Saturday, April 13, 2024

Healing After Skin Cancer Surgery

If Someone Doesnt Like A Scar What Can Be Done To Improve It

Wound Healing After Skin Surgery | Memorial Sloan Kettering

While many surgeons used to suggest waiting six months or longer to let a scar heal before having treatment to improve the way it looks, Dr. Khorasani says recent studies have shown that early scar treatment can be more beneficial. It is now becoming more widely accepted that early scars are more receptive to change, he says. He recommends starting scar treatments six weeks after surgery for cosmetically sensitive areas of the face, for example. Scars that are older can also benefit from some treatments.

Redness:Redness means blood vessels formed to heal the wound, and theyre still engorged with blood, says Dr. Khorasani. We have certain lasers we can treat those vessels with to reduce the redness of a scar.

Irregularity: The only thing that really takes care of surface irregularity in a scar is dermabrasion, which is kind of like polishing your skin to even it out, says Dr. Khorasani. Dont worry it doesnt hurt.

Atrophic scars: Some scars are atrophic, which means they are sunken or pitted. If the depression is too deep, the best option is to do a scar revision and excise the scar. For more shallow depressions, we might also inject fat or a semipermanent filler, such as Bellafill, to help even out atrophic scars, says Dr. Khorasani.

Dr. Kober adds, Particularly on the nose where sebaceous glands are more prominent, laser resurfacing is a great option. The laser smooths the scar and blends it into the surrounding skin, making it less visible.

What To Expect During And After Mohs Surgery

Mohs surgery has a 98 to 99 percent success rate on average tumors. It is also one of the most common surgeries to perform on skin cancer areas. This procedure is the most effective way of removing basal cell carcinomas and squamous cell carcinomas. Your surgeon will remove parts of the tumor and skin with a surgical blade and then send it for immediate testing. The surgery happens in stages, including lab work, waiting time, and surgery by qualified and skilled surgeons and pathologists who help spare as much healthy tissue as possible and leave the smallest possible scar.

This procedure took root in the late 1930s by Dr. Frederic E. Mohs as chemosurgery. It took 30 years before Dr. Perry Robins saw its true potential in the dermatology field. Robins decided to teach this procedure at New York University. From there, he established the first fellowship training program to teach dermatologists how to perform the Mohs surgery on skin cancer patients. After starting the program, he continued to develop the surgery as well as travel and teach it all over the world.

How Should I Prepare For Mohs Surgery

First, you need to research the physician you want to perform your surgery. Most dermatologists can, but you should always meet with the doctor before agreeing to surgery and check their success rates as well.

Once you choose your doctor, it is time to get ready for the procedure. Your doctor will ask you to stop taking specific medications like blood thinners. It is crucial that you send your doctor a list of all medications and supplements you are taking before having the surgery. After that, your doctor will then prep and examine you.

Before heading to your appointment, wear comfortable clothing that provides easy access to the problem area. Since the treatment can take several hours, many physicians recommend bringing a book or puzzle to pass the time.

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What Should People Know About Surgical Techniques

With any surgical procedure, its important to look for a doctor who is well-trained, up on the latest techniques and has performed the procedure many times.

When he was teaching medical students about surgical technique and how to handle the tissue, Dr. Khorasani says, I would tell residents they must treat the epidermis, the top layer of the skin, as if it is the most delicate flower. I would teach them to use a hook to grab the skin rather than a forceps, which can pinch the skin and traumatize that delicate flower of epidermis. I would also tell them that to give the scar an even finish, they have to make sure every edge theyre suturing together is as even as a door on a spaceship.

Larger skin cancers may need reconstruction using what is called a flap from neighboring skin or sometimes a skin graft from another area of the body.

Medical Treatments For Scars

Healing after Skin Cancer Surgery: Mastering the Process

There are also medical treatments that may help your scar look and feel better. Examples of these treatments include:

  • Steroid injections
  • Laser treatments

These treatments can be done after enough time has passed for your scar to heal on its own. Your dermatologist will tell you if one of these treatments may be right for you.

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Ping Out With My Stitches

Leaving the house was a different experience. I had 20 stitches in my face, right under my right eye. Honestly, I felt like Frankensteins monster. While that didnt bother me too much, I did wonder what people thought of me. Would they wonder if Id been in an accident? Or if someone had assaulted me? Would people stare?

Reconstruction After Mohs Surgery

In some cases, wounds from Mohs surgery can be extensive and may require the assistance of another surgeon. We will help you find a SLUCare physician or a physician close to your home who can perform these procedures.

There may also be times when your personal physician refers you to SLUCare for Mohs surgery with a plan to perform reconstructive surgery for you shortly afterwards. A delay between your Mohs surgery with us and reconstructive surgery with another doctor may not be convenient, but it will not cause ill effects. It is often necessary as the Mohs surgery may require most of the day.

