Mohs Frequently Asked Questions

When you arrive, you will be asked to complete a form regarding your past medical history. Please bring a list of medications and previous medical problems if you can‘t remember them. This form is contained in the information packet you will receive prior to your appointment and can be completed in advance. Please ask your referring physician to send a copy of your biopsy report prior to your appointment.

We ask that you take your medications as usual the day of your procedure. However, certain medications containing aspirin can prolong bleeding and complicate surgery. If approved by your primary care doctor we usually request that aspirin be discontinued 7-14 days prior to your procedure. If you are taking coumadin or Plavix please inform us in advance so that we can consult with your primary doctor regarding temporarily stopping it before surgery. Vitamin E supplements and herbal supplements such as ginger, garlic, ginseng and gingko can also cause increase bleeding and should be avoided 1-2 weeks prior to surgery.

Women should refrain from using cosmetics on the day of the procedure. The risk of infection can be reduced by washing the surgical site (most often the face) thoroughly with soap and water?

We recommend that a friend or relative accompany you to and from our office the day of surgery. Medications given for anxiety may impair driving ability and bandages can interfere with vision.

Since only local anesthesia is used, we encourage everyone, especially diabetics, to eat a regular breakfast prior to arrival.

We participate in many major insurance plans including Medicare, Blue Cross/Blue Shield, Aetna, and US Healthcare. Please provide your insurance information when making your appointment. Depending on your plan, a referral or preauthorization may be required prior to surgery. Special payment arrangements can be made for patients not covered by medical insurance plans.

After you have checked in, our medical staff will escort you to the surgical area. Depending on the site of surgery, you may be asked to put on a gown. Dr. Humphreys will review your history and pathology reports and perform an exam. The details of your procedure will be discussed and you can ask any questions at that time.

An oral medication for anxiety will be provided and is recommended if you are nervous. This will relax you for the duration of the procedure and make the experience much more pleasant. You must however, have someone to drive you home after the procedure.

Dr. Humphreys will then use a local anesthetic to numb the area. We use a special mixture of local anesthetic that minimizes any discomfort. Most patients report only a slight stinging sensation at the beginning of the injection that goes away quickly but no significant discomfort. The area becomes numb very rapidly and generally lasts 1-2 hours. Additional anesthesia is added if needed so that the procedure remains painless.

If you are extremely sensitive or anxious, a topical anesthetic can be prescribed to you to be applied prior to your arrival. Please ask when scheduling your appointment.

After the area is numbed, the area will be cleaned with an antiseptic solution and sterile drapes placed. Dr. Humphreys will then remove the visible tumor and a thin layer (1-2mm) of surrounding tissue around and underneath the skin cancer. The tissue is then taken to the lab and processed. Dr. Humphreys then examines the tissue under the microscope to determine if there is any skin cancer remaining. If any skin cancer is present, a map is made to determine exactly where it is. This takes approximately 25-30 minutes depending on the size of the tumor. The procedure is then repeated until no skin cancer remains. Smaller skin cancers may be removed in one stage while larger tumors may require multiple stages and hence more time to remove.

After the skin cancer is removed, the wound is usually sutured to provide the most rapid healing and best cosmetic result. The duration of the repair process varies widely depending on the size and location of the skin cancer and ranges from 20-45 minutes.

The total duration of the procedure ranges from an hour to the entire day for more complicated cases. We ask that you clear your schedule for the day in case your procedure takes more time than anticipated. We know that waiting for the results is difficult. Please bring a book or magazine with you to read while you are waiting. Some patients like to bring their own music to help them relax as well. You may also have someone wait with you. We request that each patient only bring one person with them due to limited space in the patient rooms and waiting area.

Most patients have surprisingly little pain. Extra strength Tylenol is usually sufficient for the first several days after surgery. Please avoid aspirin containing products since they can increase bleeding. If you think that you will require more pain relief, a prescription medication can be provided.

A pressure dressing is left in place for 1-2 days. This reduces both swelling and bleeding. After that time, the dressing is removed. Routine wound care will involve cleaning the area with water or peroxide and applying petrolatum to the area to prevent crusting. Good wound care is essential in speeding the healing process and reducing the risk of infection.

We ask that you diligently follow our written instructions given to you after surgery for the best result.

Any increased activity can result in bleeding during the first several days postoperatively we advise that you ‘take it easy’ during this time. Mild to moderate activity that does not place increase stress to the surgical site can be resumed in 5-7 days.

This really depends on what kind or work you do and how complicated the procedure was. Work requiring vigorous physical activity should be avoided for a week on average while work at a desk can be resumed as soon as you feel ready. Some degree of swelling and bruising can be anticipated with any surgery and should be taken into account when deciding when to return to work.

Any type of surgery will leave a scar. However, the Moths procedure minimizes the amount of tissue that needs to be removed which in turn minimizes the scar. After the cancer is removed, Dr. Humphreys will determine what type of closure procedure will produce the best cosmetic result. It is her goal to make the surgical site as ‘invisible’ as possible. Full healing of the wound will also take time.

Dr. Humphreys is able to reconstruct most wounds with excellent cosmetic results and restore the appearance of the treated site. The photo gallery shows actual patients with skin cancer treated by Dr. Humphreys using Mohs micrographic surgery and reconstructive techniques.

Most patients return for suture removal in 5-7 days. If the surgery is uncomplicated, it may be possible to have your sutures removed by your referring doctor for convenience.

For certain procedures, Dr. Humphreys may request that you return in 4-6 weeks to re-evaluate the site. Certain areas of the face are more likely to have prolonged redness and contraction or tightening of the scar during the healing which can be easily corrected. After that time, we advise that you return to your referring physician for routine follow up and regular skin checks since you are at increase risk for developing skin cancer at another body site. If you have any concerns about your surgical site regarding healing or appearance, Dr. Humphreys is always available to address your concerns.