Frequently Asked Questions
What is skin cancer?
Skin cancer is a term for malignant growths on the skin. Skin cancer is the most common form of
cancer in the United States. Sun exposure is the major cause of skin cancer.
Basal cell carcinoma is the most common type of skin cancer. Basal cell carcinomas are rarely fatal,
but they can be highly disfiguring and damaging to surrounding tissue. Squamous cell carcinoma is
the second most common type of skin cancer. Squamous cell carcinoma can spread to surrounding
and distant tissue.
Melanoma is the third most common type of skin cancer and it is the most serious type of skin
cancer. The incidence of melanoma continues to rise significantly. If detected early, the survival
rate is excellent, however, if left untreated, melanoma can be fatal.
How are skin cancers such as basal cell carcinomas and squamous cell carcinomas treated?
There are several effective treatments for these tumors, such as freezing with liquid nitrogen,
burning with electrosurgery devices, and radiation therapy. These types of treatments often prove
less effective because they destroy the tissue and leave no tissue for pathological examination. Mohs
micrographic surgery is an advanced treatment for skin cancer that offers the highest cure rate.
What is Mohs surgery?
Mohs micrographic surgery is an outpatient procedure that involves the surgeon removing the visible
tumor and then creating a map of the cancer site. The surgeon removes small sections of
surrounding tissue and the tissue is then immediately processed for examination under the
microscope. This process continues until the surgeon determines that all of the cancer has been
removed. Once the cancer is entirely removed, the surgeon repairs the wound using the most
advanced reconstructive procedures.
What does Mohs surgery stand for?
Mohs micrographic surgery and the Mohs College were named after Dr. Frederic Mohs, the surgeon
who pioneered the treatment about 70 years ago and helped lead the innovation that advanced the
surgery to the state-of-the-art treatment it is today.
Who performs Mohs surgery?
The American College of Mohs Surgery (ACMS) is the oldest professional organization of
physicians who have extensive training and experience in Mohs micrographic surgery. To be
accepted as a member, physicians must complete medical school, an internship, three years of
dermatology residency and a one- to two- year fellowship program approved by the Mohs College
that includes extensive training in Mohs surgery, pathology and reconstructive surgery.
What makes Mohs surgery different from other types of surgery?
The Mohs procedure involves removing the entire skin cancer in one visit, while saving as much of
the healthy surrounding tissue as possible. The surgeon will remove the visible cancer and a small
piece of surrounding tissue and then the tissue will be processed for the surgeon to check it under the
microscope. The processing of the tissue takes approximately one hour. If cancer is present in the
tissue, the Mohs surgeon marks the location on a map and then returns to the patient to remove more
tissue in that specific area. These steps will be repeated until the cancer is completely removed.
Other types of skin cancer surgery involve removing the tumor, closing the wound, and sending the
tissue to the pathologist. The pathologist will report several days later whether or not all of the
cancer is removed. If any cancer remained, the patient would need to return for a subsequent
surgery at a later date.
What are the advantages of Mohs surgery?
The main advantages are as follows:
1. The microscopic examination of the tissue and mapping technique allow the Mohs surgeon to
remove the skin cancer in its entirety, leaving healthy tissue intact and unharmed. The
procedure often results in smaller scars.
2. With its high cure rate, Mohs Micrographic Surgery minimizes the risk of recurrence.
3. Because the Mohs procedure is performed in the office and pathological examination of the
tissue is conducted immediately, the entire process can often be completed in a single day.
Will I have stitches following the surgery?
There are three main ways the surgical wound may be handled:
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Direct closure or skin flap: In most instances, surgical wounds are sutured closed.
Skin graft: In some instances, it is necessary to remove skin from in front of the ear or some
other site and graft it over the wound.
Second intention healing: The body has an excellent capacity to heal open wounds.
Sometimes we will allow the wound to heal on its own. This method requires regular, strict
wound care.
There are many factors for the surgeon to consider in choosing how your wound will be handled.
We will discuss this further with you on the day of your surgery.
Will I be put to sleep for the surgery?
No. The surgery is performed with the use of local anesthesia.
How long will the surgery last?
The length of the surgery depends on the extent of the tumor. Often surgery lasts half a day or
longer. Much of the time is spent waiting for tissue to be processed. Bring reading materials,
needlework, etc. with you to help pass the time. Please bring a snack or lunch with you on the day
of your surgery. A refrigerator and microwave are available in the waiting room.
How large of a scar will I have from the surgery?
The size of the scar depends on the size of the tumor. It is often difficult to predict the size of the
tumor prior to surgery.
Should I bring someone with me?
We prefer that you bring someone along as you may be unable to drive after surgery. Someone
other than the patient may need to perform or assist with postoperative wound care in many
instances. The nurse can give this person direct instructions, demonstrate wound care, and answer
any questions after the surgery. We ask that you do not bring children.
What should I wear?
Please wear a shirt that buttons down the front to avoid prematurely removing the bandage after
surgery. Also, avoid wearing jewelry.
Should I eat breakfast before the surgery?
Yes. A small, healthy breakfast is recommended.
Should I take my regular scheduled medications on the morning of the surgery?
Yes. Take your regular medications as they have been prescribed. Continue taking aspirin and
blood-thinning medications if these are prescribed by your physician.
Are there any medications I should avoid prior to surgery?
No. We would prefer that you continue to take all of your prescribed medications prior to your
surgery. Also, please bring a list of all your medications with you on the day of your surgery.
I have taken antibiotics in the past for other medical and/or dental procedures. Do I need to
take antibiotics before surgery?
If you have taken antibiotics prior to dental or other surgical procedures, we may give you
antibiotics in our office on the day of your surgery.
Will my activity be limited after surgery?
Yes. You may need to be out of work several days after surgery depending on your type of work. If
your work requires significant physical exertion, you may be out of work longer. An excuse for
your absence will be provided, if necessary. We prefer that you avoid long trips within the first
seven days following your surgery.
What are the potential complications of surgery?
Bleeding and infection are the two primary, yet uncommon, complications. We will discuss how to
recognize and deal with these problems when you come for your surgery.
What are the Columbus Skin Surgery Center’s office hours?
The Columbus Skin Surgery Center is open from 8:00 a.m. to 4:30 p.m. Monday through Thursday.
There will be someone available to speak with you by phone on Friday from 8:00 a.m. to 12:00 p.m.
What telephone number should I call for scheduling information or for further details
regarding surgery?
During office hours or for urgent matters after hours, you may call the Columbus Skin Surgery
Center at (614) 389-2200.
Will my insurance cover the cost of the surgery?
Under most circumstances, your health insurance company will pay for Mohs surgery. In some
instances, it may be necessary to obtain a referral or authorization from your primary physician or
insurance company prior to surgery. If you are in doubt about your particular coverage, it would be
useful to check with your insurance representative prior to your appointment. If you have specific
questions regarding insurance or billing matters, please contact our office at (614) 389-2200.
Where can I find out more information about Mohs surgery?
The American College of Mohs Surgery has an informative website, www.mohscollege.com.