Mohs Surgery

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Mohs Surgery is a precise, safe, and effective way of removing skin cancers. Under local anesthesia, layers of tissue are removed and examined under a microscope at our onsite laboratory. This process is repeated, if necessary, until all the cancer is removed and only normal tissue remains. Using this technique, 100 percent of the surgical margin can be checked, while removing the least amount of normal tissue.

Mohs surgery has the highest cure rate of any skin cancer treatment.

mohs-logoFellowship-trained Mohs surgeons have obtained the highest possible level of education and training available for the treatment of skin cancer. This training allows Mohs surgeons to accurately interpret slides of tissue from complex tumors. Mohs surgeons are also trained to perform a wide breadth of surgical skin reconstructions — from simple closures to flaps, grafts and complicated multi-step repairs.

Our Mohs surgeon has completed an American College of Graduate Medical Education approved fellowship in Micrographic Surgery and Dermatologic Oncology. He is an associate member of the American College of Mohs Surgery.


WHAT TO EXPECT

Days prior to surgery

I recommend that all patients get a pre‐operative consultation, which helps minimize confusion and misconceptions. During this short office visit we will:

  • Discuss the type and size of your tumor
  • Take pictures and identify the exact site of your cancer
  • Assess your current medications and surgical risk
  • Review the procedure and aftercare in detail
  • Review expectations for the day of surgery, including the likely surgical reconstruction, wound care and bandaging, and activity modification.

Mohs surgery has the highest cure rate of any skin cancer treatment.
You may be instructed to continue all medications, including blood‐thinners. You will be asked to abstain from alcohol 3 days prior to and for 3 days after surgery. If possible, reduction or cessation of smoking will lead to a better surgical outcome.


The tumor

Determining the accurate site of the tumor is paramount. We need to agree on the exact location of your biopsy in order to proceed with surgery. We will do this during the preoperative consultation. Because the tumor can change in size and shape after a biopsy, I recommend that you take a picture of the biopsy site at the time you and your physician select Mohs surgery as the treatment option (selfies are fine!).


Day of surgery

  • Having someone accompany you, and be able to drive you to and from your surgery is not required, but recommended ‐‐ we will discuss this at your preoperative consultation. Shower and have a full meal prior to arriving.
  • Wear loose and comfortable layered clothing.
  • Women should not wear makeup or jewelry.
  • Men should shave as appropriate around the tumor.

You will be greeted and brought back to one of our Mohs surgical suites. You will likely spend most of your visit in the surgical room. Snacks, beverages and bathrooms will be available.

Mohs surgery is done in stages and there is a lot of “behind the scenes” work with your tissue in our onsite lab. There will be some downtime, and you are welcome to bring paperwork, mobile devices, books and magazines as you like. Our surgery rooms also have televisions.


Length of surgery

Every effort will be made to make your day as efficient as possible. However, due to the surgical nature of the work, things can be unpredictable. Most patients will be done within 3‐4 hours and in many cases, much less than that. Plan on being here at least half the day. Don’t make any plans after your surgery, you should go home and rest.


Days following surgery

  • You will be given specific wound care instructions. These will all be written down as well.
  • You will be given the necessary bandaging supplies to take care of your surgical site.
  • In most cases, dissolvable sutures will be used, and there will be no required follow up visit.
  • For larger defects and repairs, you will likely receive several brief post‐operative checks so I can
  • monitor your progress, address any issues and ensure that you receive the best possible outcome.
  • If any questions or post‐operative issues arise, you may contact my office. I, or one of my team
  • members will be available to assist you.
  • After hours emergency coverage is available.

After your Mohs surgery, you will be directed to follow up with your primary dermatologist for continued skin checks, as your risk of additional skin cancers is higher once you’ve had one.

Thank you for putting your trust in me. I look forward to meeting and taking care of you!
Dr. Ken Galeckas, MD, FAAD


Mohs Surgery Providers


Helpful links on Mohs Surgery and Skin Excision