Preparing For Surgery
How do I prepare for the day of surgery?
The best preparation for Mohs surgery is a good night's rest followed by breakfast. In most cases, the surgery will be completed on an outpatient basis. If you wish to have an anti-anxiety medication, it will be given to you before the surgery begins. Because you can expect to be here for most of the day, it is wise to bring along a book or magazine. Also, because the day may prove to be quite tiring, it is advisable to have someone accompany you the day of surgery to provide companionship and a ride home. If you are given an anti-anxiety medication, we require that someone else drive you home.
You may be asked to have a preoperative visit to discuss your surgery. At this visit, the technique will be discussed in detail, you will meet the team performing the surgery, a biopsy may be performed (if it has not already been done) and necessary paperwork will be finished (consents, insurance forms, etc.).
If you are coming from a great distance and/or are being referred by a physician familiar with the technique, you may be referred directly for Mohs surgery without a preoperative visit. If you are new to our clinic then a map and travel instructions are included with this booklet, in addition to a questionnaire concerning allergies, medications, and medical history. Please fill this out and bring it with you on the day of surgery.
We request that you stop taking any aspirin or ibuprofen compounds (like Anacin, Bufferin, Advil or Motrin) at least one week before your surgery. This is because it may interfere with the normal blood clotting mechanism, making you bleed more than normal during surgery. If your doctor recommends aspirin please verify with your doctor before discontinuing aspirin. Alcohol, Vitamin E, ginko biloba and garlic pills also increase your bleeding risk, so please discontinue taking these at least one week prior to surgery.
Most insurance carriers cover the cost of Mohs surgery and reconstruction. Please be prepared to give insurance information to our billing office and bring any forms with you that may need processing. We can counsel you concerning your insurance coverage at the time of surgery. If your insurance plan requires pre-approval or an HMO referral, please help us to make sure this is in place prior to your surgery.
What can I expect after the surgery is complete?
Most people are concerned about pain. The majority of people will experience remarkably little discomfort after surgery. Due to its potential to cause bleeding, we request that you do not take aspirin for pain, but use Tylenol or a Tylenol-like pain killer. In some cases a stronger pain medicine be prescribed.
A small number of patients will experience some post-operative bleeding. It can usually be controlled by the use of pressure. You should take a gauze pad and apply constant pressure over the bleeding point for 20 minutes. Do not lift up or relieve the pressure at all during that period of time. If bleeding persists after continued pressure for 20 minutes, repeat the pressure for another 20 minutes. If this fails, a physician can be reached 24 hours a day by calling (503) 494-9000, and asking for the dermatologist on call. If necessary, visit a local emergency room for assistance. Your wound care instructions will also list phone numbers if you have questions.
There are some minor complications which may occur after Mohs surgery. A small red area may develop around your wound. This is normal and does not necessarily indicate infection. However, if the redness does not subside in two days or the wound begins to drain pus, you should notify us immediately.
Itching and redness around the wound, especially in areas where adhesive tape has been applied, are not uncommon. If this occurs, ask your pharmacist for a non-allergenic tape and let us know about this complication on your return visit.
Swelling and bruising are very common following Mohs surgery, particularly when performed around the eyes and mouth. This usually subsides within four to five days after surgery and may be decreased by the use of an ice pack in the first 24 hours.
At times, the area surrounding your operative site will be numb to the touch. This area of numbness may persist for several months or longer. In some instances it may be permanent. If this occurs, please discuss it with your physician at your follow-up visit.
Although every effort will be made to offer the best possible cosmetic result, you will be left with a scar. The scar can be minimized by the proper care of your wound. We will discuss wound care in detail with you and give you wound care information, which will explicitly outline how to take care of whatever type of wound you have.