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 most types of skin cancers, including basal cell carcinomas and squamous cell carcinomas.

Mohs Micrographic Surgery Preoperative Information Surgical Dermatology Omaha & Council Bluffs, IA

Mohs micrographic surgery is recommended to give the highest possible cure rate. This is an outpatient procedure performed in the office. Dr. Frederick Mohs developed this technique in the 1930’s, and it is now used widely for certain skin cancers, especially certain basal and squamous cell skin cancers. Mathew Davey, M.D. FAAD and James Shehan, M.D. FAAD are both members of The American Society for Mohs Surgery.

Surgical Dermatology 

At the time of the surgery, the dermatologist uses local anesthesia to numb the skin, just as was done with the initial biopsy. A section of skin including the visible cancer with a thin rim of normal tissue is removed. The section of skin is then taken down the hall to our CLIA-certified Mohs laboratory, where it is frozen, cut into microscopic-thin sections, stained, and then examined under the microscope by the dermatologist to determine if all of the cancer has 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 this surgery, because the final size and extent of the skin to be removed to clear you of the 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 most recent PT/INR levels immediately.
  2. Have an artificial joint, artificial heart valve, any other implanted electrical devices 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 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

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.

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