MOHS Surgery

What is Mohs Surgery?

Mohs surgery is a highly specialized treatment for the complete removal of skin cancer. Mohs surgery is named in honor of Dr. Frederic Mohs, the physician who developed the technique. This treatment differs from other methods of treating skin cancers by the use of microscopic examination of all the tissues surgically removed as well as detailed mapping techniques that allow the surgeon to only remove the areas of skin involved with cancer. The combination gives the surgeon the highest chance of removing every cancer cell and provides a 99% cure rate.  Other methods only offer a 50% chance of success.

Preparing for surgery

On the morning of surgery, wear comfortable clothing, avoid pullover clothing. You may want to bring a sweater for your comfort as the temperature in the office is often cool. If the site to be treated is on your face or neck, please do not wear make-up, perfume or jewelry. We recommend you eat breakfast. You are welcome to bring a companion with you to keep you company and to drive you home. Be prompt; please plan to arrive 20 minutes early.

The day of your surgery, take your normal medications prescribed by your other doctors. However, if you take aspirin or any other blood thinner, please consult your prescribing physician for permission to discontinue them prior to your surgery. Vitamins and supplements contain ingredients that lead to excess bleeding,  we suggest discontinuing all vitamins and supplements 10 days prior to surgery and for 2 days after. You should also avoid alcoholic beverages for 24 hours before surgery, as alcohol increases bleeding.

What happens the day of surgery?

Your appointment will be scheduled early in the day. Our staff will escort you into the surgery room where the surgeon will numb the area around the skin cancer. Once numb, the visible cancer and a layer of surrounding tissue will be removed. This tissue is carefully mapped and color coded by the surgeon and taken to the adjacent laboratory where the technician will immediately process the slides. You will have a temporary dressing placed over the wound and you will return to the waiting room until the tissue is processed.

The surgical procedure alone takes 10-20 minutes. However, it takes a minimum of 1-2 hours to prepare and microscopically examine the tissue. Several surgical stages and microscope examinations may be required, and you will be asked to wait in the waiting area between stages. Although there is no way to tell before the surgery how many stages will be necessary, most cancers are removed in 3 stages or less.

We want to be sure that the time you spend with us is as pleasant and as comfortable as possible. You are encouraged to bring reading material to occupy your time and numerous magazines and newspapers will be available in the waiting room. In the waiting room there will be coffee, water, soda and snacks available for your enjoyment. If your visit extends through the lunch hour, your companion may leave to bring you lunch.

For most patients the most difficult part of the day with us is the uncertainty about when their day will be over. This is unfortunately impossible to predict ahead of time, which is why we ask that you plan to be in the office the entire day.

After your surgery

Will I have pain afterwards?

Most patients do not have severe pain following surgery. You should expect mild to moderate discomfort over the first 12-24 hours. Tylenol is often all that is necessary for relief, a prescription for a stronger pain medication will be given if necessary.

Will the surgery leave a scar?

Yes. Any form of surgical treatment will leave a scar. However, Mohs surgery removes as little normal tissue as possible, scarring in minimized. It is Dr. Gill’s goal to achieve the best cosmetic result using the safest methods.

What should I do after surgery?

To aide in achieving the best possible outcome, follow our wound care directions. Should you have any additional questions or problems, you are encouraged to contact our office.

Will I need to come back?

Usually one or two follow up visits are needed to examine the healed surgical site or to remove stitches; and it will vary depending on the type of closure preformed.  We usually ask you to return to the office in 6-8 weeks after surgery to check to see how the site is healing. Afterwards, you may return to your referring physician for routine follow-ups.

Will my insurance cover the procedure?

We will submit a claim to your insurance company for you. Expenses not covered include insurance deductibles, co-insurance and co-pay amounts. Please remember that your insurance is a contract between you and your insurance company, and some plans may have limited benefits. Please check with your insurance company to see if pre-authorization is required.

We would not want anyone to be denied necessary care because of an inability to pay. If you have difficulties paying your bill, we encourage you to discuss your situation with the billing office staff.