After completing the necessary intake information, our staff will escort you into a surgical room. Photographs will be taken, and we will obtain written consent for the procedure. You are encouraged to ask any questions that you may have prior to starting. Once all of your questions are answered, we will anesthetize (numb) the area around the skin cancer. Once anesthetized, the visible cancer and a thin layer of tissue around the cancer will be removed. This tissue is carefully mapped and color-coded by the surgeon and taken to the adjacent laboratory in our office where the technician will immediately process the tissue to make microscope slides. This is done in a way to allow careful examination of the entire surgical margin. You will have a temporary dressing placed over the wound, and you will return to the waiting room as the tissue is processed.

The initial surgical procedure to remove the first layer of tissue takes only 15-20 minutes. However, it takes on average 90 minutes to prepare and microscopically examine the tissue, depending on the size, type of tissue and type of cancer being treated. If any tumor is seen during the microscopic examination, its location is established using the map and a thin layer of additional tissue is excised only from the involved area. Several layers of tissue and subsequent microscopic examinations may be required, and you will need to wait in the patient reception area between each stage. Each of these additional layers of tissue removed will take an additional 90 minutes on average to prepare and carefully examine. Although there is no way to tell before surgery how many stages will be necessary, most cancers are removed in three or fewer stages.

We want to be sure that the time you spend with us is as pleasant and as comfortable as possible. You are encouraged to bring reading material to occupy your time while waiting for the microscope slides to be processed and examined. Numerous magazines will be available in the waiting room and Wi-Fi internet access is available as well for those interested in bringing laptop computers or other wireless devices during their stay in the office. Depending on the number of layers required to completely remove your cancer your stay with us may extend into or even past lunchtime, so you may bring a sack lunch if you so desire. In the waiting room there will be coffee, tea, water and snacks available for your enjoyment. For most patients the most difficult part of the day with us is the uncertainty about when their day with us will be over. This is unfortunately impossible to predict ahead of time which is why we ask you to plan to be with us for the entire day and that you make no other commitments during the day you are scheduled to be in our office.