What is Mohs Micrographic Surgery?
Mohs micrographic surgery is an outpatient, specialized surgical technique to remove skin cancer. The Mohs procedure involves surgically removing skin cancer and examining the tissue under a microscope until healthy, cancer-free tissue around the tumor is reached (clear margins).
What Is Unique About Mohs?
There are two primary advantages. First, by using the microscope to examine the tissue, the surgeon is better able to ensure that all cancer cells have been removed. In fact, this procedure has the highest cure rate of all skin cancer treatments. Second, because only cancerous tissue is removed.
What Types of Skin Cancer Are Treated by Mohs Micrographic Surgery?
Basal cell carcinoma and squamous cell carcinomas are the most common types of skin cancer treated by Mohs surgery. These tumors start at the uppermost portion of the skin and can spread along the skin and downward. Fortunately, these two cancers do not usually spread to other areas of the body.
What Happens the Day of Surgery?
After the tumor and surrounding skin have been completely numbed with local anesthesia, the visible portion of the tumor is surgically removed. The tissue is then taken to our laboratory and processed where the physician uses a microscope to see if any cancer cells remain. If no cancer cells are seen, the surgeon will repair the wound with stitches (or allow the wound to heal if stitches are not needed.) If any cancer cells have been left behind, the surgeon will go back and remove additional tissue. This process is repeated as many times as necessary to ensure complete removal of the tumor.
The length of the surgery depends on the extent of the skin cancer, but usually takes between 3 to 4 hours. Occasionally surgery takes longer, so we ask that you come prepared to spend the day. Much of the time will be spent waiting for the tissue to be processed in the lab. Bring reading material and whatever else will help keep you comfortable while you are with us. Wi-fi is available in the Sun City West location.
Will I Need Stitches?
Many, but not all wounds, require stitches for optimal healing. Our goal is to give you the best cosmetic and functional result possible. Some wounds require more complicated procedures such as “flaps” or “grafts” while others do best if left to heal on their own. Your doctor will recommend the best option following removal of the tumor. Sutures are usually removed in 1-2 weeks.
Will I Have A Scar?
Unfortunately, there is no such thing as “scarless” surgery. However, we are trained in facial and aesthetic reconstruction and our goal is to make your scar as undetectable as possible. The size of the scar often depends on the size of the tumor.
Do I Need A Driver?
Yes. Surgery anywhere on the face can often lead to temporary swelling around the eyes making it difficult to see. Additionally, a 24-hour pressure dressing will be placed over the surgical site, which can sometimes make it difficult for glasses to rest properly. Additionally, if you are nervous the day of surgery, a medication to help you relax can be provided, but only if you have a driver to take you home. Out of concern for your safety, we ask that you bring a driver with you or make arrangements for someone to pick you up.
Should I Take My Medications?
Yes. Continue all your prescribed medications unless we specifically tell you otherwise prior to surgery. In general, we do not recommend that you stop taking any blood thinners such as aspirin, Coumadin or Plavix. If there are special circumstances where these need to be stopped, we will notify you.
DO NOT DISCONTINUE BLOOD THINNERS UNLESS DIRECTED BY YOUR PHYSICIAN.
Can I Eat Before Surgery?
Yes. Unless specifically told otherwise, you may eat a normal meal prior to surgery. It is also a good idea to bring snacks as you may be in the office for several hours.
Are There Activity Restrictions After Surgery?
Yes. Physical activity, including sports and exercise, are often restricted following the surgery. If your job requires heavy lifting or physical exertion, you may need to plan to be off for a few days. Your doctor will give you specific instructions at the time of surgery.
Will I Have Pain After Surgery?
Mild to moderate pain is normal for a day or two following surgery. It generally responds to over the counter Extra Strength Tylenol (acetaminophen) and/or ice packs. Do not use Advil, Aleve, Aspirin, or Motrin in the first 12-24 hours after surgery as they can cause bleeding. If Tylenol is not sufficient to control pain, please contact the office or after-hours line provided.
Bring your insurance information.
Want to know more?: www.mohscollege.org