What to Expect During Your Mohs Surgery Appointment

We at Dermatologic Surgery of Central Virginia know that being diagnosed with a skin cancer and having it treated can be a stressful experience. With that in mind, we want to give you a good idea of what to expect during your Mohs surgery appointment. We want you to know that because of our almost 20 years of experience performing Mohs surgery on patients, we can provide you with the best care, the best information and a low stress experience. Here’s what you can expect from the Mohs surgery process.

Some tips to get you started on the day:

• Start with a good night’s sleep.
• If you’re taking physician prescribed medicines, take them (excluding any blood thinner we might have had you stop a few days earlier).
• Have a good breakfast and don’t forget to bring a snack, a book or a project to work on during the expected down time.

What to expect when starting the Mohs surgery procedure:

1. The morning you arrive for your Mohs surgery procedure, you will be brought back to the treatment room and prepared for surgery.

• Your blood pressure and heart rate will be taken
• A quick review of the procedure will be given.
• You will be asked to sign a consent form allowing us to do the procedure.
• The location of the cancer will be marked and the cancer will be numbed using local anesthetic.
• You will have the opportunity to ask any questions you may have.

2. Once the area is numb, the physician will remove a thin layer of tissue and the tissue is taken to the lab for processing. Expect that the actual “surgery session” will be only around 30 minutes. Each stage of tissue removal can take between an hour and an hour and a half to process and analyze. Most of your time will be spent waiting, not “in surgery.” During that time you can read, rest, and/or catch up on the news on our TV. Pay attention to the surgical area; if there’s any discomfort or bleeding, make sure to let the nurse know. This process is repeated until there is no longer any evidence of skin cancer in the tissue samples.

Usually, the Mohs surgery session takes between 2 to 6 hours.

What to expect after the Mohs surgery procedure.

1. Once the surgeon has cleared the cancer, you will be left with a surgical wound.

2. Generally, there will be a short session where that wound is reconstructed, depending on the size, depth and location of the wound. Depending on the circumstances, the Mohs surgeon will:

• Let the wound heal naturally
• Stitch the wound closed
• Use a skin graft
• Use a skin flap
• Refer you to a plastic surgeon

You may be required to return for secondary reconstruction or revision days, weeks or months later.

3. Once your surgery and repair is complete, a pressure dressing will be placed on the surgical site. You will be given information and literature to take home about keeping the surgical area clean until your follow-up appointment, which will be scheduled on your way out.

4. There are risks with any procedure and complications can sometimes occur after surgery. Studies have shown Mohs surgery minimizes risk and reduces complications since it is done under local anesthetic and is tissue sparing. If you develop any bleeding or pain let us know. Some minor bleeding, itchiness or redness that’s short-lived is normal. While we strive to make the Mohs surgery less invasive and we make sure that we do the best job to reconstruct the affected area, any surgery will create a scar. Caring for your wound by keeping it clean and following the wound care instructions will help significantly reduce the prominence of the scar.

5. After having skin cancer, your chances of developing another case of skin cancer is significantly higher. You should see your dermatologist regularly to check for development of new cancers as well as recurrence of those previously treated. We will give you information and advice on how to recognize skin cancer as well as minimize the chances of getting skin cancer again.

In the care of the professional staff here at Dermatologic Surgery of Central Virginia, you will be treated with respect, courtesy and the highest caliber of medicine. The Mohs surgical process is quick, simple, less invasive and has one of the highest success rates of any skin cancer removal treatment.