Preparing for Mohs Surgery:

Try to get a good night rest and eat a light breakfast. If you are taking any medication, take it as usual unless we direct you otherwise. Please remember to bring your completed medical forms (including your pharmacy name and phone number), your insurance cards and photo ID and a current list of any medications you take.

It is a good idea to bring a book or magazine with you on the day of surgery. The procedure may take a full day, most of which you will spend in the waiting room waiting for your tissues to be examined. You may bring a lunch or snack with you. Also, wear comfortable clothing. It is wise to bring a sweater as it may sometimes get cool in the waiting room.

Reserve the ENTIRE DAY for this surgical procedure, in case the removal of multiple layers is required.

Have a friend or relative drive you, your bandage may interfere with your sight. If you have questions, please call our office 248-293-0800.

**Optional preparation- 3 days prior**

Using homeopathic Arnica Montana tablets (taken orally as directed on the bottle) for three days prior to surgery and after surgery can help reduce swelling and bruising. Mint, methanol and caffeine can reduce the efficacy of the Arnica and should be eliminated as much as possible.

No alcoholic beverages 24 hours prior to surgery

Restrictions following surgery:

No air travel

No exercise or strenuous activity for 7-14 days following surgery.

No bending or heavy lifting

What happens on the day of surgery?

Arrive for your appointment at the scheduled time. No need to arrive early unless you need to fill out your paperwork.

Appointments for surgery are usually scheduled early in the day. This allows us to continue the surgical steps throughout the entire day if necessary.

The nurse will escort you to an operating room where a local anesthetic will be used to numb the skin so that you will feel little discomfort. Be sure to inform Dr. Byrd if you do experience any pain during surgery.

The next step is for the surgeon to remove a layer of skin involved by the cancer. After this tissue has been carefully removed, bleeding is stopped with a machine called cautery. Before you leave the treatment room the nurse will dress your wound, and by the time you get to the waiting room the removed tissue will be in the laboratory where it is being prepared for microscopic examination.

The most difficult part of the procedure is waiting for the results of the surgery. It usually takes about 2 hours to prepare the slides from the removed tissue, although sometimes it may take longer. Please remain in the waiting room during this period.

If examination of the slide reveals that your tissue still contains cells of skin cancer, the procedure will be repeated as soon as possible. Several surgical excisions and microscopic examinations may have to be done in one day, and seldom is it necessary to have a patient return the following day for additional surgery.

What’s the next step after MOHS surgery has been completed?

When we have determined that the skin cancer has been completely removed, a decision is made about the wound created by the surgery:

1. The wound may be allowed to heal by itself.

2. For small post-surgical sites, direct closure by suturing the sides of the wound together may be possible.

3. In certain areas of the body, there is very little tissue that can be stretched for coverage of a wound. In this care either a skin graft or a skin flap must be used. You will have stitches anywhere from 5 to 14 days depending upon the surgical site.

You will need to return to the office within the time frame recommended for suture removal. With any of the above options, your surgical site will most likely require daily care at home; you will be given detailed instructions following your surgery.

Dr. Byrd will recommend which of these options will be best for your individual case, taking in to consideration the best cosmetic and functional results.