Following reconstruction, we will provide you with further written instructions for the care of your wound, along with verbal explanations from the doctor or nurse and phone numbers in case of questions.

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Why Is It Called Mohs Surgery

The procedure was developed by Frederic E Mohs, MD, in the 1930s and has since been refined. Originally, Dr. Mohs injected the tumor with a preserving chemical so that when removed , he could inspect the tissue under a microscope. But the initial process of preparing fixed-tissue slides took several days, the use of chemicals to cauterize the tumor was controversial and the procedure was painful.

About 20 years passed before Dr. Mohs and his colleagues tried a new technique to remove carcinoma from an eyelid: the surgery could be done in one day using frozen fresh tissue in slide preparation.

Mohs Surgery For Skin Cancer

Skin cancer surgery and recovery: Deb’s story

MOHS surgery is a step-by-step procedure for removing cancerous tissues in the skin. In this procedure, the surgeon removes one layer of visible cancerous tissue at a time.

One of the main aims of MOHS surgery for basal cell carcinoma is the minimum removal of tissues. Every layer of visible and affected tissue that is removed is examined before moving on to remove the next tissue.

The MOHS process is used to remove cancerous tissues on the face, fingers, or genitals. In many serious cases, MOHS surgery on the body is also performed depending on the need for such surgery.

The success rate of MOHS surgery is quite high as it is considered to be among the most advanced and precise surgical procedures in skin cancer surgery.

In fact, the MOHS procedure is considered a benchmark for performing surgery on high-risk cancers of the skin including in areas such as the head and neck.

When to See a Doctor

Its not easy for anyone to look at any skin disorder and imagine that s/he needs any kind of checking for skin cancer. However, a skin cancer doctor would know how to differentiate the nature of a skin disorder, if it is cancerous or not. When suspecting any potential cancerous growth, the best way to start is to search online for a Skin check clinic near me and consult a skin cancer doctor to examine the skin disorder. In areas where there is a lack of services, see your GP as soon as possible.

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How Does Mohs Surgery Work

Mohs surgery treats common skin cancers like basal cell carcinoma, squamous cell carcinoma, and even some kinds of melanoma. Unlike chemotherapy, radiation therapy, and other intense cancer treatments, Mohs surgery is an extremely precise technique used to gradually remove thin layers of cancerous skin cells.

Each layer of cancer is removed, one by one, until only cancer-free tissue remains. The Mohs technique makes it possible to preserve healthy skin, especially in highly visible or sensitive areas such as the eyes, ears, nose, face and neck. It also offers the added benefit of being an outpatient procedure.

What To Expect After Surgery

Pain. Most patients do not have severe pain, but may experience slight discomfort. If this occurs, we suggest you take two tablets of Tylenol every six hours. Pain medications stronger than Tylenol will occasionally be needed.

Bleeding. Occasionally, bleeding follows surgery. If this happens, do not become alarmed. Lie down and place steady, firm pressure over the wound as close as possible to the bleeding area. Apply the pressure continuously for 20 minutes . Do not lift the bandage to check on the bleeding. If bleeding persists after 20 minutes of steady pressure, apply pressure for an additional 20 minutes. If bleeding still continues, call our office, or go to the nearest hospital emergency room.

Swelling. Swelling is very common following surgery, particularly when it is performed near the eye. All wounds swell a little. Usually this is not a problem, and the swelling diminishes as the wound heals. Ice packs may help to reduce the swelling.

Drainage. All wounds will drain to some extent during the first week or two. This is why frequent dressing changes are necessary.

Infection. Infection of the wound is unusual. However, if you see thick, foul-smelling fluid coming from the wound, call our office immediately. An antibiotic may be necessary.

Redness. All wounds will develop a halo of redness, which disappears gradually. If the area becomes extremely red and itchy you may be allergic to either the ointment or tape. Call our office if this condition develops.

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Healing After Having Mohs Surgery On The Face

I had my surgery in the morning and was home and in bed by the afternoon. I happen to love naps, so it wasnt too difficult an ask for me to rest after having surgery. I was sent home with mild pain medication, , and for me that was fine I wasn’t in much pain. What I did have was a little sharp pain once in a while in the area where they did the surgery and around the stitches, but it wasn’t too bad or anything I couldn’t handle.

Ways To Treat An Infection At Home

Pin on MOHs

If you are concerned that you have developed an infection following skin cancer removal surgery, its best to consult your doctor.

To care for your surgical wound at home, follow the surgeons instructions carefully. Make sure to clean the wound according to the recommended schedule and cover it with a new bandage or gauze. Always wash your hands thoroughly before touching your wound.

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How Do You Treat A Wound After Skin Cancer Surgery

Keep it clean

Taking care of your wound after surgery is also very important in protecting it from any infection. As a general rule, you will need to clean the wounded area and change the bandage every day.

