Day of Mohs Surgery

The day of your Mohs surgery is a series of coordinated tasks between you, Dr. Joseph Greco, and the laboratory resulting in the successful removal of the skin cancer and reconstruction. Below is a brief synopsis of the day’s events.

two women sitting with a table between them

Before the Surgery

Dr. Greco and his staff will review your medical history, allergies, and medications. He will examine the tumor and discuss the biopsy results with you, as well as what outcome to expect.

Dr. Greco’s Bedside Manner

Because Dr. Greco fully understands that many patients coming in for surgery are typically anxious, he always tries to keep appointments as lighthearted and as fun as possible. He plays Spanish guitar music to keep you relaxed, and he will treat you like an old friend. Dr. Greco’s personal touch and excellent bedside manner are part of why his patients appreciate him so much.

The Steps

The treatment site will be cleaned with alcohol, marked, measured, and photographed.
Local anesthesia will be used to numb the site (much like the original biopsy).
Dr. Greco will obtain the skin sample along with a margin of healthy-looking skin (the is the Mohs layer or “stage”), which will be taken to the laboratory.
Next, you may hear a buzzing sound. This is the cautery we use to stop the bleeding. A compressive bandage will be placed.
You will remain in the procedure room and enjoy a quiet and restful period along with the option to listen to music or watch TV, a movie, or your choice of a streaming program.

Meanwhile, the Mohs layer is embedded and processed in a certain orientation to allow Dr. Greco to examine 100% of the margin. This is the most time-consuming part of the process. On average, this takes 30-60 minutes, depending on the size of the specimen.
Once the tissue has been examined by Dr. Greco, you will be informed if another deeper/wider layer must be taken or if the cancer has been completely removed. Some cases may require more than one layer in order to clear the cancer. As the number of layers is determined by the location and growth of the cancer, be prepared to spend at least 2-4 hours with us.
Once the cancer is completely removed, Dr. Greco will discuss the repair options with you. Most of the time sutures (stitches) are required, but sometimes the best course of action may be to let the area heal by itself (granulation) to delay the repair several days or weeks, or even to coordinate with a plastic or oculoplastic surgeon. If suturing is needed, Dr. Greco utilizes advanced reconstructive and suturing techniques.

Mohs Surgery: The Most Effective Treatment for Skin Cancer

The Importance of Being Fellowship-Trained

When you choose to work with Greco Dermatology, you can feel confident and assured you’re in the excellent hands of a fellowship-trained Mohs surgeon. In addition to being fellowship-trained himself, Joseph F. Greco, M.D. also trained other fellows at UCLA in Mohs surgery. Fellowship-trained Mohs surgeons must undergo:

A competitive application, review, and selection process to be chosen for training
Extensive hands-on direction and education from highly qualified trainers who are themselves skilled practitioners of the Mohs procedure
1-2 years of additional training after residency
Exposure to rare tumor pathology, difficult tumor locations, and complex wound reconstruction
A minimum of 650 cases during training

Post-Operative Mohs Surgery: What to Expect

You will leave our office with post-operative instructions and any prescriptions you may need. A follow-up appointment in 1-2 weeks is usually scheduled.

Side effects after the Mohs procedure are typically minimal, but they can include bleeding, infection, some swelling, and some mild to moderate pain.

You can expect to see results immediately with respect to the removal of the skin cancer and within 1-2 weeks of healing time.

Scarring is often imperceptible, and our attention detail to minimize scarring doesn’t end at the date of procedure. We monitor you for several months with that scar specifically to make sure it heals to the best of its natural ability. However, if other finishing touches need to be done, we offer dermabrasion, resurfacing, laser technology, bio-enhanced scar therapy with growth factors, or even scar micropigmentation and cosmetic tattooing.

Mohs Surgery Post-Care Instructions

A Comfortable Environment

Greco Dermatology provides soothing, spacious rooms with music and flat screen TVs to keep you entertained during the procedure. It’s important to us that you’re relaxed and as comfortable as possible during your surgery. In addition, several levels of free covered parking are available in the building. Access to the building parking garage is off Ringling Blvd. Park in any visitor parking space. Take the elevator to the 7th floor, Suite 700.

Local Restaurants and Attractions

For patients or their family/friends who are expected to be there for an extended period of the day, we’re happy to let you know that our office is located in the heart of downtown Sarasota — just steps away from many fashionable and trendy bistros, the Regal Hollywood movie theater, and numerous other downtown attractions.

Why Choose Dr. Greco?

At Greco Dermatology, your visit will be centered around an exceptional experience. You can be certain that Joseph F. Greco, M.D. will detect the issue and expertly perform your surgery. Not only are Mohs micrographic surgery and excision surgery our primary services; Dr. Greco is double board-certified by The American Board of Dermatology in Dermatology and Micrographic Dermatologic Surgery. He was also fellowship-trained in Mohs micrographic surgery, reconstructive surgery, cutaneous oncology, and laser surgery. He is a member of The American College of Mohs Surgery and served as Director of UCLA Santa Monica Dermatology and Dermatologic Surgery for 12 years. He has authored an extensive list of book chapters, publications, and national lectures, and he has been recognized annually by peers as a SuperDoctor® in Southern California (2016-2022) as well as a TopDoctor® in Los Angeles in 2018. He has performed over 20,000 Mohs and surgical excision procedures. In short, his experience is unique and extensive — and if you’re seeking a Mohs surgeon in Sarasota, he is the ideal choice for you.