Mohs surgery is a special technique used to treat skin cancers. Typically, it is performed for skin cancers of the head, neck, hands and lower legs, but is sometimes used in other locations under special circumstances. The technique has the highest cure rate for skin cancers and has the added advantage of removing the smallest amount of normal tissue compared to traditional excision.
The surgeon will mark the visible portion of the remaining tumor. Like the initial biopsy, local anesthesia will be used to numb the area before any incisions are made. Once the area is anesthetized, the marked tissue is removed. This tissue is processed, and the edges of the tissue will be examined for any cancerous cells. This processing and evaluation of tissue usually takes about an hour, but may take longer. During this time, the wound will be bandaged and you will be in the waiting room. If there are any remaining cancer cells seen at the edges, the surgeon will come back to take another layer of tissue just in the area that cancer cells were seen. The process is repeated until no more cancer cells are seen.
Once the cancer has been fully removed, there will be a wound that usually needs to be repaired with stitches. In most cases, the wound is repaired immediately by the Mohs surgeon. However, in some cases, you will be referred to a plastic surgeon for the repair of the wound.
Preparing for your Mohs surgery:
Your appointment will most likely take between 2 and 4 hours, but depending on how many layers are required it may last much longer than that. It is a good idea to bring a snack and drink, as well as a form of entertainment (books, magazines or iPad) to keep you occupied in the waiting room in between stages. Please do not schedule any other appointments or engagements (except with a plastic surgeon if they will be performing the repair) on the day of your procedure.
As you will most likely have stitches that need to be removed in 5-14 days, please do not plan any trips for several weeks after the procedure. You should also plan to avoid any strenuous activity for 2 weeks after the procedure.
You may eat and drink normally the morning before your procedure.
Take all medications prescribed by physicians as you normally would.
If you are taking any blood thinners (Aspirin, Plavix, Coumadin, Eliquis, Xarelto), please consult with the prescribing physician to see if you can safely stop them for any duration of time. If you are not able to safely stop them, the procedure can still be performed. If you are taking Coumadin (Warfarin), please have your INR checked several days prior to surgery.
Please stop fish oil, Vitamin E, and other over the counter blood thinners for several days before and after your procedure. Do not drink any alcohol for 24 hours before and after the procedure.
If you require pre-operative antibiotics (if you take medication before dental procedures or have recent artificial joints or heart valves), please take them 30-60 minutes prior to your procedure..
The waiting room fills up quickly, so please limit moral support to one person if possible.
The schedule of a Mohs day is inherently unpredictable, and we may call to let you know that we are running behind or ahead of schedule and may ask you to come in earlier or later than your scheduled appointment. We appreciate your flexibility.
If you have any questions prior to your surgery, please call 732-280-1200 and ask to speak with the surgical coordinator.