Mohs Surgery: How to Prepare

Preparing for Mohs surgery

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Mohs surgery is a surgical and microscopic procedure that is used to treat skin cancers. It can take several hours but can be done as an outpatient procedure. Learn how to prepare for this surgery.

Location

Mohs surgery is performed as an outpatient procedure. It is recommended that you find a surgeon specially trained in the Mohs procedure, so your choice of location may be limited by availability and preference of the surgeon.

Since this highly specialized procedure requires a quick turnaround of laboratory samples, this surgery is usually done in an outpatient surgery center or office setting with a procedural area and onsite lab.

Room requirements are not extensive—the surgeon only needs access to the surgical site. Large tools aren't required, either. You may want to ask about where you will be waiting as the lab processes your tissue sample, as this surgery can take the better part of a day, depending on how many layers deep your tumor extends.

What to Wear

What you wear to your surgery will depend mainly on the location of your tumor. Typically, Mohs surgery is performed on basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). These cancer types are most often found on areas with a lot of sun exposure, like the scalp, face, neck, and hands.

While Mohs surgery may be used to treat other types of cancers, these are the most common and do not require a full change of clothes. Your surgeon may allow you to wear your regular clothes and then use a sterile drape to isolate the surgical area.

If your tumor is located somewhere not easily accessed with your regular clothes on, you may be asked to change into a hospital gown. This may also be a matter of surgeon preference.

Food and Drink

Some outpatient procedures involve deep anesthesia, but for Mohs surgery, only local anesthesia is used. Since you won't be "put under" the effects of full anesthesia, it's not necessary to refrain from eating or drinking before your procedure.

Your surgeon may ask you to refrain from certain foods or drink within a short period of time. But often you will be encouraged to have breakfast before arriving for surgery.

The surgery can take place over several hours, with breaks for lab analysis. Snacks and drinks may be available, but you might be instructed to bring your own. Check for this, especially if you have dietary preferences or needs.

Medications

You may be asked to stop medications that could increase your risk of bleeding, like blood thinners, in the days before your surgery, but these medications are generally considered low risk for the Mohs procedure.

Discuss any medications or supplements you are taking with your doctor before the day of surgery. Many different medications and even herbal remedies can cause interactions during surgery, or with other medications your surgeon may use during the procedure.

What to Bring

As with any medical procedure, you should bring your identification and insurance information on the day of surgery. Your provider may also recommend making a payment on or before the day of the procedure, as well.

You will be able to wear the same clothes you wore to the surgery home again, so you don't need to bring any special clothing to change into. Unless you are concerned about your pain or fatigue after the procedure, you should not need someone to accompany you home since your surgeon will only be using a local anesthetic.

Lastly, you will want to bring something to do on the day of surgery—and your patience. Reading material, listening material, or game apps can help you pass the time. Ask whether there is wifi available. One of the disadvantages of this highly effective surgery is the labor- and time-intensive process it requires.

The procedure usually lasts at least two to four hours—longer for more complicated cases. A highly trained surgeon, and an understanding and cooperative patient are essential to a successful outcome in Mohs surgery.

Pre-Op Lifestyle Changes

One of the best preparations you can make before your surgery is to quit smoking. Even if you aren't undergoing general anesthesia, smoking can delay healing and cause other post-operative complications. Even quitting the day of surgery can have benefits.

A Word From Verywell

Mohs surgery is an outpatient surgery that, in most cases, results in a very small surgical wound. However, preparation is still key. Make sure you discuss what to expect with your doctor before the day of surgery, know which medications to take or avoid, and make positive lifestyle changes to optimize your healing.

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Article Sources
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  1. American College of Mohs Surgery. The Mohs procedure. 2017.

  2. Skin Cancer Foundation. Mohs surgery.

  3. Nehal K, Lee E. Mohs surgery. UpToDate. Updated March 26, 2020.

  4. Cleveland Clinic. 3 reasons why smoking before surgery isn’t an option. August 2020.