Dont worry, you wont need to put skin cleansers, soaps, and alcohol on your skin . Washing the area with water, keeping it dry and covering it with clean gauze or cloth can do the trick.

What You Should Know About Mohs Surgery Recovery Aftercare And Follow


Mohs surgery is a minimally invasive procedure that offers the best chance of returning to normal life after a skin cancer diagnosis. The complete removal of all malignant cells may produce a sizable wound in a conspicuous body part. So, naturally, recovery and cosmetic outcome are two of the biggest patient concerns when they are advised to undergo this minor operation.

At BHSkin Dermatology, our medical experts understand the impact of such information on treatment decisions. This article explains the most important aspects of the Mohs surgery recovery process to guide and empower patients considering this therapeutic option.

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Recommendations For After Mohs Surgery

You can expect minimal discomfort after Mohs surgery pain can usually be managed well with acetaminophen . Significant discomfort should be reported to us.

You may experience some localized swelling and bruising, which may not be at its worst until three to four days after surgery. Some swelling and bruising is normal and should improve within a week.

If you have surgery on your forehead or nose, you may experience some swelling of your eyelids, which, at times, may nearly close them due to swelling and bruising settling in that area. Similarly, swelling and bruising may occur down the neck, and rarely the chest, when surgery is performed on the chin or jawline area. To help reduce swelling and bruising, apply an ice pack for 20 minutes each hour while awake for the first 48 hours following Mohs surgery.

While bleeding rarely occurs after Mohs surgery, a little blood or seepage on the dressing is normal. If you notice active bleeding , remove the bandage and apply firm pressure over the area with dry gauze or a dry cloth for 20 minutes.

If bleeding continues, contact our office or the on-call dermatologist . On rare occasions, it may be necessary to have the bleeding stopped by cauterization.

We recommend you limit vigorous physical activity, excessive bending over or exercise for seven days after your Mohs surgery to allow your wound to heal and prevent bleeding or damage to your stitches.

Will The Mohs Surgery Leave A Scar

Skin Cancer: After the Removal

Yes. All surgical operations leave scars. However, scarring left after the Mohs surgery is minimal as compared to other surgical methods. Thats not an insurmountable problem. The scar could be reduced with the help of anti-scarring medication injections, dermabrasion, or laser treatment. These measures are typically taken between 4 to 8 weeks after the surgery. In the first months, the scar will be reddish and become lighter gradually. The appearance of the scar will improve within the first year. You should avoid direct, unprotected sun exposure if you dont want it to become more severe or get an uneven skin tone.

What places you at increased risk of complications?

Your doctor will necessarily discuss the risks related to your individual health condition and medications, especially blood-thinning drugs. We just want to put the particular emphasis on the hazards of smoking. It negatively affects your healing process and increases your risk of skin cancer recurrence along with the appearance of other types of cancer. The benefits you get if you quit smoking are enormous.

What should you do to make rehabilitation faster and more efficient?

When you return home, follow these steps to ensure a normal recovery:

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After A General Anaesthetic

You are likely to be sleepy. Exactly how sleepy you are and how quickly you recover depends on the type of operation, and the type and length of your anaesthetic. People vary in how they feel straight after a general anaesthetic.

Some people feel fine but others feel:

When you first go back to the ward the nurses carry on checking you. At first, this is every 15 minutes and they gradually check you less often as you recover. So that within a few hours it is every 4 hours. The checks include your blood pressure, heart rate, temperature, breathing rate and your wound.

You have a dressing over your wound. You might have some tubes near it to drain any fluid that builds up.

You have a drip giving you fluids into a vein until you can eat and drink again. You might also have a tube in your bladder called a catheter. This stays in until you can get up to wee normally.

How Much Do Patients Worry About Scars

When doctors tell patients they need skin cancer surgery, they hear a wide range of reactions, says Dr. Kober. I have some patients who say, I dont care about the scar, Doc. I dont have a modeling career. Just get the cancer out. Thats one extreme. There are also patients on the other side of the spectrum, she says, who are very concerned about the scar and its cosmetic appearance.

Hooman Khorasani, MD, former chief of the Division of Dermatologic & Cosmetic Surgery at Mount Sinai Medical Center in New York City, sees the full gamut of reactions in his private practice on the Upper East Side of Manhattan as well. That includes celebrity patients who know an unsightly scar could hurt their career. Dr. Khorasani, who is quadruple board-certified in dermatology, Mohs surgery, cosmetic surgery and facial cosmetic surgery, spends about 50 percent of his time doing Mohs surgery and says hes careful to reassure patients as well as manage their expectations. Most cases are BCCs and SCCs. When detected early, theyre almost always curable. I explain to patients that these are very common skin cancers and that theyre not alone, he says. Were definitely going to take care of it and get rid of the cancer. Thats the most important thing. He knows the importance of a good cosmetic outcome, too. In fact, hes done extensive research on minimal scar wound repair.

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