About Mohs

What you need to know about Mohs surgery
Mohs surgery is a highly specialized treatment for the removal of skin cancer. Developed by Dr. Frederic E. Mohs in 1938, this method involves microscopic examination of the surgically removed skin tissues as well as detailed mapping techniques.

By using this technique along with complete microscopic control, a specially trained physician can pinpoint areas with cancer that are otherwise invisible to the naked eye; therefore, even the smallest roots of cancer can be removed from the skin with minimal sacrifice of healthy skin. The result: minimal removal of healthy tissue with the highest possible cure rate.

The Mohs surgery will be performed by Dr. Khan, a board certified dermatologist and a fellowship trained Mohs surgeon. Fellowship training takes place at an American College of Mohs Surgery approved training center, which is a practice that itself has passed a rigorous application and review process.

Preparing for surgery
Once your physician or provider has contacted us and we have received and reviewed the necessary paperwork, your appointment for surgery will be scheduled for early in the morning, and we will advise you as to what time you need to arrive (usually around 7:30 to 9:30 a.m.). It is best to wear a shirt that buttons down the front if your skin cancer is on your chest or back.

No makeup or jewelry should be worn if surgery is to be performed on your face. Bring a good book or magazine with you, as you will spend a significant amount of time waiting while the microscopic slides are prepared and interpreted.

Blood thinners
DO NOT STOP prescription blood thinning medications. You should continue taking ASPIRIN if it was prescribed by your doctor.

If you chose to take aspirin on your own, stop it at least 7 days before surgery. This is because aspirin tends to prolong bleeding during the operation. Aspirin can be found in the following medications: Excedrin, Bufferin, or Anacin. Also, eliminate medications containing ibuprofen and naproxen, commonly found in Advil, Motrin, and Aleve for at least 7 days before surgery. If you need a pain reliever, you may take acetaminophen (brand name Tylenol). Please also stop supplements such as Fish Oil, Vitamin E as well as other over the counter supplements at least 1 week before your surgery.

The day of surgery
Eat a breakfast on the day of surgery. If you are currently taking medication, continue as usual unless directed otherwise by your physician.

When you arrive for your appointment, you will be greeted by our front office team, and we will verify that you have all necessary paperwork completed. You may also be asked to sign some additional consent and privacy forms.

You will then be escorted into a procedure room where one of our clinical staff members will discuss your health history with you, and answer any questions you may have about the procedure.

Your physician will then meet with you to discuss your treatment options, and he will perform an examination. Once you are in agreement that Mohs surgery is the best option, the skin cancer and the surrounding area will be numbed with a local anesthetic. Once the area is numb, the visible cancer and a thin layer of surrounding tissue will be removed. This tissue is carefully mapped and coded by the physician, and is taken to our laboratory where the technician will process the microscope slides.

You will have a temporary dressing placed over the area, and you will be escorted to the waiting room. The surgical procedure takes approximately 20 minutes; however, it takes a minimum of 1 hour to prepare and microscopically examine the tissue. Multiple surgical stages and microscopic examinations may be required, and you will need to stay in the surgical waiting area between stages. Although there is no way to tell before the surgery how many stages will be necessary, most cancers are removed in three stages or less. Most patients are here between 3-6 hours. The repair stage of the surgery usually will begin late morning or early afternoon.

Visits might extend through the lunch hour, so we encourage you to bring a lunch with you since you will be required to remain in the surgical waiting area until all procedures are completed. Alternatively, your companion may leave to get lunch for you at any of the nearby restaurants. Because this is a surgical waiting room with other patients, we kindly ask that each patient only have one companion with them on the day of surgery.

Will my surgery leave a scar?
Yes. Any form of treatment for skin cancer will leave a scar; however, because Mohs surgery removes as little healthy tissue as possible, scarring is minimized. Immediately after the cancer is removed, Dr. Khan will help you choose the safest method of repair to provide the best cosmetic result.

