Mohs Surgery

What is Micrographic Surgery?

Micrographic surgery is a very specialized way of treating skin cancers. It provides the highest
possible cure rate while removing as little normal skin as possible. Micrographic surgery is also
called Mohs surgery in honor of Dr. Frederic Mohs who developed the technique.

The procedure begins by thoroughly numbing the area with a local anesthetic. Then all visible
cancer is removed and a very thin layer of surrounding skin is taken to check for any remaining
cancer cells that are otherwise invisible to the naked eye. This layer is processed by a technician
and examined under the microscope by the micrographic surgeon. The location of any remaining
cancer is carefully mapped on a diagram of the surgical wound and then removed in a thin layer.
This tissue is also examined under the microscope and the process is repeated as often as
necessary until all the cancer cells have been completely removed.

By using these detailed mapping techniques and complete microscopic margin control, the micrographic surgeon is able to locate and remove even the smallest microscopic cancer roots
without sacrificing large and unnecessary amounts of normal, uninvolved skin. By minimizing the amount of normal skin that is removed, the best cosmetic result is achieved after the wound is
repaired.

What are my chances for cure?

Micrographic surgery offers the highest available cure rate of all skin cancer treatments. 99% of
skin cancers are cured if Mohs is performed as an initial treatment. Over 96% of skin cancers are
cured following micrographic surgery even if other forms of treatment have failed. Other methods of treatment average only a 60% cure rate if previous treatments have failed.

Will I be hospitalized?

No. Micrographic surgery is performed in an outpatient surgical suite and you will return home the
same day.

What happens the day of the surgery?

Your appointment will be scheduled early in the morning or just after noon. Our staff will escort you
into a surgical suite where the area around the skin cancer will be numbed. Once it is numb, the
visible cancer and a thin layer of tissue will be removed. This tissue is carefully mapped and coded
by the surgeon and taken to the adjoining laboratory where the technician processes the tissue and prepares microscope slides. You will have a temporary dressing placed over the wound during the
period of waiting.

The surgical procedure takes only 10-15 minutes. However, it takes a minimum of 1-2 hours in the laboratory to process and examine the tissue. If remaining cancer is found you will be brought back to the surgical suite and a additional thin layer will be taken from that area. This will also be taken to the laboratory for processing while you wait. Although there is no way to tell before surgery how many stages will be needed, most cancers are removed in three stages or less.

The hardest part of the procedure is waiting for the results from the laboratory. 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. Magazines, snacks and beverages will be available near the waiting
room area. Personal DVD players and a selection of movies are available for viewing while waiting. Please feel free to bring a DVD of your choice if desired. If your visit extends through the lunch hour, your companion may visit a nearby restaurant and bring you a snack or lunch since you are asked
not to leave the waiting area until all surgical procedures are completed.

Since we do not know in advance how much time will be needed to remove the cancer and repair the wound, we ask that you make no other commitments for the entire day that you are scheduled for surgery.

Will the surgery leave a scar?

Yes. Any form of skin cancer treatment will leave a scar. However, because micrographic surgery removes as little normal tissue as possible, scarring is minimized. After the cancer is removed we
may choose to (1) let the wound heal by 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.

Will I have pain after surgery?

Most patients do not complain of significant pain. If there is any discomfort, Tylenol is usually
adequate for relief. Avoid taking medications that contain aspirin as they may cause bleeding.

Preparing For Surgery

Medical History: A day or two before your appointment, please complete the attached medical
history form and bring it with you the day of surgery.

Medications: Continue any medications prescribed by your doctor. Aspirin however is a drug that
may prolong bleeding. We ask that you avoid aspirin (including Anacin, Bufferin, Excedrin,
Alka Seltzer and Percodan) for at least 10 days prior to surgery. Also avoid Vitamin E and Non
steroidal anti-inflammatory drugs (ibuprofen,Motrin, Advil Celebrex, Aleve, Bextra, etc.) for five days.
If your doctor has prescribed any of these medications for you, please contact his/her office to be
sure it is safe for you to stop taking them in preparation for surgery. You may take Tylenol any time before surgery, if needed for pain. Click here for a list of precationary medications.

If you are taking blood thinners (Coumadin), please notify our office before your scheduled
surgery. In addition, alcohol will also increase bleeding, so avoid alcoholic beverages for at
least 24 hours before surgery, as well as 48 hours after surgery.

Cosmetics: Do not wear any cosmetics on the surgical area on the day of surgery.

Transportation: Only local anesthesia will be used during the procedure. Most patients are able
to drive themselves to and from the surgery with little difficulty.

Eating: The day of surgery, we suggest that you eat a normal meal just prior to your scheduled appointment.

Arrival: Please plan to arrive fifteen minutes early so that we may complete your medical record and obtain necessary insurance information.

Questions: If you have any additional questions, please call us at (602) 954-7546.

Insurance Information: Micrographic surgery is covered by all major insurance carriers. We also accept assignment on Medicare. This means that we agree to accept their approved fee as payment, however please remember that Medicare only pays 80% of their approved fee; you or your secondary insurance carrier is responsible for the remaining 20%.

We will submit a claim to your insurance company for you. Please bring any necessary insurance information (including the mailing address of your insurance company) with you to your visit. You will also be responsible for any deductibles or co-payments required by your insurance.

Please contact your insurance company before surgery if prior authorization is required.

For More information on Mohs Surgery go to the American Society of Mohs Surgery.

 

Health Care Participation: