Dermatology - Osprey
2179 South Tamiami Trail Suite 101
Osprey, FL. 34229
Phone (941)966-0222

Fax (941)966-5100

Are skin cancers life-threatening?
Basal cell carcinomas (also referred to as basal cell epitheliomas) are the most common form of skin cancer and are extremely unlikely to be life threatening. Squamous cell carcinomas, the second most common skin cancer, are also rarely life threatening. These tumors replace normal surrounding tissue and generally do not spread to other areas. The third most common skin cancer, malignant melanoma, can be life threatening if treated late. When discovered and treated early, malignant melanoma may be cured. Basal cell carcinomas and squamous cell carcinomas never '-turn into" malignant melanoma.

What are possible treatment options for Basal Cell and Squamous Cell Carcinomas?
There are several effective treatments: curetting (scraping) the cancer, freezing the cancer, radiation therapy, topical anti-cancer creams, standard excision, & Mohs surgery.

What does "Mohs" stand for?
Dr. Frederic Mohs developed this technique almost 70 years ago. The procedure has been modified and refined over the years. Practitioners of the technique have kept Dr. Mohs' name out of respect for his contribution. It has also been called Mohs chemosurgery and Mohs micrographic surgery.

What makes Mohs surgery different from other types of surgery?
The difference is what happens to the tissue after it is removed. After removing all obvious tumor, the surgeon removes a thin layer of normal-appearing skin surrounding the cancer. A map is made of the specimen. It is then processed in the laboratory (the processing takes approximately one hour). The surgeon then examines the specimen under the microscope. If cancerous cells are present in the specimen, the corresponding location on the map is marked. The Mohs surgeon then returns to the patient and removes more tissue only in the area where the cancer remains (which will once again be processed in the lab). This is repeated, if necessary, until the tumor is completely removed.

What are the advantages of Mohs surgery?
The two main advantages of Mohs surgery are cure rates and skin conservation. Since microscopic examination of the tissue is used as a guide, the Mohs surgeon is better able to remove the skin cancer while leaving behind as much normal skin as possible. Mohs surgery offers the highest cure rate of any other cancer removal procedure.

Will I have a scar after surgery and how large will it be?
Anytime the skin is cut a scar is formed. The goal of the surgeon is to maintain function & minimize the appearance of the scar as much as possible. The size of the scar depends on the size & location of the tumor. It's often difficult to predict the tumor size before surgery.

Will I have stitches following the surgery?
There are 3 main ways your surgical wound may be handled and will be fully discussed with you on your day of surgery.

  1. Direct closure of the wound: In most cases, surgical wounds are sutured (sewn) together.
  2. Skin graft: In some instances, it is necessary to remove skin from another location (in front of your ear. behind your ear, etc.) and graft it over the wound.
  3. Second intention healing; The body has an excellent capacity to heal open wounds. This healing period is approximately four to eight weeks. depending on the size of the wound. It requires regular wound care.

Will I be put to sleep for the surgery?
No. The surgery is well tolerated with local anesthesia, thus sparing you the possible side effects of general anesthesia.

How long will the surgery last?
The length of the surgery depends on the extent of the tumor. Often surgery lasts the better part of a day. Much of the time is spent waiting for the tissue to be processed. Prepare to spend the whole day. Bring reading materials, needlework, etc. to help pass the time.

Should I bring someone with me?
Yes. It is essential that you bring someone with you, as most people do not want to, and may be unable to, drive after surgery. Often, someone other than the patient must help in postoperative wound care. That person can be given direct instructions, have wound care demonstrated for them, and answer any question after the surgery.

Should I eat breakfast before the surgery?
Yes, breakfast is recommended. If your surgery appointment is at 1pm, we recommend you eat lunch beforehand.

Should I take my regular medications on the morning of the surgery?
Yes. Take your regular medications as they have been prescribed.

Are there any medications I should avoid prior to surgery?
We would prefer that you continue to take all of your pre,scribed medications prior to your surgery, including blood thinners. If your physician has prescribed or recommended that you take blood thinning medications such as aspirin. coumadin, ibuprofen (Motrin, Advil), naproxen (AlIeve). Persantine, and/or Plavix, please continue to take them. Please bring all of your medications with you (or a complete list) on the day of surgery. Certain vitamins (Vitamin E) and herbals (Ginseng, Ginkgo Biloba, Garlic pills) should be stopped 2 weeks before surgery.

I have taken antibiotics in the past for other medical and/or dental procedures. Do I need to take antibiotics before surgery?
If you have ever taken antibiotics prior to dental or other surgical procedures, or have a history of rheumatic fever, heart murmur, artificial heart valves, or artificial joints, please call our office prior to your Mohs surgery to discuss the need for antibiotic prophylaxis.

What if I recently had cataract surgery?
Consult with your eye surgeon as to how soon you may undergo Mohs surgery. If your lesion is close to your eye, he or she may advise you to Walt a few weeks.

What are the potential complications of surgery?
Bleeding and infection are the two primary complications. Both are uncommon. We will discuss how 10 recognize and deal with these problems when you come for your surgery.

Who will be my Mohs Surgeon?
Dr, Heather S. Larabee graduated college from West Virginia University. After spending a year conducting research, she attended medical school at the West Virginia University School of Medicine. and performed her Internal Medicine Internship at the Charleston Area Medical Center in Charleston, WV. Dr. Larabee was then accepted into a Dermatology Residency program at the University of North Carolina in Chapel Hill, NC, and became a Board Certified dermatologist. Upon completion of residency, she returned to her home state of Pennsylvania and was in private practice with a large dermatology group for three years. During that time, she was also a Clinical Assistant of Dermatology at Penn State Milton S. Hershey Medical Center. In 2005 she embarked on a Mohs fellowship/Procedural Dermatology Surgical fellowship at Geisinger Medical Center, in Danville, PA She has since finished her fellowship and has joined Dr. Stephanie Caradonna at the Sarasota Skin and Cancer Center, and performs over 1000 surgeries per year.