How do I prepare for the procedure?

Prior to any surgery, Dr. Ciocon, our fellowship trained dermatologic surgeon, will meet with you and discuss the various treatment options for your skin cancer. If you decide you want to undergo Mohs surgery, the surgery will be scheduled at a future date. During this initial consultation, it is important that you inform Dr. Ciocon of any medications, vitamins, supplements, or special foods that you ingest on a daily basis. It is also important that you tell him your medical history, including any history of bleeding disorders, implantable metal devices, or history of heart valve disease. If you have a history of anxiety, feel free to inform Dr. Ciocon as medications can be prescribed on the day of surgery to minimize your discomfort.

What should I expect on the day of the procedure?

You can expect to be at the office for a minimum of two to three hours on the day of surgery. If multiple layers are to be taken, this number can double, or in rare cases, triple. For this reason, we recommend you eat a healthy breakfast and bring a second meal or snack with you if you become hungry during the day. You might also want to bring a book to occupy your time.

When you arrive at the office, your records will be reviewed, photographs will be taken, and the affected area will be numbed. It takes only minutes for Dr. Ciocon to take the first layer of tissue. You will then wait for that first layer to be processed and analyzed under the microscope which can take an hour. If that first layer shows the tumor has cleared you will be taken back to the procedure room, and your wound will be closed. If the tumor has not been removed by the first layer, additional layers will be taken until the tumor is completely removed.

Are all wounds closed in the office?

Dr. Ciocon closes greater than 90% of his Mohs surgery cases on the same day as the procedure. Very rarely does he send the patient to another surgeon for closure unless the patient requests it or if the tumor has invaded a facial structure that requires the expertise of another specialist (i.e. the eyelid). If the patient has been in the office for several hours because multiple layers were removed, he/she may request that their wound be closed on a separate day.

Dr. Ciocon is unique in that he trained in general and plastic surgery in addition to completing a one-year fellowship in Mohs micrographic surgery and dermatologic surgery. He uses the most up-to-date techniques and technology to ensure minimal scar formation. Depending on the location and size of your defect, he can close the defect in standard side-to- side fashion or in some case, by rearranging the tissue to cover the defect (flap) or by taking tissue from one part of your body and transplanting it to the affected area (graft). All procedures are perfomed under local anesthesia.

What can I expect postoperatively?

Swelling and bruising are common, especially around the eyes for cases involving the upper third of the face and scalp. Ice packs and elevation can help to alleviate these symptoms. Depending on the size and location of the defect, Tylenol alone should be enough to minimize your discomfort after the procedure. You may also be given antibiotics if warranted. Aspirin and ibuprofen cause bleeding and should not be used after surgery, unless they are recommended by a primary care physician or cardiologist. Most stitches are removed within one to two weeks.

Can I be closed with absorbable, invisible sutures?

Yes. Dr. Ciocon prefers this type of closure as it is more cosmetically appealing and requires less wound care by the patient. However this type of closure can only be used with specific types of wounds on specific parts of the body. Dr. Ciocon would be happy to discuss with you if this type of closure is possible the day of your surgery.