What is Mohs Surgery?
Mohs surgery is the commonly the best method to remove most skin cancers of the face and neck, and occasionally the body as well. Mohs surgery involves removing smaller pieces of normal skin around the tumor in order to preserve skin around the area or normal form and function of vital structures such as the eyes, nose, and ears. The skin is removed in stages, processed immediately, and placed on a slide in a way that will show whether or not 100% of the skin margins are free of tumor. If there is remaining tumor, then only the remaining area involved is re-excised.
How Long Does Mohs Surgery Take?
Mohs surgery days can be very long. The stage removals, processing, tissue examination, and wound closure can last 3-4 hours, or even up to 8 hours for more complex cancers.
What Do I Need To Do Before Mohs Surgery?
We don’t recommend any specific changes to your lifestyle before Mohs surgery. Get rest the night before your surgery as it may be a long day in our office. You may eat the night before and the morning of the surgery. We do not ask any of our patients to stop their blood thinners or aspirin prior to surgery.
What Will My Day Be Like?
On the day of your Mohs surgery, we recommend that you have someone drive you to our office. You will be taken back to our procedure room, the cancer site will be identified, you will sign the informed consent for the surgery, and we will begin.
We start by outlining the tissue to be removed. We will then clean the area with isopropyl alcohol, and then begin to inject anesthetic into the area. We will then re-cleanse the area and cover/prep the uninvolved areas. The first incision will be made, tissue removed, and the bleeding stopped. The tissue will be sent to an onsite lab where it will be prepared onto slides for examination. A pressure dressing will be applied and you will be asked to wait in the waiting room while your tissue is processed.
What Should I Do While I’m Waiting?
Each waiting period between stages can be 30-60 minutes. We advise patients and their companions to bring reading materials (newspapers, magazines), iPads, work, or other possible ways to pass time and keep busy. You may also eat during this waiting period, so you can either bring food to eat or even leave the office for a short time to grab coffee or food.
Will My Surgery Site Be Closed Up The Same Day?
As some cancers can spread far and wide under the skin, we don’t know how much skin we will have to remove in order to fully remove the tumor. Surgery sites can be wide or deep, or both, and may necessitate remove of ear or nose cartilage if the tumor is longstanding or aggressive. We will make every effort to close the surgery site the same day, but some tumors will require a referral to a plastic surgeon. Sometimes we can predict which tumors have a high likelihood of needing a plastic surgery closure, and will have an authorization or appointment with a plastic surgery already set up for you prior to your surgery day. Other times, we may have to arrange a plastic surgery appointment for you the day of your surgery. In all cases, our staff will work to make sure that you have a clear direction on what to do after your tumor has been removed.
What Do I Have To Do After Surgery?
You will be provided with post-op surgery and wound care instructions on the day of your surgery. Click here for online instructions. As always, we are happy to answer any questions you have before, during, and after your surgery.
Still have questions about your Mohs surgery day? Call us at 310.205.3555 or 818.914.7546, email us, or click on the chat box on the right lower edge of your screen. We’d be happy to help!