I am having Mohs on my left cheek 1.5 cm and want to try and heal naturally is this ok?
I Am Having Mohs on my Left Cheek 1.5 Cm and Want to Try and Heal Naturally is This Ok?
Doctor Answers 6
Secondary intention is ideal in come locations
There are certain anatomic locations where leaving the tissue defect to heal in after Mohs is actually cosmetically superior to suturing the wound closed with a flap or skin graft. However, this is generally reserved for concave locations like the inner canthus or ear rather than the cheek. Generally cheeks heal best when they are appropriately closed with suture. They heal the fastest and also leave the nicest cosmetic result.
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Healing after Moh's surgery
The original healing of Moh's surgery when it was first described was to heal on its own. This requires dressing changes and time and will leave some sort of a scar. Normally, patients want some plastic surgical closure but you can always heal it on your own and do a scar revision if needed.
Mohs cheek defects heal best by suturing them together
Technically, any Mohs defect can be left to heal on its own (also known as secondary intention healing). This may work well for small defects and those in select areas (as mentioned, the concave regions of the face, for example). Given that your site is moderate size even before the surgery has been done (ie, the defect will be larger than 1.5cm after the surgery), it would likely take months to heal on its own and result in a sub-optimal scar cosmetically if left to heal on its own. Most cheek defects are closed easily using sutures since the cheek tissue is fairly mobile and the healing will be much faster with suturing. I hope your surgery goes well.
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Mohs on the cheek
This completely depends on how deep the lesion is and where on the cheek it is. Your surgeon should be able to look at the defect and help you determine not only what will look the best but also heal the fastest. The most superficial of lesions can take 2 weeks to heal "naturally" while most facial sutures are taken out a t one week. Also to consider is whether by letting it heal naturally you will be at higher risk for a keloid scar (which not only looks bad but can be quite irritating).
Healing without reconstruction
I'm not sure why you would want to leave the wound open to heal by secondary intention. The cheek is an especially cosmetically sensitive area an the reconstruction may not take lone but even with reconstruction, there will be a scar. Make sure you are seen by a board certified plastic surgeon who has trained for many years to repair these defects. Just "sewing it closed" is almost never indicated in the cheek.
Healing Naturally after Mohs surgery
Allowing the wound to heal by itself, also know as secondary intention healing, is a good option sometimes after Mohs surgery. The areas that heal best by this method are usually concave areas (i.e. slightly depressed in the center), including the concave areas of the temple, nose, eyes and ears. For superior cosmetic results on the cheek, it's usually better to repair the surgical wound either by a side-to-side repair or flap. Talk to your Mohs surgeon or the person planning to perform your repair about what are the best options for your particular surgical defect. Good luck.