Surgical Dermatology

Skin cancer is the most common form of cancer in the United States. More than 2 million people are diagnosed in the United States annually, and the incidence is rising faster than any other type of cancer. 

Advanced Dermatology of the Midlands in Omaha & Council Bluffs, IA, specializes in the diagnosis and treatment of skin cancer, emphasizing the use of Mohs Micrographic Surgery to treat skin cancers, including basal cell carcinomas and squamous cell carcinomas. Omaha Mohs surgery treatment at Advanced Dermatology of the Midlands is often the best treatment option for skin cancers that have a high risk of recurrence or that have recurred after previous treatment.

Mohs Micrographic Surgery Preoperative Information

About Mohs Surgery Omaha

Skin Cancer Treatment – Mohs micrographic surgery (MMS) is recommended to give patients the highest possible cure rate for skin cancer. Dr. Frederic Mohs developed this skin cancer surgery called Mohs micrographic surgery in the 1930s, and it is now used widely for two common types of skin cancer – basal and squamous cell skin cancers.

During Mohs surgery, the surgeon removes thin layers of skin and inspects them carefully for signs of cancer. One of the main advantages of Mohs surgery is that it is able to eradicate skin cancer while preserving the surrounding skin that is healthy. By ensuring the complete removal of cancer, Mohs surgery increases the likelihood of a cure, reducing the need for additional treatments or surgeries.

Mohs surgery is particularly beneficial for skin cancers that exhibit any of the following characteristics:

  • A high probability of recurrence or have already returned after prior treatment.
  • Located in areas where preserving healthy tissue is critical, such as around the mouth, nose, eyes, ears, hands, feet, or genitals.
  • Possess poorly defined edges.
  • Are extensive or have a rapid growth rate.

This is an outpatient procedure performed in our Mohs surgery Omaha, NE & Council Bluffs, IA offices. Our Mohs surgeons, Mathew Davey, M.D. FAAD and James Shehan, M.D. FAAD, are both members of The American Society for Mohs Surgery.

Surgical Dermatology Omaha & Council Bluffs, IA

At the time of the surgery, the dermatologist uses local anesthesia to numb the area (skin) completely, just as was done with the initial biopsy. A section of skin including visible cancer with a thin rim of normal/healthy tissue is removed. The section of skin is then taken down the hall to our CLIA-certified Mohs laboratory, where it is frozen (in a machine known as a cryo-stat), cut into microscopic-thin sections, stained, and then examined under the microscope by the dermatologist to determine if all of the cancerous cells have been removed.

If any remaining cancer is noted under the microscope, the dermatologist can pinpoint exactly where the involved portion is, and the process above is repeated until the entire area is deemed cancer-free. Following that, your dermatologist will discuss the best ways to close the area of skin – in many cases, this closure will be performed the same day.

Reserve the entire day for Mohs surgery, because the final size and extent of the skin your Mohs surgeon will remove to clear you of cancer cannot be predicted in advance. After your Mohs surgery is completed, we will review care for the area with you and schedule your post-operative visit. You will leave the office with a bandage in place over the surgery area.

If any of the following apply to you, please notify our office on the day of surgery (if you did not already discuss them with the nursing staff when you scheduled the procedure):

  1. If you take Coumadin (warfarin), please call our office with your most recent PT/INR levels immediately.
  2. Have an artificial joint, artificial heart valve, or any other implanted electrical device(s) in your body or have been told by another doctor to take antibiotics prior to dental or surgical procedures, please contact our office immediately.

Plan on being in the office for at least 3 to 4 hours for the procedure, processing, and testing.

We encourage you to bring a book or some magazines to read as well as a snack/drink. Also, we encourage you to:

  • Bring a family member or friend with you on the day of the procedure
  • Wash your hair and face the night before and the morning of the surgery
  • Do not wear any make-up, hair products (spray, gel, etc.), or hair pieces to the surgery
  • A hat may be worn but will need to be removed during the procedure
  • Wear an old, clean shirt, but do not wear any jewelry
  • Consider bringing an old, clean blanket or jacket to the office
  • Unless otherwise directed, take all of your normal medications, and feel free to eat breakfast the morning of your procedure

Post-Mohs Surgery to Remove Skin Cancer

  • After Mohs surgery, minimal discomfort can be managed with acetaminophen.
  • Localized swelling and bruising are normal side effects and may peak 3-4 days after surgery.
  • Swelling of eyelids or neck may occur, which can be reduced by applying ice for 20 minutes per hour for the first 48 hours.
  • Minor bleeding may occur, but active bleeding should be addressed by applying firm pressure or contacting your dermatologist.
  • Vigorous physical activity should be avoided for seven days after surgery to prevent damage to stitches or bleeding.
  • Sutures are removed five to 10 days after surgery, and post-operative follow-up will be provided to ensure proper healing.

Scars improve over several months after Mohs surgery, with significant improvement in the first month. Scar revision or resurfacing may be beneficial in some cases. Regular follow-up examinations with your dermatologist are important to monitor for the recurrence of skin cancer or pre-cancers and to detect any new skin cancer early.

Surgical Dermatology – Mohs Surgery Omaha, NE

If you need to change or reschedule your procedure date, please call the dermatologist’s nursing staff as soon as possible.

For any questions, please feel free to contact the office. Also, please feel free to ask any questions before, during, and after your appointment. We look forward to seeing you soon.

Additional Information

Omaha Mohs Micrographic Surgery

American Society for Mohs Surgery
American Society for Dermatologic Surgery
American Board of Dermatology