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What to Expect from Mohs Surgery

September 24, 2021

Doctor examining a face

If you are diagnosed with skin cancer, you want the most effective and advanced treatment offering the highest potential for cure. That optimal treatment option is Mohs micrographic surgery.

Developed by Frederic Mohs, M.D. in the 1930s and modified over the decades, Mohs surgery is a precise method of tumor removal. It strives to eliminate cancer – most commonly basal cell carcinoma or squamous cell carcinoma – in stages, one tissue layer at a time while visualizing the tumor with a microscope to trace and ensure it is completely removed down to its roots.

The objective of Mohs surgery is to accurately identify and remove all localized cancer cells while leaving healthy surrounding tissue unharmed. This minimizes the chance of regrowth and lessens the possibility of scarring or disfigurement. Its success rate is up to 99 percent for new skin cancers and 95 percent for recurrent skin cancers.

How to Prepare and What to Expect of Mohs Surgery

Before undergoing Mohs surgery, you don’t need to stop taking any of your prescribed medications unless your physician directs you to do so. However, you should avoid supplements, such as vitamin E, ginkgo, ginger, garlic, ginseng, and feverfew at least one week prior to surgery, as these can thin your blood and increase your risk of heavy bleeding. Also, you should refrain from alcohol three days before your procedure for the same reason. If you have a pacemaker or defibrillator, notify your doctor in advance of the surgery.

On the day of your surgery, you can eat your usual breakfast – since local anesthesia is used for the surgery and there is no need to fast. You should shower in the morning, cleaning the surgical site and surrounding area with antibacterial soap and water. However, do not wear makeup or apply any lotions or creams on or near the area to be treated. Wear comfortable clothing to your appointment, preferably a two-piece outfit.

Mohs surgery is an outpatient procedure that uses local anesthesia, which means you will be able to drive yourself home or go to work after the procedure. However, if the cancer is near your eyelid skin, you may prefer to have someone drive you home.

Once a local anesthetic is administered at the site, the doctor will begin removing the tumor with a surgical instrument in a thin layer of tissue with a small margin around the tumor site. Using a map or drawing of the tissue as a guide, the doctor will determine the precise location of any remaining cancer cells.

The tissue will be taken to a lab area, where it is sliced into extremely thin layers and mounted on microscope slides by a technician. The layers are then stained to help get a better view of the tissue, which is thoroughly examined for evidence of remaining cancer cells. If more are found, the doctor will return to the specific area of the tumor and proceed to remove another thin layer of tissue from the area where cancer cells remain for further microscopic analysis. This process is repeated, layer by layer, until the cancer is completely removed, at which point, you will be evaluated to determine the best option to help the affected area heal.

Mohs surgery takes anywhere from one to five hours to complete, depending on how many stages of complete tumor removal are necessary. There is a one to two-hour wait between stages while each layer is carefully examined for any remaining cancer cells. In the meantime, you can wait comfortably wearing a simple bandage, and read, listen to music, or have a snack or lunch.

MOHS Surgeon in Miami, Florida

When choosing a Mohs surgeon for your skin cancer treatment, you want someone with the best skills and training, such as T.J. Giuffrida, MD. Dr. Giuffrida is fellowship-trained in Mohs micrographic surgery and provides this service in his Miami dermatology office. Dr. Giuffrida is highly respected throughout South Florida. In fact, many of his patients are referrals from other doctors.

To learn more about Mohs Surgery and how it can help treat your skin cancer, schedule a private consultation with Dr. T.J. Giuffrida at Dermatology and Skin Cancer Center by calling (305) 461-2000 or use our convenient, online Request an Appointment form.

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Board-Certified Mohs Surgeon Dr. T.J. Giuffrida is the founder of  Dermatology and Skin Cancer Center. Dr. Giuffrida provides comprehensive skin cancer prevention, diagnosis, and treatments.