What to Expect: After Surgery
Detailed written instructions on wound care will be given to you and reviewed upon completion of the surgery. Essentially, you will leave the original bandage on for the first 48 hours and then you will clean the wound daily, place an ointment (white petrolatum, Polysporin ointment, or Aquaphor) on the wound and then cover it with a small dressing. This will be continued until the sutures are removed (usually 7 to 14 days after the surgery or until they dissolve). It is very important to keep the wound moist with ointment and not to let it dry out. When a wound dries and a scab forms, it will take longer to heal and is more likely to form a more noticeable scar.
Most patients report minimal amount of discomfort the first day or two following surgery. This discomfort usually responds readily to Tylenol™ Extra Strength in its usual dosage. We do not want you to take any aspirin, naproxen or ibuprofen containing products for three days following surgery. There may also be a normal sensation of itching or tightness that is experienced in the immediate post-operative period. Some minimal spot bleeding is normal and expected post-surgery.
Often times patients will have "black and blue" marks and swelling around the surgery site. This reaction is particularly frequent and exuberant around the eyes. Most of this is your body's reaction to being wounded. Cells from other areas come to the wound to help repair it. In doing so, they create swelling. This usually gets worse for the first three days after surgery and then slowly begins to improve.
You may also experience some numbness around the area that was operated on. There are many small nerves that carry sensation to the skin. Some of these may be cut during surgery and it may take 6-12 months before full sensation returns. Rarely the skin cancer involves larger nerves. When these are cut, the loss of sensation or muscle weakness may be permanent.
Remember, every surgical procedure produces some form of a scar. Although every attempt will be made to minimize and hide the scar, the extent of the scarring depends on the location, size and depth of the skin cancer and the healing properties of the individual. The scar will continue to improve for 8-18 months. After the first three months the area can be gently massaged, as directed by your dermatologist, if it feels thick or lumpy.
You may be seen for suture removal seven to fourteen days after surgery and in many cases a few months after surgery to make sure everything is healing appropriately. After the three month visit, you should be monitored every six months to twelve months for new skin cancers. Although the chance of having the skin cancer recur after Mohs surgery is only 1-2%, it can happen and the area should be monitored. There is also a possibility that a new skin cancer may develop in other areas in the future. Remember that 50% of patients will have a second skin cancer within five years of their first. This is why it is very important to protect yourself from the sun's rays and to have a dermatologist follow your skin closely. If you should notice any new lesions and suspect they might be skin cancers, you should schedule an appointment promptly and not wait the six or twelve months before the next scheduled visit.