No real preparation, other than a good night's sleep, is required. Eat a light breakfast on the day of surgery and if you are on any medications, take them as usual unless directed otherwise. Most doctors, but not the website author, request patients avoid aspirin (or any medications such as Bufferin, Anacin, Nuprin or Advil, which contain aspirin or are aspirin-like) for ten days prior to surgery as aspirin tends to prolong bleeding during the operation. Try to have a relative or a friend with you for company ,or bring a good book or magazine with you. You may be spending a good portion of the day with other Mohs patients in the waiting room while the microscopic slides are being prepared and interpreted. Because there is usually no way to know in advance the extent of surgery that will be necessary, you need to be prepared to spend the day at the office.

At the time of your visit, before you have Mohs Surgery, you may be interviewed. Please bring an up-to-date list of the medicines you take regularly.

Your surgery will usually be scheduled for early morning. This allows your doctor to complete the surgical steps in one day and relieves you of having to make another trip into the office the next day.

The actual procedure is as follows:

1.	The nurse will escort you to the procedure room. A local anesthetic will be injected into the area of surgery to numb the skin. This is usually the only part of the surgery that will cause discomfort. Be sure to inform the doctor if you do experience any discomfort during the surgery.
2.	Once the area is numb, a layer of tissue corresponding to the visual estimate of the extent of tumor will be removed. Unless the cancer is quite small, this may be an underestimate. Remember, it is always better to remove too little initially and to perform a second stage than to remove more uninvolved normal skin than necessary.
3.	Bleeding will be stopped with a machine that coagulates the blood vessels, a dressing will be applied and you will return to the waiting room. IF YOU HAVE A PACEMAKER, please notify your skin-cancer surgeon and your cardiologist or internist well in advance of surgery, so they may discuss electrocoagulation. Newer pacemaker models are relatively well insulated, compared to older models.
4.	The tissue specimen (stage) will be taken to the laboratory where it will be processed by a technician and examined by the doctor for presence of skin-cancer cells at the outside margins.
5.	If microscopic examination reveals remaining tumor, a map will be drawn indicating the precise location.
6.	Then you will be brought back to the operating suite and additional anesthetic will be injected to reinforce the first injection. In most cases, the initial anesthetic will not have worn off so you will feel little or no discomfort from the additional injection.
7.	If a second stage is necessary, it will involve the removal of another layer of tissue only where the map indicates residual cancer. The healthy tissue will not be disturbed and only the diseased tissue will be excised.
8.	This tissue will be taken to the laboratory. The process will be repeated until all cancer is removed.

The author continues to operate one of the first labs in the world to allow patients, if they wish, to observe all aspects of the processing of their own specimens and preparation of the glass slide. Patients are easily taught how to read their own slides and to compare what they see with a medical textbook on cell pathology.

The average tumor requires one to four stages for removal in the hands of most certified Mohs surgeons of the American COLLEGE of Mohs Surgery. Do not be discouraged if your cancer is not removed in one step. The Mohs surgeon is tracing the extent of the tumor very carefully and trying very hard not to remove any uninvolved normal tissue. Only by removing small layers carefully and meticulously can this be done. Sometimes, the most difficult part of the procedure is waiting for the results of the surgery. It usually takes 10 minutes to prepare the slides (using special methods developed and published in the official Mohs journal by the website author) although sometimes it may take longer depending upon how large your tumor is and how many other patients are having Mohs surgery the same day. It might help to bring a book. Most patients are finished by midday, although you should be prepared to spend most of the day, if necessary. If you must stay through the afternoon, you may have a light lunch, but please do not consume alcoholic beverages. Alcohol dilates blood vessels and promotes bleeding.