Mohs surgery is a specialized form of skin cancer surgery. There are two main benefits of Mohs surgery. First, it allows the highest cure rate out of any type of skin cancer treatment because 100% of the surgical margins are evaluated. Second, it spares the amount of normal skin that has to be removed. This is important in cosmetically sensitive areas such as the head, neck, hands, feet, genitalia, etc.
The entire procedure is performed under local anesthesia. Once the tissue is anesthetized, a layer of tissue is removed with the goal of getting around and below the tumor. A bandage is placed while you wait in the office for the tissue to be processed. The tissue is examined under a microscope in our office laboratory. The orientation of the specimen based on its location on your body is maintained throughout the process so that if any tumor remains, only that section will be removed next. The process is repeated until there is no more remaining tumor.
As a Fellowship-Trained Mohs Surgeon, Dr. Blechman completed the highest level of training to perform this procedure and treat skin cancer. This training prepared Dr. Blechman on proper Mohs surgery technique including accurate interpretation of tumor cells when viewing slides under the microscope. It also included training on complex facial repairs such as flaps and grafts.
Dr. Blechman recommends that all patients meet with him first for a consultation visit to discuss the procedure thoroughly and answer any questions.
We will also:
- Review the pathology report and discuss the type of tumor.
- Identify and confirm the tumor site.
- Review medications, medical history, allergies, and surgical risk.
- Discuss the procedure and aftercare in more detail.
- Review expectations for the day of the surgery including possible repair options, wound care instructions and post-operative activity restrictions.
- Based on the patient’s risk factors, the decision will be made to either continue or stop blood-thinners.
- Cessation of alcohol 3 days prior and 3 days after the date of the surgery will minimize bleeding risks.
- Reduction or cessation of smoking will help with healing of the wound.
DAY OF PROCEDURE
- Eat and drink your breakfast as normal, you will be awake throughout the entire procedure.
- Prepare yourself to be at the office until 1 pm (most of the time is waiting).
- Take the entire day off from work and go straight home to rest after finished.
- Bring a book to read or an iPad/Kindle to keep you occupied while you wait.
- It is not required but recommended that somebody accompany you and drive you to and from your appointment.
- Men should shave carefully around the tumor.
- Do not wear makeup or jewelry.
- Wear comfortable, loose and layered clothing.
- Bring snacks and something to drink while you’re waiting.
We will make every effort to make your day as efficient as possible. Though, please be patient as some aspects of the process can be unpredictable. This is another reason we recommend you do not make any plans following the surgery and go directly home to rest.
AFTER THE PROCEDURE
- You will be provided with verbal and written wound care instructions.
- For the first night following the surgery, you will have a large pressure bandage in place. This will stay on for 24 hours and should not get wet.
- After 24 hours you will remove the pressure bandage, and begin daily dressing changes.
- You will be given necessary bandage supplies.
- Please refrain from heavy lifting (> 10 pounds) and strenuous activity for at least 3 weeks following the date of your surgery.
- You will return for suture removal 1 or 2 weeks after the surgery, based on the tumor site.
- For any questions/concerns, please contact our office at 908-237-4124 during office hours or for emergencies outside of office hours, please contact 908-237-5542.
Below are additional resources on Mohs Surgery:
Adam B. Blechman, MDDermatologist
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