What if I require reconstruction?
In a few cases, allowing the area to heal by itself without surgical reconstruction is the best option, because in some anatomic locations natural wound healing results in a better cosmetic outcome than by surgical intervention. In other cases, the tissue-sparing benefits of Mohs surgery allow removal of the skin cancer with a resultant wound so superficial that there is no need for further repair. If the area is allowed to heal by itself, it will usually heal within 3 to 8 weeks, depending upon the size, depth and location of the wound.

In most cases, reconstruction will provide you with the best outcome. Dr. Khan will discuss the best reconstructive option taking into account individual preferences, lifestyle, and aesthetic expectations. If you do require reconstruction, Dr. Khan have undergone extensive training in the area of reconstruction after Mohs surgery, and have gained expertise in repairs, particularly those in the facial areas. Depending upon the size, depth and location of the removed skin cancer, we may choose to repair the wound with stitches, staples, a skin graft or skin flap in order to provide the best cosmetic result. In some cases a referral to another reconstructive specialist may be made.

For reconstruction, just like with the Mohs portion, we will use local anesthetic and you will be awake. A small surgical drape will be placed over the area just before the surgery begins. This drape can be adjusted as needed.

Will I experience pain?
Most patients do not complain of uncontrolled pain after surgery. If there is discomfort, acetaminophen (Tylenol®) provides excellent relief. Avoid taking aspirin-containing medications the first few days after surgery (these include aspirin, Aleve®, Ibuprofen, Advil®, etc.) as they may cause bleeding. Do not stop your blood-thinner unless specifically instructed by our office to do so. If necessary, a prescription for pain medication and/or antibiotic will be given to you when you are given your instructions following the surgery.

Will I have any limitations on activities?
Each repair has its own unique restrictions, but generally we ask that you do not:

  • Engage in sports or exercise, including golf
  • Engage in any other activities that will increase your heart rate, blood pressure, or cause you to perspire
  • Get the area wet
  • Bend over (in the first few days)
  • Lift anything heavier than a gallon of milk

What about follow-up care?
Usually at least one return visit with one of our clinical staff members will be needed to examine the healed area or to remove stitches. Some patients are also scheduled for post-operative visits with Dr. Khan.

Whether your wound is allowed to heal or it requires stitching, you and your companion at the appointment will be given oral and written instructions on daily wound care in order to prevent infection and to promote healing for the best cosmetic result. A follow-up appointment will be scheduled to remove the stitches or staples (if necessary), and to monitor the healing process before you leave on the day of your surgery. Your insurance may require us to collect your copay (if you have one) for follow-up appointments. But, generally a follow-up is covered by your insurance in the cost of surgery.

Once you have been released from our care, you should return to your referring physician for routine check-ups. A follow-up period of five years for the treated cancer is essential. After having skin cancer, statistics show that you have a much higher chance of developing additional skin cancers. You should have your skin checked by your physician at least once a year, not only to examine the treated area, but also to check for new cancers.

Our Phoenix Arizona dermatologists are available throughout AZ cities including Gilbert, Chandler, Mesa, Tempe, Ahwatukee, Carefree, Cave Cree, Pardise Valley, Fountain Hills, Anthem and Surprise. Call us if you are looking for a skin cancer dermatologist in Arizona, acne treatment dermatologist in Arizona, Rosacea dermatologists in Arizona, wart removal treatment in Arizona, psoriasis treatment in Arizona, Vitiligo treatment in Arizona, eczema treatment in Arizona, skin infection treatment in Arizona, Arizona dermatologists who treat hair loss, eliminating wrinkles in Arizona, eliminating brown spots in Arizona, looking to find out how To get rid of broken blood vessels in Arizona, laser hair removal in Arizona, dermatology laser surgery in Arizona, Botox® injections in Arizona, Restylane® treatment in Arizona, tattoo removal in Arizona, Fraxel® treatments, BLU-U® Light treatments, dermoscopy, removal of acne scars or sclerotherapy treatment in Arizona.