Mohs Micrographic Surgery
For cancers that have returned after previous surgery, larger cancers, or cancerous areas where the edge is either undefined or the surrounding skin must be preserved, Mohs micrographic surgery is frequently the best treatment choice.
As a double board certified Dermatologist and Skin Pathologist, Dr. Dubow is specially qualified to both surgically remove and microscopically interpret specimens removed by the Mohs method. Dr. Dubow is a Fellow Member of the American Society for Mohs Surgery, an organization committed to excellence, training, and the ethical use of Mohs surgery. For more information about the Mohs procedure, click here.
Before Your Surgery:
Before your Mohs surgery, you should inform Dr. Dubow of all medications you are taking, particularly if you are currently on any blood thinners or herbal supplements, and you should avoid any elective blood thinners (ibuprofen, naproxen, etc.) for 7 days prior to your surgery. Please note that if you are REQUIRED to be on a blood thinner because of a medical condition or previous procedure do NOT discontinue your blood thinner before Mohs surgery unless specifically told to do so by both Dr. Dubow AND your primary Physician. For a complete list of medications to avoid, please click here.
Please avoid alcohol for at least one day before and after your surgery.
If your surgery will be on your face or neck, please wear a loose fitting tee shirt or a shirt with a zipper in front.
Please eat a normal breakfast the morning of your surgery; however, try to minimize caffeinated beverages. If you “need” your morning cup of coffee, please have it but not the extra one(s)!
For more detailed pre-operative instructions, please click here.
Mohs surgery is an outpatient procedure that Dr. Dubow performs in the office himself. All Mohs surgery is performed under local anesthetic and patients are awake during the procedure.
Before your surgery, the cancerous area and surrounding skin will be thoroughly cleansed and a local anesthetic will be injected into the area being treated.
During the Mohs procedure, Dr. Dubow will remove the visible cancerous tissue as well as thin margins of normal appearing skin surrounding the skin cancer. Once this tissue is removed, it is processed by an in office laboratory and then examined by Dr. Dubow under the microscope. Areas where cancerous cells remain are marked and Dr. Dubow then removed additional tissue only in those areas affected.
Therefore the primary benefits of Mohs surgery are to allow for in office examination of all margins during the procedure (vs. afterwards) and the removal of as little unaffected skin as possible which can often reduce the size of scars.
Typically, Dr. Dubow can complete most Mohs surgery within 2 to 3 hours but because some cases may require extra samples being taken we recommend you not schedule any other appointments or plan to work on the day of surgery.
During Your Surgery:
Your surgery is performed in our office on an outpatient basis.
We perform all surgery under local anesthesia (lidocaine/Marcane). Sedation or more extensive anesthesia is not required.
Please notify our staff prior to your surgery if you have any history of sensitivity or allergy to injectable anesthesia or epinephrine!
There is a lot of waiting time during Mohs surgery. Although it takes only a few minutes for Dr. Dubow to take a “layer” or “stage,” the processing of the tissue and preparation of microscopic slides takes 30 to 60 minutes per sample. Please be patient and bring a book or your laptop. We have WiFi in our office for patient use.
The AVERAGE Mohs surgery takes 2 to 3 hours! PLEASE do not make any other plans on the day of your surgery to minimize any potential stress.
After Your Surgery:
Patients typically do not experience much pain following the procedure. Mild discomfort is expected, but Tylenol should be enough to ease the discomfort.
Occasionally, patients do experience more severe pain for 1-3 days after surgery, and we will give you a prescription for pain medication if this occurs.
It is likely that you will experience minor bruising and swelling at the surgery site. You may also experience some minor bleeding for the first 1-2 days after surgery. If your bandage becomes soaked with blood, please apply pressure to the surgical site for 20 minutes continuously and then call our office. If your surgical site will require special post-op care instructions, you should receive these at the time of the procedure.
For post operative instructions, click here.
PLEASE call our office if you experience pain, swelling, redness, or pus discharge from your surgery site please call our office at (310) 888-4070.
If you want to know more about how you can completely cure your skin cancer with a minimally-invasive treatment, call our office today at (310) 888-4070 today to schedule your appointment!