Will I have pain after surgery?
Every patient is different. Some patients tell us that they have no pain following their procedure. Many patients take only Tylenol for pain relief, while others use a stronger pain reliever such as Norco that we prescribe to the patient. Most only need to take pain medicine for the first evening after the surgery and perhaps the next day. We ask that you avoid taking aspirin-containing medications or NSAIDs (ibuprofen, naproxen, etc.) as these medications can cause bleeding. If you take the prescription pain medication, please take it with a full meal.
How do I take care of the surgical wound?
Depending on the type of procedure that was performed, we will discuss with you exactly how to care for your surgical site. We will also give you written instructions. You may access these wound care instructions here.
What limitations will I have after surgery?
You should plan on light activity for 3-7 days after surgery. This includes minimizing daily exercise and limiting the amount of weight that you lift during the normal course of your job. This will help limit the possibility of complications after surgery such as bleeding or breaking the stitches and opening the surgical wound. If you need a physician’s request for light duty at work for a limited time we can provide this for you.
Will the surgery leave a scar?
Yes. Any form of skin cancer treatment will leave a scar. However, because Mohs micrographic surgery removes as little normal tissue as possible, scarring is minimized. Our primary goal, of course, is to cure the cancer. Once we are sure of the complete removal of the cancer, our goal is to allow your wound to heal so that the final result is as cosmetically pleasing and inconspicuous as possible. Immediately after the cancer is removed, we may choose to
(1) repair the wound with a primary closure (line of stitches)
(2) reconstruct the wound with a skin flap or skin graft
(3) have the reconstruction performed by a plastic surgeon or oculoplastic surgeon
(4) allow the wound to heal on its own
This decision is based on what we feel will provide the best cosmetic result, but also takes into account the patient's preferences. In some cases, such as an extensive skin cancer or one in a difficult location, a very large reconstructive procedure may be required. In such cases, we may discuss a referral to a plastic surgeon for reconstruction under general anesthesia.
How long will the recovery take?
There are two components to the recovery. Social recovery refers to when patients can go out in public without drawing attention to themselves, and complete recovery is when the site has finally improved to the point at which it is fully healed. Everyone is different, and heals at a different rate. Generally, during the first 3-7 days after surgery, the patient has a bandage, and when the bandage is removed, they may have noticeable swelling and bruising. Many patients return for removal of sutures at one week, and once the sutures are out, it is difficult to see the incision site! Their social recovery is complete in one week. Other people may experience more pinkness/redness of the skin around the area, or more swelling or bruising that can take more weeks to resolve.
Complete recovery always takes longer. For months after a procedure, your body continues to remodel and subtly heal. Because of this, it takes 6 months, and sometimes up to a year for the lines to fade and minor swelling to subside. In some cases, a surgical site that looks good at one month can be almost undetectable at six months.
Will I need to come back?
Usually one follow-up visit is all that is required to examine the healing surgical site and to remove the stitches. We do realize that many patients travel a very long distance for their surgery and we will make an effort to have you follow-up with your referring physician if this is the case. Afterwards, you may return to your referring physician for routine check-ups.
Who will I follow up with (long-term) after my procedure?
A follow-up period of four years for the treated cancer is essential. We strongly recommend this since studies show that people who develop a skin cancer have a high likelihood of developing new skin cancers in other locations. You should have your skin checked by your referring physician at least once a year for four years, not only to examine the treated site, but also to check for new skin cancers. You will be encouraged to return to your referring dermatologist for skin examinations. Catching these early is key to easy treatment and cure.