If your referring physician has performed a biopsy prior to the consultation, we will have received this prior to your consultation, stating the type of skin cancer that you have. If this information has not been obtained, we will perform a biopsy during the preoperative visit. The biopsy is important because it will tell us what type of cancer you have which is critical in planning the treatment. The date and time of your surgery will also be scheduled during your consultation. How Should I Prepare For Surgery? Eat your usual breakfast. If you usually skip breakfast, please have a morning snack on the day of surgery. Take all of your regular medications unless directed by your surgeon or your regular physician. If you take any medicine containing aspirin, ibuprofen, pain medications, anti-inflammatory medications, arthritis medications or blood thinners please discuss this with our office. Please inform your surgeon if you have a pacemaker, defibrillator or if you take antibiotics before dental procedures. Wear comfortable loose clothing that you can get in and out of easily. Avoid pull over clothing. If necessary, we may give you a hospital gown to wear during the surgery. You may also want to bring a sweater in case you are cool. Please leave the whole day available for surgery. Surgery time can be anywhere from four to eight hours. This includes the time that is necessary for our laboratory to process your tissue and will allow you enough time to recover from the procedure. On the day of surgery, we encourage you to bring a friend or relative with you who can safely return you home and keep you company between each stage of the procedure. How Is The Surgery Performed? Mohs micrographic surgery is performed in a procedure room under sterile conditions with local anesthesia. Once anesthesia is complete, the visible portion of the tumor is removed by excision or scraping with a sharp instrument called a curette. Following the removal of most of the tumor, a thin layer, encompassing the complete undersurface of the tumor is excised. That layer is then cut into small pieces and a map is drawn toidentify the location of each piece. The edges of the piece are marked with dyes to aid in the orientation on our map. Each piece is then frozen and these slices are cut, stainedand examined under the microscope. Any areas in which the tumor is found are marked on the map. Regions with remaining tumor tissue are then re-excised. This procedure is repeated until no more tumor is found and the cancer is entirely removed. After each layer of tissue is obtained, oozing or bleeding vessels are cauterized or ligated with suture. A pressure dressing is applied. You may rest in the waiting area with your relative or friend. How Long Does It Take? It takes 30 minutes to remove each layer of tissue and one or two hours to process and examine it. Most tumors require the removal of two to three layers. Extensive tumors may need more surgery and may require a second visit, but this is a rare occurrence. PREVIOUS NEXT