What is Mohs Surgery?
Mohs micrographic surgery is a specialized, highly effective technique for the removal of skin cancer. Your physician serves as surgeon, pathologist, and reconstructive surgeon. The technique relies on the precision and accuracy of a microscope to trace and ensure complete removal of skin cancer. The procedure was developed in the 1930’s by Dr. Frederic Mohs. The procedure has been modified and refined over the years. Mohs surgery differs from other skin cancer treatments in that it permits the immediate and complete microscopic examination of the removed cancerous tissue, so that all the “roots” and extensions of the cancer can be eliminated.
When is Mohs the best treatment option for my skin cancer?
Mohs surgery is selected as the best treatment method based on several factors including but not limited to: Recurring tumor, tumor in a difficult-to-treat body location, size of the tumor, and how aggressive the tumor is based on the initial biopsy report.
What are the advantages of Mohs surgery?
There are two primary advantages to Mohs surgery. First, by using microscopic examination of the tissue as a guide, the Mohs surgeon is better able to remove all of the skin cancer. Second, by carefully mapping out the tumor, the surgeon removes cancerous tissue and leave as much normal skin as possible.
Will I have stitches following Mohs surgery?
There are three main ways your surgical wound may be handled:
- Direct closure of the wound—In most cases, surgical wounds are sutured (sewn) closed with stitches.
- Skin graft—In some instanced, it is necessary to remove skin from a separate location on the body and graft it over the surgical wound.
- Second intention healing—The body has an excellent capacity to heal open wounds. Based on the body location of the surgery, second intention healing may be the best choice. This healing period may take several weeks depending on the size of the wound. It requires regular wound care by the patient or their caregiver.
In addition to wound size and location, the surgeon considers other factors to determine how your wound will be handled. This will be fully discussed with you on the day of surgery. Sometimes, for more extensive repairs, we will ask that you return the following day for the repair of your surgery site.
Will I have a scar?
YES! All surgical procedures will leave some degree of visible scarring. The appearance of post-Mohs surgical scarring will depend on several factors, including size and location of the final defect, individual skin characteristics, and the reconstruction options available.
Will I be put to sleep for Mohs surgery?
NO. The surgery is well tolerated with local anesthesia. Because the surgery may be time-consuming, the risk of prolonged general anesthesia is avoided.
How long will my Mohs surgery last?
Most Mohs cases can be completed in three stages or fewer, lasting half a day or longer. However, it is not possible to predict how extensive a cancer will be, as the extent of a skin cancer’s “roots” cannot be estimated in advance. Most of the time is spent waiting for tissue to be processed. It is advisable to reserve the entire day for the surgery. Also, bring reading materials, an iPad, snacks, or lunch with you on the day of surgery.
Should I bring someone with me?
It is not required that you have a driver for this procedure, but it would be advisable if there is a chance you may not feel up to driving after your surgery or if you will need help caring for you wound so we can give that person wound care instructions the day of surgery.
Should I eat breakfast before Mohs surgery?
Should I quit smoking before and after surgery?
YES! is highly recommended to stop or significantly decrease the amount of smoking for 2 weeks prior to and 2 weeks after surgery, as smoking significantly affects the ability of the skin to heal and increases risk of infection after surgery.
Should I avoid medications on the morning of Mohs surgery?
NO. Take your regular medications as they have been prescribed. Our surgical team will review all of your medications before your procedure. If we require any medications to be stopped (this includes blood thinning medications), we will let you know before your surgery date.
Do I need to take antibiotics before Mohs surgery?
If you have ever taken antibiotics prior to dental or other surgical procedures or have history of rheumatic fever, heart murmur, artificial heart valve or artificial joints, we may prescribe an antibiotic for you prior to Mohs surgery. We will go over this information with you during your scheduling process. Please let us know at that time whether you require antibiotics before your procedure.
Will my activity be limited after Mohs surgery?
YES! Your activity will be restricted. Depending on the location and extent of your surgery you will be given restrictions the day of your surgery. Avoid any long trips within the first ten days following surgery, in the rare case that you develop any complications.
Are there any potential complications of Mohs surgery?
Bleeding and infection are the two uncommon yet possible main complications, however, patients should understand that there is not an absolute guarantee that any given procedure will be totally free of complications or adverse reactions. The surgical area may remain tender for several weeks or months after surgery, especially if large amounts of tissue was removed.
Will my insurance cover the cost of Mohs surgery?
Mohs surgery is covered by most insurance plans, including Medicare. The amount that will be paid by insurance is subject to your plan’s deductible and co-insurance terms. Our billing department will contact your insurance company to verify you benefits. Once this has been completed, we will contact you with this information. If you are in doubt about your particular coverage, it would be advisable to check with your insurance company prior your appointment.