What to Expect from Mohs Surgery
Preparing for Mohs Surgery
- The MOHS technique of skin cancer removal is a staged procedure. Therefore, we are unable to provide you with a specific length of time that you will be in the office. Please expect to be here between 2-5 hours.
- Feel free to bring reading material or something to pass the time as well as water and/or snack.
- You are welcome to bring family members or friends with you.
- Take all the medications that were prescribed to you by a physician including Aspirin and other prescribed or recommended blood thinners as normal.
- If you need to take a pain medication before or after the surgery, please take Tylenol, which does not thin the blood. Try to avoid Ibuprofen, Advil, Naproxen, Aleve, and Vitamin E if able as these can thin the blood.
- If you require a prophylactic antibiotic before dental procedures, you will require a prophylactic antibiotic before your surgical procedure with us. We ask that you take the prophylactic antibiotic 1 hour prior to the surgical appointment and again 6 hours after the first dose.
- Because Mohs surgery utilizes local anesthesia instead of general anesthesia, you may eat normally before surgery.
- Please shower before the surgery, and don’t apply any type of cosmetics including lotion, makeup, or perfume.
- Dress comfortably, wearing a shirt that unbuttons or unzips.
- Be sure to talk about any questions or concerns you have to the staff upon arrival at the office.
- Smoking hinders wound healing and can be hazardous to your health. Please consider cutting back or quitting.
What to Expect the day of Surgery
We are here to serve you and to partner in your care. Please ensure all your questions are answered before the procedure.
Mohs micrographic surgery is an outpatient procedure done in our office. We have an on-site surgical suite and a laboratory for immediate preparation and microscopic examination of tissue. Typically, surgery appointments start early in the morning. Most patients spend at least two to four hours in the office but sometimes longer, depending on the extent of the tumor and the amount of reconstruction necessary.
Local anesthesia is administered around the area of the tumor. The use of local anesthesia in Mohs surgery versus general anesthesia provides numerous benefits, including the prevention of lengthy recovery and possible side effects from general anesthesia. After the area has been numbed, then Dr. Davis removes the visible tumor along with a thin layer of surrounding tissue. This tissue is prepared and put on slides by a technician and examined under a microscope by Dr. Davis. The lesion is marked in such a way Dr. Davis can see where the tumor is still present or if more needs to be taken when she reviews it under the microscope. If there is evidence of cancer, another layer of tissue is taken from the area where the cancer was detected. This ensures that only cancerous tissue is removed during the procedure, minimizing the loss of healthy tissue. These steps are repeated until all tissue is free of cancer. While there are always exceptions to the rule, most tumors require 1 to 3 stages for complete removal.
When the surgery is complete Dr. Davis will assess the wound and discuss options for reconstruction. Regency has the benefit of a plastic surgeon in office that is available for all reconstructive repairs during your visit. This is a luxury that we have to offer and is ideal for skin cancers on the face or lesions large in size, however, it is still available for all site locations and sizes.
Your surgical wound will require care during the following weeks after surgery. Please plan to avoid strenuous physical activity for 48 hours and in some cases one to two weeks. You may experience a sensation of tightness across the area of your surgery site. Complete healing of the scar takes place over 3-12 months. During the first few months, the site may feel “thick”, swollen or lumpy and there may be some redness. Gentle massage of the area (starting about one month after your surgery and excluding grafts) will speed the healing process.