Day of Surgery

What happens the day of surgery?

Your appointment will be scheduled early in the day. Many patients with conditions as serious or more serious than yours will also be present on your surgery day. Each patient and each cancer removal are unpredictable and therefore you may not be brought back to the patient room right after check in. Delays occur and should be expected. That is the nature of surgery. Please be tolerant and aware of your fellow patients.

Our staff will escort you into the surgical suite at which time any additional questions can be addressed. We will numb the area around the skin cancer. Once the skin is numbed, the visible cancer and a thin layer of tissue will be removed by the surgeon. This tissue is carefully mapped and coded by the surgeon and taken to the adjacent laboratory where our technicians will immediately process the microscope slides. You will have a temporary dressing placed over the wound and you will be free to return to the reception area.

The FIRST surgical removal takes 10-15 minutes. However, it takes a minimum of 1 ½ to 2 hours to prepare, freeze, cut, stain, and microscopically examine the tissues of each layer. Several surgical stages and microscopic examinations may be required and you will be asked to wait in the patient reception area between stages.

Although there is no way to tell before surgery how many stages will be necessary, most cancers are removed in 3 stages or less.

IF YOUR CANCER HAS ROOTS, ADDITIONAL DEEPER PENETRATION, AN AGGRESSIVE GROWTH PATTERN OR ANY OTHER FEATURES OF GROWTH, YOU SHOULD ANTICIPATE THAT MULTIPLE SPECIMENS WILL BE REMOVED IN ORDER TO CURE YOUR CANCER AND THAT THE DURATION OF YOUR PROCEDURE COULD TAKE THE LENGTH OF THE DAY. IF THIS IS UNACCEPTABLE TO YOU FOR ANY REASON, PLEASE TALK TO YOUR REFERRING DERMATOLOGIST AND EXPLORE OTHER METHODS FOR REMOVING YOUR SKIN CANCER.

We would like to make the time you spend with us
as pleasant and comfortable as possible.

You may want to bring reading material to occupy your time while waiting for the microscope slides to be processed and examined. Wi-Fi is also available throughout the facility. You may want to bring a sweater, as the temperature in our office varies. Soft beverages and light snacks will be available in the reception area, free of charge. If your visit extends through the lunch hour, your companion may leave the office and bring you a snack or lunch from one of the local restaurants or eateries, since you are asked not to leave the reception area of our office.

The most difficult part of the procedure is waiting for the results from the laboratory. Since we do not know in advance how much time is necessary to remove the cancer and repair the wound, we ask that you plan to be in the office the entire day and that you make no other commitments. If you inform us on the day of surgery that you have other commitments, we will not be able to treat you on that day.

What complications may occur?

Complications after Mohs surgery are rare but may include a chance of bleeding or infection. For any complications or questions following surgery, please review the written instructions sheet we will provide to you on the day of surgery. You may also review our FAQ list on this website or review any of our wound care videos also present on this site. If questions remain, please call our office and ask to speak to a clinical staff member. Typically they will all be assisting patients during the day, therefore a message will be taken and our clinical staff will call you back. ALTHOUGH EXTREMELY UNLIKELY, IF YOU HAVE UNCONTROLLED AND CONSTANT BLEEDING PLEASE HEAD TO URGENT CARE OR THE EMERGENCY ROOM.

Will I be hospitalized?
No, Mohs surgery is performed in a pleasant out-patient surgical suite and you may return home the same day. Hospital facilities are available, if necessary.
Will the surgery leave a scar?

YES. Any form of treatment or trauma to the skin will leave a scar. However, because Mohs surgery allows us to target the cancer on a cellular level then the most minimal amount of tissue required to remove your cancer will be taken and scarring can be greatly reduced. Immediately after the cancer is removed, we may choose to 1) leave the wound to heal itself, 2) repair the wound with stitches, or 3) reconstruct the wound with a skin graft or flap. This decision is based on the safest method that will provide the best cosmetic result and will be discussed with you during your surgical visit.

Will I have pain after the surgery?
Most patients do not complain of pain. If there is any discomfort, Tylenol and ibuprofen is all that is usually necessary for relief. Opioid prescriptions are not written in our practice.
What to Expect When Having Mohs Surgery
ACMS Mohs Surgery Video