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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.
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Checklist for consultation:
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- Bring a list of all of your present medications
- 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.
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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.
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Checklist for consultation:
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- Bring a list of all of your present medications
- 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.
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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. There is a needle stick only. Once the surgical area is numb, the skin cancer will be cut out 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.
 Download Checklist 
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 would 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.
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. There is a needle stick only. Once the surgical area is numb, the skin cancer will be cut out 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.
Download Checklist
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 would 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.
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Surgery Expectations/Risks
The area surrounding the skin cancer will be anesthetized (numb) by a small local injection, usually similar to the one you received for your biopsy.
After the skin cancer has been completely removed, a decision is made on the best method for treating the wound created by the surgery. These methods include letting the wound heal by itself, closing the wound in a side-to-side fashion with stitches, closing the wound with a skin graft or flap, or smoothing down the edges of the area without any stitches. In most cases, the best method is determined on an individual basis after the final defect is known.
Your surgical wound will likely require care during the weeks following the surgery.
You should plan on wearing a bandage for 10-14 days. Please plan to avoid strenuous physical activity for 48 hours and in some cases one week.
You may experience a sensation of tightness across the area of your surgery. Skin cancers frequently involve small superficial nerves and months may pass before your skin sensation returns to normal. A numbness sensation may be expected over the area. This is common and usually expected but is something that with time will return to normal. In very rare instances, the numbness may be permanent.
Complete healing of the scar takes place over 3-12 months. Especially during the first few months the site may feel “thick, swollen or lumpy”, and there may be some redness. Gentle massage of the area (starting about one month after your surgery and excluding grafts) will speed the healing process.
The defect created by the removal of the skin cancer may be larger than anticipated. There is no way to predict prior to surgery the exact size of the final defect.
There will be a scar at the site of removal. We will make every effort to obtain optimal cosmetic results, but our primary goal is to remove the entire tumor. Again, Moh’s surgery will leave you with the smallest wound thus creating the best opportunity for optimal cosmetic results.
In some cases there may be poor wound healing. At times, despite our best efforts, for various reasons (such as bleeding, poor physical condition, smoking, diabetes, or other diseases), healing is slow or the wound may re-open. Flaps and grafts used to repair the defect may at times fail also.
Although these instances are not common, they are to be expected with the instances listed above. Under these circumstances, the wound will usually be left to heal on its own and in some cases after healing certain procedures may be done to improve the cosmetic appearance of the area.
Finally, while the Mohs technique offers the highest cure rates, no technique offers a 100% chance of a cure. There is a small chance, at least 1-2%, depending on tumor type and location that the skin cancer will recur. Previously treated tumors and large, longstanding tumors have the greatest chance of recurrence.
Surgery Expectations/Risks
The area surrounding the skin cancer will be anesthetized (numb) by a small local injection, usually similar to the one you received for your biopsy.
After the skin cancer has been completely removed, a decision is made on the best method for treating the wound created by the surgery. These methods include letting the wound heal by itself, closing the wound in a side-to-side fashion with stitches, closing the wound with a skin graft or flap, or smoothing down the edges of the area without any stitches. In most cases, the best method is determined on an individual basis after the final defect is known.
Your surgical wound will likely require care during the weeks following the surgery.
You should plan on wearing a bandage for 10-14 days. Please plan to avoid strenuous physical activity for 48 hours and in some cases one week.
You may experience a sensation of tightness across the area of your surgery. Skin cancers frequently involve small superficial nerves and months may pass before your skin sensation returns to normal. A numbness sensation may be expected over the area. This is common and usually expected but is something that with time will return to normal. In very rare instances, the numbness may be permanent.
Complete healing of the scar takes place over 3-12 months. Especially during the first few months the site may feel “thick, swollen or lumpy”, and there may be some redness. Gentle massage of the area (starting about one month after your surgery and excluding grafts) will speed the healing process.
The defect created by the removal of the skin cancer may be larger than anticipated. There is no way to predict prior to surgery the exact size of the final defect.
There will be a scar at the site of removal. We will make every effort to obtain optimal cosmetic results, but our primary goal is to remove the entire tumor. Again, Moh’s surgery will leave you with the smallest wound thus creating the best opportunity for optimal cosmetic results.
In some cases there may be poor wound healing. At times, despite our best efforts, for various reasons (such as bleeding, poor physical condition, smoking, diabetes, or other diseases), healing is slow or the wound may re-open. Flaps and grafts used to repair the defect may at times fail also.
Although these instances are not common, they are to be expected with the instances listed above. Under these circumstances, the wound will usually be left to heal on its own and in some cases after healing certain procedures may be done to improve the cosmetic appearance of the area.
Finally, while the Mohs technique offers the highest cure rates, no technique offers a 100% chance of a cure. There is a small chance, at least 1-2%, depending on tumor type and location that the skin cancer will recur. Previously treated tumors and large, longstanding tumors have the greatest chance of recurrence.
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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.
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