Mohs Surgery: Complete Before & After Instructions

Preparing for Mohs Surgery: Why It Matters

When your Mohs surgery date is scheduled, it is natural to feel a mix of relief and anxiety. Relief because you have a clear plan to treat your skin cancer. Anxiety because surgery is surgery, no matter how routine it may be. The good news is that being well-prepared can significantly reduce your stress and help the day go as smoothly as possible.

Dr. Yehonatan Kaplan performs Mohs surgery at Assuta Hospital and Herzliya Medical Center (HMC), and his team provides detailed pre-operative instructions to every patient. This guide expands on those instructions so you can walk into your appointment feeling informed and ready.

Medications

Continue taking all your regular medications without any changes. There is no need to stop or modify medications before Mohs surgery.

Bring a complete list of all medications and supplements you take to your pre-operative consultation.

What to Eat and Drink

Mohs surgery is performed under local anesthesia, which means you do not need to fast beforehand. In fact, eating a good meal before your appointment is strongly recommended.

Eat a nutritious breakfast or lunch. The procedure can take several hours, and you want to have steady energy throughout the day. Choose foods that are filling and balanced, such as eggs, whole grain toast, fruit, or a sandwich. Avoid anything that might upset your stomach if you tend to feel nervous.

Stay hydrated. Drink water or other non-caffeinated beverages. While moderate coffee consumption is fine, avoid excessive caffeine, which can increase anxiety and may slightly increase bleeding.

Bring snacks. Because the procedure involves waiting periods between each layer of tissue removal, having snacks on hand is a practical choice. Pack something simple like nuts, a granola bar, or fruit.

What to Wear

Your clothing choice matters more than you might think, especially depending on where your surgery will be performed.

If surgery is on your face, head, or neck, wear a button-down or zip-up shirt. You will want to avoid pulling clothing over your head after the procedure, as this could disturb your bandage or cause discomfort.

If surgery is on your body or limbs, wear loose, comfortable clothing that allows easy access to the surgical site. Layers are also helpful since hospital rooms can be cool.

Wear comfortable shoes. You will be at the hospital for several hours, and comfort should be your priority.

Leave jewelry at home. Remove any jewelry near the surgical site before arriving. It is simplest to leave watches, necklaces, and earrings at home on the day of surgery.

Transportation

Arrange a ride. While Mohs surgery uses local anesthesia and you will be fully alert throughout, it is strongly recommended that someone drive you to and from the hospital. If your surgery is near your eyes, bandaging may temporarily limit your vision. Additionally, after spending several hours in a medical setting, most patients prefer not to drive. If you are having surgery at Assuta or Herzliya Medical Center, be aware that parking can be busy, so a drop-off arrangement is often most convenient.

Plan for a companion. Having a friend or family member with you provides both practical support and emotional comfort. They can help carry your belongings, keep you company during the waiting periods, and drive you home afterward.

What to Bring

Because Mohs surgery involves periods of waiting while tissue samples are processed and examined under the microscope, plan to keep yourself occupied.

Entertainment. A book, magazine, tablet, or downloaded shows on your phone can make the waiting time much more pleasant. The processing time for each layer is typically 30 to 45 minutes.

Phone and charger. A portable phone charger is especially useful since the procedure can last several hours.

Snacks and water. As mentioned above, pack light snacks and a water bottle.

A list of your medications. Bring a complete list of all medications and supplements you take, including dosages.

Your insurance information. Have your Maccabi or Clalit insurance card and any required referral documents ready.

Reading glasses. If you need them for your phone or book.

A small pillow or neck support. This is optional but can make waiting in a chair more comfortable, especially if your surgery takes several hours.

Mental Preparation

Being psychologically ready for surgery is just as important as the physical preparation. Here are strategies that Dr. Kaplan's patients have found helpful.

Understand the procedure. Knowledge reduces fear. If you have not already, read our complete guide to Mohs surgery so you know exactly what will happen at each stage. Patients who understand the process tend to feel calmer and more in control.

Acknowledge your feelings. It is completely normal to feel scared, anxious, or overwhelmed. These feelings do not make you weak. They make you human. Many patients find that simply naming their anxiety reduces its power.

Focus on the outcome. Mohs surgery has a 99 percent cure rate for basal cell carcinoma and 97 percent for squamous cell carcinoma. You are choosing the most effective treatment available. That is an empowering decision.

Practice relaxation techniques. Deep breathing, progressive muscle relaxation, or guided meditation can be helpful in the days leading up to surgery and during the waiting periods on the day itself.

Ask questions in advance. If there is anything you are unsure about, do not wait until surgery day to ask. Contact the clinic beforehand. You may also want to review our list of 10 questions to ask your dermatologist before Mohs surgery.

Timeline: What to Expect on Surgery Day

Understanding the timeline helps set realistic expectations.

Arrival (15 to 30 minutes before). Check in at the hospital and complete any remaining paperwork.

Preparation (15 to 20 minutes). The surgical area is cleaned and marked. Local anesthesia is administered. This involves a brief pinch and sting that subsides quickly.

First layer removal (10 to 15 minutes). The visible tumor and a thin layer of surrounding tissue are removed.

