Mohs Surgery (cont.)
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.
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.
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
How do I take care of my surgical area after Mohs surgery?
It is recommended to check with your surgeon for specific post surgery wound-care instructions. Often, you will be asked to go home and take it east for the rest of the day. A few patients like to return to work and resume their work the day after surgery. It may be advisable to avoid heavy lifting and exercise, especially the first 24-48 hours after surgery. Your physician will usually give you more detailed instructions depending on the area and size of the surgery. You will have usually have a bulky "pressure" dressing on the surgery area for one day. You may be asked to keep the area dry for 24 hours. Swimming pools, oceans, and Jaccuzis are usually not permitted while the stitches are in. These may increase your chance of infection. Many physicians allow you to shower the next day after surgery. Wound care may require cleaning the wound with soap or hydrogen peroxide two to three times a day and applying petroleum jelly to the area. Mild swelling is not uncommon the first day or two after surgery and can be lessened by use of an ice-bag application, ice cubes or chips in a small Ziploc baggie, or frozen peas in the bag. Leaving the dressing in place, use cold pack application every five to 15 minutes every hour for the first eight to 24 hours after surgery. Swelling is more common for surgeries around the eyes or lips. Sleeping propped up on a few pillows or in a reclining chair may help decrease swelling after surgery of the head and face area.
The surgical area may ooze a little blood or clear liquid especially in the first few hours after surgery; activity may aggravate this. Hot drinks or bending over at the waist can also initiate or worsen bleeding of face wounds. If bleeding occurs, firm pressure applied directly to the site for 10-15 minutes may be helpful. Most bleeding will stop if you apply enough pressure. Your surgeon should be notified if bleeding persists. Rarely, a visit to the hospital emergency room may be necessary for severe bleeding.
Your surgeon will need to know if pain is increasing after one to two days after your surgery or if you are having fever or other concerning symptoms. In such cases, you may need to be seen at the surgeon's office. The surgical area may need to be checked for bleeding or infection. Limiting hot foods, hot drinks, and heavy chewing for 48 hours may help decrease the chances of postoperative bleeding for wounds around the mouth or cheek areas. Your physician will explain recommended wound care.
Most patients are advised to try to avoid applying makeup or powder directly on a fresh wound unless the surface is fully healed. Skin-colored tape strips called Steri Strips are available to minimize wound leakage and help cover up a visible wound. It is important to follow your physician's instructions for wound care.
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