Once your skin cancer has been completely removed, your provider will discuss repair options with you. Repair options are individualized, but options include sewing the skin together (simple closure or skin flap), taking skin from another similar-looking area (skin graft) or actually allowing the wound to heal by itself (granulation). Your provider will discuss options with you and decide on the best repair. For special wounds, other surgical specialists can be involved in the repair of your Mohs wound. Typically sutures are removed 7 days after surgery on the face, and up to 14 days on certain areas. Mild to moderate post-operative pain usually lasts less than 24 hours and can be controlled using Tylenol (acetaminophen). Bruising and swelling are common following surgery and usually last for 5-7 days. Applying ice during the first 24-hours after surgery reduces bruising, swelling and pain. As the surgery site heals, it is normal for the area to feel like it is tightening. The risk of significant postoperative bleeding is very low. Our staff will place a pressure dressing on the wound after surgery, which should stay in place for 48 hours. A small number of patients have some postoperative bleeding as the epinephrine (adrenaline) in the anesthetic wears off, which usually occurs 1-2 hours after surgery. Applying direct pressure over the dressing for 20 minutes can usually stop this. For any bleeding that is not controlled after 20 minutes of direct pressure, notify us immediately. Numbness is also common at the surgical site because skin cancers are often found around nerves that carry sensation. This can sometimes become permanent, but most initial numbness improves over 4-6 months. When skin layers are realigned correctly, sensory nerves slowly grow across the scar minimizing numbness. This healing process often makes patients feel like theirscars are sensitive or itchy . This is normal andcan be expected. Occasionally, a patient’s tumor is large and reconstruction may be easier for the patient if they are put to sleep by an anesthesiologist. In these cases, your provider will discuss your case with a trusted surgeon for your reconstruction. Most of the time, your provider will repair your wound on the same day as your Mohs surgery. After any surgical procedures you will be left with a scar . Every effort will be made to offer the bestpossible cosmetic result. The scar will often be longer than what you may have anticipated because cancer “roots” beneath the surface extend beyond what is visible before surgery. The scar may also need to be lengthened to better fit the contours of the skin. Scars can take a few months or longer to heal completely. The scar can be minimized by the proper care of your wound. Your provider will individualize wound care after your surgery, but you should plan on applying ointment to your wound twice daily for 2 weeks and applying a bandage twice daily for 1 week. Keeping the area moist after surgery and being disciplined to not let air get to the suture line will generally give you the best cosmetic and functional result . Three weeks after surgery, a thickor bumpy scar line can be improved with gentle massage performed for 2 minutes, 2 times daily for 2 months. Follow-Up Care After you have a skin cancer, there is a 50% chance that you will develop a second skin cancer within 5 years. After a diagnosis of skin cancer, your provider recommends that you see a dermatologist at least once per year for 3-5 years following Mohs surgery. Frequently Asked Questions I don't see anything after my biopsy. Do I really need to be treated? Yes. Following a biopsy, your skin cancer may no longer be visible. However, the surface lesion that was removed can represent the "tip of the iceberg." More tumor cells may remain in the skin. These can continue to grow downward and outward, like roots of a tree. These "roots" are not visible with the naked eye. If they are not removed, the tumor will likely reappear and require more extensive surgery (see examples of cited studies below). Tumors that are neglected can spread deeply into the skin and invade nearby structures. On rare occasions, these cancerous cells can metastasize to lymph nodes and other organs in the body. Why does my skin cancer need to have Mohs surgery?
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