We’re continuing our deep dive into Mohs reconstruction surgery, a common treatment for basal cell and squamous cell carcinomas. In my last post, I outlined what the procedure entails. Here, I’ll detail what you can expect during the days and weeks afterward.
First, let me say this: While Mohs should be considered a major surgery – more because of its impact on your life than its invasiveness – it’s OK to fret over the scar you’ll be left with. After all, how we perceive our appearance has a big effect on our mental health, which, in turn, can affect our physical health. So, don’t be hard on yourself.
The first week
As with any major surgery, bruising and swelling around the affected area is a distinct possibility. Both should subside after a week or two.
If a flap was used to fill in your wound, prioritize moisturizing for at least the first few days after your surgery. The notion that a wound isn’t healing properly unless there’s a scab is a myth. Scabs are a physical barrier to the new skin cells that are facilitating the healing process.
Clean around the area with a gentle cleanser, then carefully apply a layer of greasy ointment, such as Vaseline, Aquaphor, or a prescription-strength antibiotic ointment. Avoid over-the-counter antibiotic ointments because they can be very allergenic.
If you have a skin graft, don’t get it wet for at least a week. That’s because you’re going to have a special kind of bandage sewn over it to keep the graft in place. Not disturbing the graft is critical because it’s growing new, delicate blood vessels that will fuse with ones from the wound. If the graft shifts at all, and interrupts that process, it’s going to fail.
What you can do is carefully clean the rest of your face with a washcloth or face wipe. You can also continue your usual skincare regimen on the rest of your face. There’s no need to change lotions or anything like that.
Week two and beyond
If you have a flap, your stitches will be removed about a week after your surgery and replaced with butterfly bandages over your incision. They’ll most likely stay in place for another week or so. At which point, you can start looking into scar treatments. (More about those in my next post.)
If you have a skin graft, the bandage will be removed about a week after your surgery. From there, you can follow the same steps I outlined above for caring for a flap: gentle cleanser, greasy ointment. It’s OK now to let your graft get wet. Just try to avoid letting the shower hit it with its full force.
After two to four weeks, your graft will be more or less healed. After one to two months, it’ll be completely mature. That’s when you can discuss scar treatments with your dermatologist, along with ways to decrease redness and texture, both of which are completely normal.