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Medical Author:

Nili N. Alai, MD, FAAD

Nili N. Alai, MD, FAAD

Dr. Alai is an actively practicing medical and surgical dermatologist in south Orange County, California. She has been a professor of dermatology and family medicine at the University of California, Irvine since 2000. She is U.S. board-certified in dermatology, a 10-year-certified fellow of the American Academy of Dermatology, and Fellow of the American Society of Mohs Surgery.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is Mohs micrographic surgery (MMS)? Why is the procedure called Mohs?
• Where can I have Mohs surgery, and how long does the surgery take?
• What kind of physician can perform Mohs surgery? Where can I find a doctor board-certified in Mohs?
• Is Mohs only for skin cancer?
• Am I a good candidate for Mohs surgery?
• What if I have artificial joints or other health issues?
• What areas are treatable by Mohs surgery?
• What are possible complications of Mohs?
• What is reconstruction? Will I have a scar?
• What are alternatives for Mohs surgery?
• What about insurance coverage and costs?
• How do I prepare for my surgery?
• How is recovery? Is it painful?
• How do I take care of my surgical area after Mohs surgery?
• What is the chance that my cancer will recur?
• How many "levels" of Mohs will I need?
• How are skin cancers treated?
• Find a local Dermatologist in your town
• Mohs Surgery Index

How do I prepare for my surgery?

Your personal physician will let you know the preoperative instructions specific for your condition.

Smoking is discouraged for at least one to two weeks before surgery. Smoking can slow down wound healing and cause more wound infections.

Heavy alcohol use is not advised at least one week before surgery. Heavy alcohol use can cause more bleeding and thin your blood. An occasional glass of wine or small cocktail may not cause severe bleeding. Your physician will want to know of any factors that may affect your surgery or wound healing.

For many typical outpatient Mohs surgeries in a physician's office, most patients are advised to eat a good breakfast on the day of surgery and take all of their regular daily medications. Patients are advised to wear comfortable casual clothes and bring a sweater or small blanket.

In most cases, patients are usually able to drive after most procedures and do not necessarily need a driver unless they feel uncomfortable. Diabetic patients may need to be more cautious about maintaining good blood sugars and avoiding dangerous lows in their sugars from fasting.

Since you will be in the office for several hours, you may want to bring some personal snacks, drinks, and reading or knitting material. Personal music headsets or iPods may also provide relaxation and help pass time between Mohs levels.

For surgery center or hospital-based procedures requiring any type of sedation or general anesthesia, patients may be required to not eat or drink anything past midnight the night before surgery. Your plastic surgeon or anesthesiologist will advise you of specific instructions before surgery.

Most patients continue all doctor prescribed medications including aspirin and any blood-thinning medication unless specifically advised otherwise only by the primary physician or plastic or Mohs surgeon. Patients with a significant history of stroke, heart attacks, or even heart pain (angina) under a doctor's care must discuss their medications with their doctor before making any changes. It is important to not discontinue blood thinners without a doctor's specific instructions because of a potential greater risk of a heart attack and/or stroke.

For otherwise healthy (non-cardiac and non-stroke patients) nonessential, nonmedically prescribed medications that thin the blood such as Advil (ibuprofen), Motrin, aspirin, vitamin E, garlic supplements, Alka-Seltzer, Pepto-Bismol, other aspirin-containing medications, etc., can be stopped at least seven to 14 days before undergoing Mohs surgery to minimize bleeding and bruising. These medications can thin your blood and make you more prone to bleed during and after surgery. Again, it is important to not discontinue or start any medication without a doctor's specific instruction.