FAQ | NESSC

Dr. Helen Raynham

Dr. Loreen Ali

Dr. Suzanne Freitag

Dr. Christine Hayes

FAQ

Here are some questions that our patients frequently ask us. Hopefully these answers will help you and make your surgery day more comfortable.

What is basal cell carcinoma?
What is basal cell carcinoma? Basal cell carcinoma is the most common type of skin cancer. It does not spread to distant sites, however if not removed it might continue to grow leading to a non- healing sore. Some basal cell carcinomas if left untreated for many years, can cause local tissue destruction. This might result in deformities of the eye, nose or ear, if the tumor is already growing in those areas.
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What is squamous cell carcinoma of the skin ?
What is squamous cell carcinoma of the skin ? Squamous cell carcinoma is a type of skin cancer that can be cured if treated early. If left untreated, and if it is an aggressive subtype, there is an extremely small risk that it might spread to the lymph nodes.
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Why did I get a skin cancer?
Why did I get a skin cancer? Skin cancers develop from multiple causes. One of these is sun exposure, especially as a child. In addition, skin cancer is more common in certain families, particularly those with fair complexions.
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Are skin cancers life threatening?
Are skin cancers life threatening? Basal cell carcinomas and squamous cell carcinomas are rarely life threatening. They generally do not spread to other areas. Malignant melanoma, the third most common form of skin cancer, can be life threatening if treated late. Melanoma if treated early, can be cured. Squamous cell carcinoma and basal cell carcinoma do not become or turn into malignant melanoma.
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What is Mohs surgery?
What is Mohs surgery? Mohs surgery is a type of skin cancer treatment in which the physician uses both surgery and the microscope when removing a skin cancer. It is called Mohs surgery, after Dr. Frederic Mohs, who developed this technique about 65 years ago. This procedure has been refined and modified over the past years. Mohs surgery is also called Mohs micrographic surgery. Mohs surgery offers the highest cure rate for skin cancers such as basal cell carcinoma and squamous cell carcinoma.
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How is Mohs surgery different from other types of surgery?
How is Mohs surgery different from other types of surgery? The difference is that the surgeon exams the tumor tissue under the microscope after the tumor removal. Specifically, after the removal of the obvious skin cancer, the surgeon takes a small layer of normal appearing skin surrounding the tumor. A map is made of the skin specimen which is removed. It is then processed in the laboratory. The processing takes about thirty minutes to one hour. The surgeon then looks at the specimen under the microscope. If tumor is present at the edge of the specimen, then the Mohs surgeon marks the area on the map, and returns to the patient and removes more tissue in that location on the patient. This process is repeated if necessary until the tumor is 100% removed.
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How long will my surgery last?
The length of the surgery varies, depending on how large the tumor is and depending on whether the surgeon needs to remove more tissue after the first stage of tumor removal. Most of your time at the office will be spent waiting while the tumor is processed. You should expect to be at the office for at least 3 to 4 hours, and some surgeries might continue for up to 6 hours.
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What should I bring with me and what should I wear?
You might want to bring some reading material to keep you busy while you wait for your results. We also have wireless internet which you can access if you bring a laptop. We recommend you wear a button down shirt or top, so that it can easily be removed or put back on without disturbing any bandages. We also encourage patients to wear comfortable clothes. If you are having surgery on your arm or leg, please ensure that you wear clothes that will stretch and will not be too tight over bandages in those areas.
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Should I bring anyone with me?
Yes, we recommend you bring someone with you. Since you might be at the office for a number of hours, many of our patients are reassured by having a family member or friend present for the procedure. In addition, we can also share wound care instructions with your companion. Furthermore, many of our patients are unable to drive home afterwards, as bandages might prevent their glasses from being worn correctly.
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Should I skip breakfast before the surgery?
We recommend you eat a small breakfast before surgery. If you will be having further surgery with another doctor later in the day, we recommend you check with that doctor about your breakfast.
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Should I take all of my medications on the day of the surgery?
Yes, take all of your prescribed medications for the morning, unless your primary care physician has specifically instructed you to stop a particular medication.
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Will I have a scar?
Whenever a person has surgery on the skin, there always is a risk of scarring. Furthermore, incisions change after surgery and what you see at 2 weeks after surgery is very different from what you see at 6 months after surgery. Our doctors will make every effort possible to give you the best cosmetic result.
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Do I need to take antibiotics before the surgery?
If you have had to take antibiotics before dental work or any other type of surgery in the past, we should review this issue prior to your surgery. This can be done at your initial office visit/consultation with our doctors before the day of surgery. If you will have surgery on your initial visit with our doctors, we will review this issue over the telephone prior to your visit.
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Can I have surgery if I have a pacemaker?
Yes, we do perform surgeries on patients with pacemakers. However, you must inform the doctor and her staff about your pacemaker, and we will use a special device that will not interfere with your pacemaker.
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Will I be able to exercise or go back to work after surgery?
We recommend you avoid any significant exercise for the week after surgery. If you are having surgery on your leg, we recommend you avoid strenuous leg exercises for at least two weeks. If you are having surgery on your face, you will have a bandage and stitches for one week. Therefore, you might want to delay your return to work for one week.
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How should I clean my incision?
Detailed wound care instructions will be given to you after surgery. Some of these can be downloaded from this website.
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What do I do for pain?
If you are having pain after the surgery, we recommend you take extra strength Tylenol. However, if your pain persists please call the office at 781-431-0060 or at 978-244-0060, so that we can prescribe you medication.
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What if I have a concern or problem after the surgery?
If you are concerned about anything after the surgery, do not hesitate to call our office. If it is after hours, you can reach the doctor on her pager.
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Will insurance cover the procedure?
Yes, in most circumstances the majority of the procedure will be covered by you health insurance. If you have any questions, do not hesitate to contact our staff about insurance coverage.
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Do I need a referral for my visit?
In most cases, you will need a referral from your primary care physician depending on your insurance type. Your primary care physician’s office can obtain our doctor’s provider numbers which are necessary for the referral, by calling our office. Most primary care physicians will provide 3 referrals which will cover all of your visits with us.
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Once I have completed all necessary post-operative visits with the doctor, who do I see for my future skin care?
You should make sure to follow up with your own general dermatologist. Our doctors apologize that they do not perform general skin checks. If you were referred by a doctor other than a dermatologist, our doctors recommend that you see a dermatologist for general skin checks at least once a year.
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