How to Prepare and What to Expect When Undergoing Mohs Surgery

Skin cancer is the most common form of cancer, and its incidence is rising. About 20% of people in the United States are likely to develop skin cancer during their lives. If you’re in that group, you want to learn about effective treatments. 

Our board-certified dermatologists with Vivida Dermatology are fellowship-trained to perform Mohs micrographic surgery, the most precise, minimally invasive surgery for skin cancer. Our team has the highest qualifications possible to treat your skin cancer. 

Skin cancer has high cure rates when detected and treated at early stages. Our dermatologists perform regular skin cancer screenings to detect and remove cancer before it spreads. 

What is Mohs surgery? 

Mohs surgery versus excision surgery for skin cancer could be compared to the difference between sewing with a machine and sewing by hand. There’s a significant difference in the degree of surgical precision between the two techniques. 

Standard excision for skin cancer removes a wide margin of skin to ensure all of your cancer is removed. Mohs surgery aims to preserve as much healthy skin around the margins of the affected areas as possible. This makes a difference in removing skin cancer in areas where your skin is delicate, such as your eyelids, nose, face, hands, neck, toes, and genitals. 

You can rest assured that Mohs surgery removes all your cancer cells, including lesions that may have spread out like tree roots. 

Mohs surgery is named after the surgeon who pioneered it in the 1930s, Fredric Mohs. The micrographic method of Mohs surgery eliminates skin cancer completely and precisely, while simultaneously preserving the maximum amount of healthy tissue. 

Preparing for Mohs surgery

Mohs surgery includes some necessary preparations before your procedure. These guidelines help ensure an optimal outcome:

Two weeks before surgery

Check with your primary care doctor to see if you need pre-op antibiotics. If you’ve had heart or joint replacement surgery, you’ll likely need them. 

If you have heart disease and take blood thinners, talk to your cardiologist. You may need to stop taking blood thinners prior to surgery. Your doctor lets you know how far in advance of your procedure you need to stop taking them, if at all. 

You’ll also need to stop taking aspirin, ibuprofen, and naproxen for up to two weeks before your procedure to lessen your risk of excessive bleeding. 

 If you smoke, you should stop using any form of tobacco for at least two weeks before and two weeks after your surgery; it retards wound healing. 

One week before surgery

If you take supplements such as vitamin E, vitamin C, fish oil, ginseng, ginkgo biloba, and garlic, you should stop taking them for at least a week before your procedure. The same goes for alcohol. Don’t drink alcoholic beverages for at least one week prior to the surgery. Both can elevate blood pressure and cause excessive bleeding. 

The morning of your surgery

Take a shower or bath and clean the area of the surgery with extra care. Your doctor may provide a special antibacterial cleanser. Don’t use moisturizer, makeup, or perfume on the surgical area. Wear loose-fitting, comfortable clothes. 

Eat breakfast and pack snacks and a book or electronic device. You’ll need something to occupy yourself while your doctor checks samples of your skin under a microscope. Take all prescribed medications. 

What happens during Mohs surgery 

Be prepared to spend several hours at our office during your procedure, although it may take less time than that. Your procedure may or may not entail several stages. 

We start by injecting an anesthetic to numb the treatment site so you won’t feel pain. The visible part of the cancerous lesion is removed first, along with a thin layer of surrounding tissue (marked for reference) which is carefully examined under a microscope for cancer cells.

In up to half of Mohs cases, we complete the surgery in one step, meaning the first layer of surrounding skin tissue is clear of cancer cells. If the tissue still shows signs of cancer, you’ll receive another anesthetic injection and another thin layer will be removed from any sections of skin that still contain cancer cells. 

Mohs surgery can take several hours because it can take up to one hour to analyze your skin sample properly under a high-powered microscope. We continue the removal and analysis process until we see no more cancer. 

Most cancers are completely removed in just 1-3 rounds of surgery. You may or may not have stitches, depending on the extent of your surgery. 

If you need surgery for skin cancer, call our office or schedule an appointment online today. For your convenience, we have offices in Las Vegas and Henderson, Nevada, and St. George, Utah.