer is removed, we will discuss the closure of the wound with you.

HOW LONG CAN I EXPECT TO BE IN THE OFFICE?

It is impossible to know how many “stages” a skin cancer may require until clear margins are present. Each stage takes about an hour. Usually, it takes 2-3 stages to clear most skin cancers. Please come prepared to spend the entire day with us.

HOW IS THE SKIN CANCER SITE REPAIRED?

After the cancer is “cleared”, we will discuss with you the best possible repair options that will allow the best cosmetic result. These may include:

• Suturing the wound

• Healing by secondary intention (no stitches)

• Skin flap or graft

• Referral to another specialist (usually a plastic surgeon or ENT)

WHAT HAPPENS AFTER SURGERY?

We will usually have you return 1-2 weeks after surgery. You should expect some swelling and bruising. There may be numbness around the site for up to a year after the surgery. While scarring cannot be prevented, every e ort will be made to minimize scarring. You will be given contact information should any problems arise after the surgery. Usually, this is minimal pain for the first 2-3 days after surgery.

Exercise and vigorous physical activity should be limited the first 2 weeks after surgery. Please discuss any concerns with our team.

DO I NEED TO RETURN FOR FOLLOW UP AFTER MOHS SURGERY?

Once you have had a skin cancer, you are at an increased risk for additional skin cancers (50% chance of developing another skin cancer). For this reason, it is very important to follow up with your general dermatologist on a regular basis.

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