Laboratory processing (30 to 45 minutes). While the tissue is being processed and examined, you wait comfortably.

Additional layers if needed (variable). If cancer cells are detected at any margin, additional targeted layers are removed. Most cases require one to three layers, though some may require more.

Reconstruction (30 to 60 minutes). Once the site is cancer-free, the wound is repaired with the most appropriate technique for your specific situation.

Post-operative instructions (10 to 15 minutes). You receive detailed wound care instructions and any prescriptions needed.

Total time: Plan for 3 to 5 hours. While some procedures are shorter, it is best to block out the full day and not schedule other commitments.

The Night Before

The evening before your surgery, take some time to prepare so the morning goes smoothly.

Lay out your clothes. Choose your outfit based on the guidelines above.

Pack your bag. Gather your book, charger, snacks, insurance cards, and medication list.

Set your alarm. Give yourself plenty of time in the morning to eat breakfast, take your regular medications, and arrive without rushing.

Get a good night's sleep. This is easier said than done when you are feeling nervous, but try to go to bed at your usual time. Avoid screens for the last hour before sleep, and consider a warm shower or calming music to help you relax.

Shower and clean your skin. Wash the surgical area gently with soap and water. Do not apply any creams, lotions, makeup, or sunscreen to the area on the morning of surgery.

After Surgery: Recovery and Wound Care

Once Dr. Kaplan confirms that all margins are clear and the reconstruction is complete, you will receive personalized aftercare instructions. The following guidelines apply to most patients.

The First 24 Hours

Keep the bandage in place. Do not remove or change the original bandage for the first 24 hours unless instructed otherwise. The pressure dressing helps control bleeding and protect the wound.

Minor bleeding is normal. If blood seeps through, apply gentle, steady pressure with a clean gauze pad for 20 minutes without peeking. If bleeding does not stop after 20 minutes of continuous pressure, contact the clinic.

Apply ice packs. During the first 48 hours, apply a cold pack wrapped in a thin towel to the area for 20 minutes on and 20 minutes off. This is especially important after surgery on the face, where swelling and bruising can be more noticeable.

Sleep with your head elevated. Use an extra pillow or two to keep your head above your heart level. This reduces swelling and helps with comfort, particularly after facial surgery.

Rest. Avoid bending over, lifting heavy objects, or any strenuous activity for the remainder of the day.

Pain Management

Use Paracetamol (Acamol) for pain relief. Most patients find that mild to moderate discomfort is well controlled with Paracetamol taken as directed on the package.

Avoid Aspirin, Ibuprofen (Advil, Nurofen), and similar anti-inflammatory drugs for two weeks. These medications thin the blood and increase the risk of bleeding. If you take Aspirin daily for a medical condition, consult Dr. Kaplan before stopping it.

Take antibiotics as prescribed. If Dr. Kaplan prescribes a course of antibiotics, complete the entire course even if you feel fine. Not all patients receive antibiotics, only if needed based on the location and extent of surgery.

Daily Wound Care (Days 2 Through Suture Removal)

Change the bandage once daily. Gently remove the old bandage. If it sticks, moisten it with clean water or saline to loosen it. Clean the wound with mild soap and water, pat dry with a clean gauze, apply a thin layer of Vaseline (petroleum jelly) to keep the wound moist, and cover with a fresh bandage.

Keep the wound moist. A moist wound heals faster and with less scarring than a dry one. Vaseline is preferred over antibiotic ointments, which can sometimes cause allergic reactions.

Showering is allowed after 24 hours. Let lukewarm water run gently over the wound. Do not scrub or soak it. Avoid swimming pools, hot tubs, saunas, and baths for at least two weeks.

Activity Restrictions (First Two Weeks)

Avoid strenuous exercise including running, weightlifting, cycling, and swimming. Increased blood pressure during exercise can cause the wound to bleed or the sutures to pull apart.

Avoid alcohol for at least 48 hours after surgery, as it increases bleeding risk.

Limit sun exposure. If the surgical area is exposed to sunlight, cover it with a bandage. Once fully healed, apply SPF 50+ sunscreen daily to the scar for at least 12 months to minimize discoloration.

Return to work. Most patients can return to desk work within one to two days. Physically demanding jobs may require a longer break. Discuss timing with Dr. Kaplan.

Suture Removal

Follow-up appointment in 7 to 14 days. Sutures on the face are typically removed after 5 to 7 days. Sutures on the body or limbs remain for 10 to 14 days. Dr. Kaplan will schedule this appointment before you leave the hospital.

When to Contact the Clinic

Call Dr. Kaplan's office if you experience any of the following:

Long-Term Follow-Up

Annual skin examinations are recommended for all patients who have had skin cancer. Having had one skin cancer increases your likelihood of developing another. Dr. Kaplan will schedule regular follow-up appointments to monitor both the treated area and your skin overall.

You Are Ready

By following these before and after instructions, you are giving yourself the best chance for a smooth procedure and optimal healing. Mohs surgery is a highly controlled, well-established procedure with the highest cure rate available. Dr. Kaplan and his team will be with you every step of the way.