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Moh’s Surgery
Clear, evidence-based information on the conditions we treat — written and curated by our clinical team.
Moh’s Instructions
A Word About Medications
Please take all your normal medications the morning of your surgery.
1) Blood Thinners: Most people should stop all aspirins, aspirin-containing medications (Alka-Seltzer, Anacin, Ecotrin, etc), and non-steroidal anti-inflammatory medications (Motrin, Naproxen, Advil, Midol, Aleve, etc.) for 7 days prior to your scheduled surgery.
If you take aspirin because you have had a stroke, heart attack, heart disease, other condition, or your physician has prescribed you to take it, please continue your aspirin.
Ask your doctor if prior to surgery you should stop your prescribed blood thinners, such as Coumadin/Warfarin, Plavix, or Aggrenox. Never stop them without your doctors permission or knowledge. If you have had a stroke, heart attack, or have an irregular heartbeat, your doctor may want you to continue your medication. We can still do your surgery.
2) Antibiotics: If you usually require antibiotics prior to dental work, please let us know prior to your surgery. Medical conditions that sometimes require preoperative antibiotics include artificial heart valves and heart murmurs.
3) Vitamins and Supplements: Avoid taking any supplements with Vitamin E, Fish Oil, Gingko, Ginseng, and Garlic for 2 weeks before and 2 days after your surgery.
4) Alcohol: Avoid drinking alcohol for 2 days prior to your surgery, and for 2 days afterwards (it thins the blood and causes more bruising and swelling).
Additional Points
- Eat before you come (unless you are instructed otherwise by another surgeon who will be seeing you later in the day) and bring a snack. Try not to overdo it with caffeine the morning of (whereas this makes some people anxious and need to the bathroom more frequently).
- Bring a friend to keep you company and drive you home. They are not permitted to wait in the exam room during the surgery itself, for safety reasons, but are welcome to sit in our waiting room.
- Be prepared for a delay if your surgery start time is after 10 AM. We strive to stay on time, however the start and stop time can be unpredictable for the Moh’s procedure.
- Bring your insurance card and ID, as well as any needed referrals (if your insurance requires it).
- Wear comfortable clothes- not something you need to dry clean. If the cancer is on your trunk, please wear only button up shirts.
- If you would like a low dose of anti- anxiety medication (and have a driver), please let us know and we will prescribe this for you.
- Expect to have a bulky gauze pressure dressing placed over your excision site. This should remain in place for 24 hours. You may take Tylenol for pain as needed.
- Avoid activities that may place a strain on your incision until your return visit (usually 7 days). This is to help prevent bleeeding, pulling of sutures, and minimize scarring.
- Expect to have a white tape over your excision. This will be covered with a bulky gauze dressing. The white tape flat to your skin is to be left on your skin until you return for suture removal. If it falls off prior to your suture removal date- please notify us.
FAQ
Questions Frequently Asked by Patients
If you have any type of suspicious skin lesion you should seek evaluation by a dermatologist. If skin cancer is suspected, he or she may recommend and perform a biopsy. Mohs surgery may be recommended based on the type and location of the skin cancer, as well as other factors. We strictly adhere to the American Academy of Dermatology’s Appropriate Use Guidelines to determine if and when Moh’s is needed.
Because it involves a special multi-step process, Mohs surgery is typically slightly more expensive than other skin cancer treatments. It is important, however, to consider the advantages of the Mohs technique (healthy tissue sparing capabilities, lower recurrence rate, etc.) in examining the total cost.
Mohs surgery is covered by most insurance plans, including Medicare. Please enlist the aid of your employee benefits administrator or health insurance company to determine estimated out-of-pocket expenses.
All surgical procedures have the potential for some degree of visible scarring. The appearance of a post-Mohs surgical scar will depend on several factors, including size and location of the final defect, individual skin characteristics, and the reconstruction options available. You should keep in mind, however, that the tissue-sparing nature of the Mohs technique may result in a smaller, less noticeable scar than other skin cancer removal methods. We are often able to incorporate suture lines into the patient’s natural skin lines and folds. Most scars improve in appearance naturally over time, and future scar revision techniques may employed if necessary.
All procedures are performed under local anesthesia in the comfort of our office suite.
The duration includes waiting after removal to confirm the margins are clear of residual skin cancer, hence be prepared to stay up to 3 hours, depending on the size/ difficulty of the tumor.
Typically, most cancers removed need one or two layers. Sometimes, cancers require more than this, depending on the unpredictable shape and location of the tumor.
Yes. We recommend that you bring someone to drive you.
Usually no. Unless the cancer is located on the nose or around the mouth, we typically do not use antibiotics.
Yes, stop only multivitamins, NSAID (like Motrin, Advil) and Asprin (unless your physician has suggested you take this) 2 weeks prior to the procedure. If you are on a blood thinner, such as Plavix or Coumadin, consult with our Surgical Coordinator and see our “Pre Op Handout”.