On your surgery day, we ask that you do not make any other appointments. Due to the detailed nature of the procedure, Mohs can take up the better part of the day. On occasion, you may need to return the next day. You are to eat your normal meals and take all of your normal medications. You do not need to fast or to discontinue the use of blood thinners unless the doctor instructs otherwise.
In the office, the surgical site will be inspected once again. The skin cancer area will be re-identified, photographed, and anesthetized with local anesthetic. First, the cancer obvious to the naked eye is removed along with a thin layer of skin from around the site. The tissue specimen is then immediately processed in our on-site Mohs laboratory. Patients are bandaged and permitted to relax in our private, comfortable MOHS lounge during this process.
The doctor will microscopically examine the specimen to identify and map any persistent cancer. Patients with persistent cancer have the procedure repeated, as required, and another layer is excised until the cancer is completely removed. The area where the cancer was removed is then repaired using the doctor's unique techniques developed to give the best cosmetic and functional outcome. Every effort is made to keep our patients comfortable, so repairs will either be on the same day or early the following day. In some cases, the patient is referred to a plastic surgeon for final wound repair. In each case, the doctor will advise the patient on the best option.
Points to remember:
Keep in mind there will be restrictions on activities for 7-14 days. Once your surgery is completed, we will review the care required for your surgery site and you will be given a set of written instructions on wound care from the doctor. As a convenience to our patients, we have specially prepared wound care kits available for purchase. You can expect to return to the office within 7-14 days for a suture removal or a wound check. This appointment will be scheduled before you leave our office.
As I have said so many times over the years, WHY? Why do I get every freaking medical thing under the sun? It has been quite enough already, thank you very much...
PS The test they did the first visit was just to confirm cancer cells, a scraping. The nurse was sure it was just a Basal cancer at the time. I thought it was a done deal, that that was the diagnosis. But one look from the actual doctor changed that very quickly! I guess there is a difference between a doctor and a nurse after all, even though i think nurses often knows more than doctors...