New York Mohs Surgery Recovery - Related FAQ's
I had a basal cell carcinoma removed from my nose, the tip, and my dermatologist only gave me a bandaid and ointment and said he would see me in four weeks. Should I not have had stitches?
Wounds heal poorly on convex or rounded-up surfaces. I usually dissuade patients from putting a band-aid on for the four to six week period because it still will look different after healing. Skin grafts are often done by plastic surgeons because they find that reconstruction flaps are difficult and not perfect. Skin grafts may leave you with a permanent whitish patch and the skin becomes thinner and loses its pores. Some of my best grafts look imperceptible when the woman wears makeup, but no graft looks identical to normal skin. Flaps can look identical in color and texture but there is a secondary change of the neighboring skin from where the patient has the flap taken. There are times that a side-to-side closure works well despite the slight flattening of the nasal tip.
I had Mohs surgery on my lip two months ago and despite being happy with the shape of the lip, I wish the surgical line would look less like a deep crease. The light hits it funny and deep shadows occur at times. My surgeon said that I would have to wait one year for surgical revision. Is there anything else I could do sooner to help?
Surgery should not be done sooner rather than later, because you need new blood flow to occur in the flap for it to heal well. The crease of the incision, though, can be made to look better, as early as two months after surgery by performing laser resurfacing, Dermabrasion or other resurfacing. Fraxel restore laser resurfacing works very well for many Mohs surgical patients. There is a series of many treatments, with minimal downtime. There is some redness, slight swelling and flaking for about one week or less. Every three weeks or so, this can be repeated. It can help immensely in bringing the eventual good appearance into the forefront.
I have had quite a few Mohs surgery treatments for skin cancer. Is there anything I can do to eliminate future surgeries from being needed?
Probably not. The damage was done many years ago but it is possible to lessen the numbers that will still develop. Photodynamic therapy with lasers, and topical cream such as 5-FU (fluorouracil), Imiquimod, Carac, etc., may diminish actinic keratoses (precancerous growths) and even basal cell carcinoma. Some studies discuss topical use of some creams to reverse the DNA damage that was induced by ultraviolet exposure but human studies are lacking.