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Mohs Surgery

What is Mohs Surgery?

Mohs surgery is a highly specialized treatment for the total removal of skin cancer. Mohs surgery is named in honor of Dr. Frederic Mohs, the physician who developed the technique. This method differs from all other methods of treating skin cancer by the use of complete microscopic examination of all the tissues removed surgically as well as its detailed mapping techniques to allow the surgeon to remove every cancer cell.

What are the advantages of Mohs Surgery?

By using these detailed mapping techniques and complete microscopic control, the Mohs surgeon can pinpoint areas involved with cancer that are otherwise invisible to the naked eye. Therefore, even the smallest microscopic roots of cancer can be removed. The results are 1) the removal of as little normal skin as possible, and 2) the highest possibility of curing the cancer.

What are my chances of cure?

Using Mohs surgery, the percentage of cure is more than 95% for many skin cancers, even when other forms of treatment have failed. Other methods of treatment may offer only a 50% chance of success if previous treatments have failed.

Will I be hospitalized?

No. Mohs surgery is performed in a pleasant outpatient surgical suite and you may return home the same day. Hospital facilities are available, but are rarely necessary.

What happens the day of surgery?

Our staff will escort you into a surgical suite where the surgeon will numb the area around the skin cancer. Once it is numb, the 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 adjacent laboratory, where the technician will immediately process the microscope slides. You will have a temporary dressing placed over the wound. The surgical procedure alone takes only 10-15 minutes. However, it takes a minimum of 1-2 hours to prepare and microscopically examine the tissues. Although there is no way to predict before surgery how many stages will be necessary, most cancers are removed in 3 stages or less.

The most difficult part of the procedure is waiting for the results of the surgery. Since we do not know in advance how much time is necessary to remove the cancer and repair the wound, we ask that you plan to be in and around the office essentially the entire afternoon and that you make no other commitments.

Will the surgery leave a scar?

Yes. Any form of treatment will leave a scar. Because Mohs surgery removes as little normal tissue as possible, scarring is minimized. Immediately after the cancer is removed, we may choose 1) to leave the wound to heal itself, 2) to repair the wound with stitches, or 3) to reconstruct the area with a skin graft or flap. The decision is based on the safest method that will provide the best cosmetic result.

Will I have pain after the surgery?

If there is any discomfort, Tylenol is all that is usually necessary for relief.

Will I have a bandage?

Yes, most patients can expect some sort of bandage to be necessary for a week. We will provide detailed wound care instructions.

Will my insurance cover the cost?

We accept assignment on Medicare policies. We will also submit a claim to any other insurance company for you.

We do not want anyone to be denied necessary medical care because of an inability to pay. If you have difficulties understanding or paying your bill, we encourage you to discuss your problem with the business office staff.

Preparing for Surgery

Medications: One to two weeks before surgery: stop taking ANY aspirin or over the counter pain medication products except Tylenol (acetaminophen). Aspirin and other products such as ibuprofen (Advil) act as blood thinners and increase bleeding.

Also discontinue ANY vitamin or herbal supplements, as certain products will increase bleeding or bruising. The ideal time to discontinue many of these supplements before surgery is not known, but we suggest that you discontinue supplements 1 to 2 weeks before your surgery.

If you are taking blood thinners (Coumadin): we would like for you to discontinue your Coumadin a few days before surgery, but please check with your prescribing physician first. Continue any other medications prescribed by your doctor.

Avoid alcoholic beverages for 1 week before surgery because alcohol can also increase bleeding.

Stop Smoking! Smoking will increase you risk of complications from surgery. Smoking can also interfere with normal wound healing and we want you to recover as quickly as possible.

The Morning of Surgery

Breakfast: eat your normal breakfast.

Please do not wear makeup, nail polish, or jewelry if it will cover your surgical site. Also, avoid using moisturizers on the surgical area the day of surgery.

Take your usual medications except any blood thinners, herbs, or vitamins as mentioned above.

Be prompt: Plan to arrive 10-15 minutes early so that you can undress and we can update your medical history.

 

To learn more about Mohs Surgery, please contact us today to schedule an appointment.

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