10 Questions to Ask Your Dermatologist Before Mohs Surgery
Why Asking Questions Matters
Being diagnosed with skin cancer and told you need surgery is a lot to process. In that initial moment, it can be hard to think clearly or know what to ask. Many patients leave their consultation with lingering questions they wish they had raised.
There is no such thing as a question that is too basic or too detailed when it comes to your health. A good surgeon welcomes questions because informed patients make better decisions, follow post-operative instructions more carefully, and experience less anxiety. Dr. Yehonatan Kaplan encourages every patient to come to their consultation prepared.
Here are the ten questions that matter most, along with the context behind each one.
1. What Is the Cure Rate for My Specific Type of Skin Cancer with Mohs Surgery?
Why this matters. Not all skin cancers respond identically to treatment, and knowing the expected cure rate for your specific diagnosis helps you understand the effectiveness of the recommended approach.
What to expect. Mohs micrographic surgery has a cure rate of approximately 99 percent for basal cell carcinoma (BCC) and 97 percent for squamous cell carcinoma (SCC) when treating primary tumors. For recurrent tumors, those that have come back after previous treatment, the cure rates are still excellent at approximately 94 to 96 percent, which is significantly higher than repeat standard excision.
To understand the science behind these numbers, read our article on why Mohs surgery achieves a 99 percent cure rate.
2. Are There Alternatives to Mohs Surgery for My Cancer?
Why this matters. Understanding your options allows you to make a truly informed decision. While Mohs surgery is the gold standard for many skin cancers, it is important to know whether alternatives exist for your specific situation.
What to expect. Depending on the type, size, and location of your skin cancer, alternatives may include standard surgical excision, curettage and electrodesiccation, radiation therapy, or topical treatments. However, for skin cancers in cosmetically sensitive areas, recurrent cancers, or tumors with aggressive features, Mohs surgery offers clear advantages in terms of cure rate and tissue preservation. Your surgeon should explain why Mohs was recommended over these alternatives.
3. What Is Your Reconstruction Plan?
Why this matters. Reconstruction is not just about closing the wound. It determines how you will look after healing. Understanding the plan in advance helps set realistic expectations.
What to expect. Dr. Kaplan develops a preliminary reconstruction plan before surgery begins, though the final approach depends on the size and shape of the wound after complete cancer removal. Ask about the specific options: direct closure, local skin flaps, or skin grafts. A surgeon who performs the reconstruction immediately after cancer removal, rather than referring you to a different specialist, offers the advantage of continuity since the person who understands the defect best is the one repairing it.
For details on reconstruction in specific areas, see our articles on Mohs surgery for the nose and Mohs surgery on the eyelid, ear, and lip.
4. How Long Will the Procedure Take?
Why this matters. Practical planning requires knowing how much time to set aside. Many patients are surprised to learn that Mohs surgery can take several hours.
What to expect. Plan to be at the hospital for 3 to 5 hours, though some cases may be shorter and some longer. The actual surgery involves relatively brief periods of tissue removal, typically 10 to 15 minutes per layer, interspersed with waiting periods of 30 to 45 minutes while each layer is processed and examined. Most tumors require 1 to 3 layers. The reconstruction adds another 30 to 60 minutes.
For a complete breakdown of the day, see our guide on how to prepare for Mohs surgery.
5. What Type of Anesthesia Will Be Used?
Why this matters. Many patients worry about being awake during surgery. Understanding the anesthesia approach can significantly reduce this anxiety.
What to expect. Mohs surgery is performed under local anesthesia, similar to what you receive at the dentist. The surgical area is completely numbed, so you should feel no pain during the procedure. You will be fully awake and alert. General anesthesia is almost never required. The initial injection of local anesthesia involves a brief pinch and sting, but once it takes effect, the area is completely numb. Additional anesthesia is given before each subsequent layer, so you remain comfortable throughout.
6. How Many Layers Are Typically Required?
Why this matters. This question helps you understand how long the procedure is likely to take and what the cancer's complexity might be.
What to expect. Most skin cancers require 1 to 3 layers of Mohs surgery before the margins are completely clear. However, some tumors, particularly recurrent cancers, cancers in challenging locations, or those with aggressive growth patterns, may require additional layers. Each additional layer means another 30 to 45 minute waiting period. Dr. Kaplan cannot predict the exact number in advance because it depends on how far the cancer extends beneath the surface, which is precisely what Mohs surgery is designed to determine.
7. Who Will Perform the Reconstruction?
Why this matters. The quality of reconstruction directly affects your cosmetic outcome. Knowing who will repair the wound, and their experience, is important.
What to expect. In an ideal scenario, the Mohs surgeon performs the reconstruction as part of the same procedure. Dr. Kaplan is trained in both Mohs surgery and reconstructive techniques, meaning you receive continuous care from start to finish. In some complex cases involving the eyelids or ears, a specialist such as an oculoplastic surgeon may be involved. Ask about this in advance so you know the plan.
8. What Does Insurance Cover?
Why this matters. Understanding your financial obligations before surgery eliminates unwelcome surprises afterward.
What to expect. In Israel, Mohs surgery for skin cancer is covered under the national health insurance system. Maccabi patients can have their surgery performed at Assuta Hospital, while Clalit patients can be treated at Herzliya Medical Center. Bring your insurance card and any required referral documents to your appointment. If there are any out-of-pocket costs, such as for specific reconstructive procedures, ask about these during your consultation so you can plan accordingly.
9. What Is the Follow-Up Schedule After Surgery?
Why this matters. Skin cancer can recur, and patients who have had one skin cancer are at increased risk of developing new skin cancers. Regular monitoring is essential for long-term health.
What to expect. After Mohs surgery, Dr. Kaplan typically schedules a wound check within 1 to 2 weeks to remove stitches and assess healing. Following that, follow-up skin examinations are usually recommended every 6 months for the first 2 years, then annually afterward. These visits serve two purposes: monitoring the surgical site for recurrence and performing a full skin examination to detect any new skin cancers early.
The follow-up schedule may be adjusted based on your individual risk factors, including how many skin cancers you have had, your skin type, and your sun exposure history.
10. What Happens if the Cancer Comes Back?
Why this matters. While Mohs surgery has the highest cure rate of any skin cancer treatment, no procedure offers a 100 percent guarantee. Understanding what would happen in the unlikely event of recurrence provides peace of mind.
What to expect. If skin cancer recurs after Mohs surgery, which happens in approximately 1 percent of BCC cases and 3 percent of SCC cases, it can usually be treated again with Mohs surgery. Recurrent tumors are often detected early during routine follow-up examinations, when they are small and more easily treated. This is one of the important reasons why keeping your follow-up appointments is essential.
In the rare case that a tumor recurs, Dr. Kaplan will discuss all treatment options with you, including repeat Mohs surgery, radiation therapy, or other approaches tailored to your specific situation.
Bonus: Questions About Your Specific Situation
Beyond these ten core questions, you may want to ask about preparation (see our pre-surgery checklist), when you can return to work (see our activity guidelines), what the scar will look like (see our article on minimizing scars), and whether you can see before-and-after photos from similar procedures.
Being Your Own Advocate
Asking these questions is not about questioning your surgeon's ability. It is about being an active, informed participant in your own healthcare. Write your questions down before your consultation so you do not forget them in the moment, and bring a family member or friend who can help remember the answers.
Your skin cancer is treatable, and understanding your treatment is one of the most powerful things you can do to feel prepared and confident going into surgery.