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Frequently Asked Questions - Mohs Surgery

Skin Cancer Treatment

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Frequently Asked Questions - Mohs Surgery

Skin Cancer Treatment


Answering Common Questions About Dermatology

Dermatology is a varied discipline that covers both medical and cosmetic procedures involving the skin. So, it’s understandable that our patients will have many questions when scheduling an appointment. We’ve answered some of the most common questions below. For more specific answers, please contact our Winston-Salem clinic online or by calling (336) 439-1627.

Happy woman receiving dermatological treatment

Dermatology FAQs

Our Fellowship-trained Mohs physicians offer Mohs Micrographic Surgery for the treatment of high-risk skin cancer.

Finding skin cancer is the first step towards curing it. Mohs micrographic surgery is the next step. Skin cancers that occur in high-risk areas such as around the eyes, ears, nose and lips, or which have recurred after previous treatment are more effectively treated using Mohs Micrographic Surgery.

Dermatology is the segment of healthcare dedicated to skin health. This includes treating the skin for medical conditions and improving its overall appearance with cosmetic procedures.

HSA accounts can be used to cover some visits to a dermatology office. However, not all services will be covered. It’s important to check your plan’s details before relying on it to reimburse your treatment.

Dermatology appointments (especially initial visits) can take as little as 15 minutes. If a skin exam is needed, the appointment may take 20-30 minutes. The times for procedures and treatments vary, but most typically take less than an hour. Some complex procedures make take longer.

Your first visit will typically begin with a review of your medical history. If you’re considering a cosmetic procedure, it will also include a discussion of your goals. It will then include a careful inspection of your skin. The area that will be inspected depends on the reason for your visit, but it’s usually best to prepare for a full-body inspection for some procedures (especially skin cancer).

You shouldn’t wear makeup during your visit to a dermatologist. It can cover the condition in question and may even lead to an improper assessment of your skin (whether it’s for a medical or cosmetic procedure).

It depends on the reason for the visit. For example, insurance and Medicare plans may cover some medical and surgical procedures at a dermatology clinic, but typically won’t cover cosmetic treatments. It also depends on the size of the area in question.

Dr. Frederic Mohs developed this technique about 60 years ago. The procedure has been modified and refined over the years. Practitioners of the technique have kept Dr. Mohs’ name in respect for his contribution. Mohs surgery has other names including Mohs chemosurgery, Mohs microscopically controlled surgery and Mohs micrographic surgery.

This actually depends. Acne outbreaks may look similar, but they can be caused by different triggers. The severity of the outbreak may also determine the best treatment. A board-certified dermatologist can help determine the best treatment for acne on a case-by-case basis.

Melanoma is cancer that is treated surgically. When the melanoma is thin (has not penetrated deeply into the skin), surgical removal is usually the cure.

The Mohs surgeon uses conventional surgical instruments and removes malignant tissue during surgery.

The difference is what happens to the tissue after it is removed. After complete removal of the obvious tumor, the surgeon removes a thin layer of normal appearing skin surrounding the tumor. A map is made of the specimen. It is then processed in the laboratory for approximately one hour. The surgeon then examines the specimen under the microscope. If cancer is present in the specimen, the Mohs surgeon marks its location on the map and then returns to the patient and removes more tissue in that area. This step is repeated, if necessary, until the tumor is completely removed.

There are two primary advantages. First, by using the microscopic examination of the tissue as a guide, the Mohs surgeon is better able to remove all of the skin cancer. Secondly, by carefully mapping out the tumor, the surgeon removes cancerous tissue and leaves behind as much normal skin as possible.

Other advantages of Mohs include:

  • Cost effective compared to other surgical options
  • Highest cure rate of any existing procedure
  • Lowest functional and cosmetic morbidity of any procedure
  • Optimal skin tissue preservation
  • Single-day outpatient procedure with local anesthesia

The size of the scar depends on the size of the tumor. It is often difficult to predict the size of the tumor before surgery.

There are three main ways your surgical wound may be handled:

  1. Direct closure of the wound: In most instances, surgical wounds are sutured (sewn) closed.
  2. Skin graft: In some instances, it is necessary to remove the skin from some other site and graft it over the wound.
  3. Second intention healing: The body has an excellent capacity to heal open wounds. This healing period is approximately 3-6 weeks depending on the size of the wound. It requires regular wound care.

In addition to wound size and location, the surgeon considers other factors to determine how your wound will be handled. This will be fully discussed with you on the day of surgery.

No. The surgery is well tolerated with local anesthesia. Because the surgery may be time-consuming, the risk of prolonged general anesthesia is avoided.

The length of 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 or mobile device entertainment with you to help pass the time.

If you have to travel a great distance, you may want to spend the night before surgery in the surrounding area. There are several moderately priced motels nearby. A list of these is available upon request.

Disclaimer: Families and patients traveling from out of town for treatment can find affordable lodging in a caring environment at the SECU Family House on the Richard J. Reynolds III & Marie M. Reynolds Campus.

Due to COVID restrictions, we are not allowing any visitors in the waiting room unless they are needed to directly assist the patient during surgery.  Anyone who comes with the patient will be asked to wait in their car or return at a later time once the patient’s surgery is complete.

It is strongly recommended that you arrange to have someone drive you to and from your appointment.. The nurses will give you wound care instructions after your surgery, and since some sites require someone else to perform the wound care, they can go over that with them as well and answer any questions. Even with minor procedures, some patients may feel anxious or nervous. We can give you something to help you relax, but this would require that someone else comes with you and drives.

Men or women should wear a shirt that buttons down the front and slacks. A skirt for women can also be worn instead of slacks.

Yes. Breakfast is recommended.

Yes. Take your regular medications as they have been prescribed.

Possible hindrances depending on your specific situation will be discussed with you on the day of your surgery.

Bleeding and infection are the two primary complications. Both of these are uncommon. We will discuss how to recognize and deal with these problems on the day of surgery.

The Skin and Mohs Surgery Center is open 8:00 a.m. to 5:00 p.m., Monday through Friday. Mohs surgery is scheduled Monday through Friday of each week.

During office hours, you may call 336-724-2434. For urgent matters after hours, this number will be directed to the provider on-call. The medical staff of The Skin Surgery Center or Skin Cancer Center is available to assist you on the day of surgery and to answer your questions before and after surgery.

Under most circumstances, your carrier will pay for the surgery. If you are a member of an HMO, it may be necessary to obtain a referral or authorization from your primary physician. If you are in doubt about your particular coverage, please check with your insurance representative before your appointment. If you have specific questions regarding insurance or billing matters, please contact our office at 336-724-2434.

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