Your Surgery Visit

What to expect for the day of your consultation and Surgery.

You will be scheduled for a consultation with the Mohs Surgeon on the day of surgery. We ask that you complete a brief form about your past medical history. The consultation is to ensure you understand why you have been referred for the procedure, what your treatments options are, and what to expect after surgery. The consultation also helps make sure you are medically prepared for the procedure.

Checklist for consultation:

  • Bring any photographs or drawings that you have or may have been given to you by your referring physician that will assist us in locating the tumor site. Be sure you know where the biopsy was taken.
  • It is often helpful to have a friend accompany you to the consultation who may help you with questions, remembering instructions, and locating the tumor site.

Mohs Surgery

Unless told to do otherwise, you should eat your regular breakfast and take all of your medications as usual on the day of surgery. You will be checked in by a nurse who will confirm that you have followed any pre-operative instructions that may have been specified at the time of consultation.

At this time, the doctors will clean the surgical field with an antiseptic and inject you with local numbing medicine. You will not be put to sleep. Once the surgical area is numb, the skin cancer will be removed and sent to the lab to make into a microscope slide.

The process of creating and reviewing the microscope slide may take 30-45 minutes. We recommend you have a book, magazine, or friend to keep you company during this time. If there is some cancer left based on the microscopic exam, the surgical field will again be cleaned and numbed so additional tissue may be removed. This process of removing tissue is repeated until the entire tumor has been completely removed based on microscopic examination.

While most patients have their skin cancers removed in two or three rounds, it is impossible to know exactly how many rounds it will take for your skin cancer. Similarly, it is impossible to know exactly how big your wound will be until all edges have been reviewed under the microscope.

Once the skin cancer has been removed, the wound is repaired. The repair may be performed by suturing the wound closed directly, rearranging skin from adjacent areas (flap), grafting skin removed from another site (such as behind the ear or shoulder), or allowing it to heal by second intention without suturing. The wound size and location determine the type of repair performed and will be discussed fully with you at the time of surgery.

Preoperative Instructions & Check List

  • No alcohol five days prior to surgery
  • Eat a light breakfast before surgery
  • Eat a light lunch before surgery
  • We do not have accommodations for multiple family members, so please limit to two friends or family members.
  • You will be admitted in our operatory suite and your family member will have an opportunity to wait for you during the surgery in our waiting room.
  • We ask that you plan to be at our office for 3-4 hours. This does not mean that you will be in surgery the entire time. We process the tissue in the lab, which takes at least 30-45 minutes. At that time the tissue will be analyzed and if the margins show to be clear, the necessary means to repair the area will take place.
  • If the tissue shows roots of the cancer extending through the margin, a second portion of the tissue will be taken to be analyzed. This process takes place until all the margins are cleared. This method is performed to assure that all the cancer cells are removed so there is less chance of any recurrence.
  • Please cancel all activities for the day of surgery and possibly longer. You will receive postoperative instructions before you leave our office.
  • Be prepared to spend the night before your surgery if you are coming from out of town as well as the night of surgery if the surgery becomes more extensive.
  • You may want to bring a sweater to be worn in the waiting rooms because the temperature in our office is very cool, although it will not be allowed in the operating room.
  • Please do not apply any make up the day of surgery.
  • You will be required to remove your shirt and a gown furnished by the office will be worn to surgery. (Therefore, you may not want to wear one piece garments such as jumpsuits, etc.)
  • Report any changes in your health including fever to your doctor’s office.
  • Check your medications and bring a list of all medications you are taking. If you are unsure of your medication, please call our nursing staff.

Please review the Preoperative Instructions and Check List again prior to your arrival to our office. If you have any questions, please feel free to call our office for assistance. (If you are a new patient, a map to our office and hotel information should be included with your instructions.)
We wish you a pleasant visit and a speedy recovery.