Analogies and metaphors are frequently employed in medicine to explain difficult medical concepts and procedures to patients. Learning is enhanced when visual analogies are used to present new concepts, and the use of effective analogies decreases both learner (patient) and teacher (physician) anxiety. 1,2 This is a desirable result of physician-patient discussions about anxiety-inducing interventions, such as surgery.Patient education prior to Mohs micrographic surgery (MMS) is paramount, including a comprehensive discussion of the procedure, the steps involved, and the time necessary to perform these steps. 3 Certain abstract aspects of the Mohs procedure can be difficult for patients to conceptualize; therefore, clear and adequate physician-patient communication is essential. Metaphorical and analogical approaches are frequently employed in the field of dermatology and can be effectively used by the surgeon. 4 Expressions used to describe the Mohs procedure include "digging up a tree along with its roots" and the "iceberg" illustration. These analogies aid in explaining the infiltrative tumor growth patterns under the biopsy site and the possibility that residual malignant tissue may remain after skin biopsy.The peanut butter cup encased in its wrapper serves as a visual representation of the unprocessed tissue obtained by the initial tumor excision by MMS (Figure). The sloped edges of the peanut butter cup are analogous to the beveled edges of a primary Mohs excision, because the incisions are made at a 45°angle