I Am Having Mohs Surgery and Will Not Have Any Stitches or Sutures and I Am Worried I Will Have a Raised Scar or Lump. (photo)
- Asked by KrissyS in San Jose, CA
- 2 years ago
It is on my left cheek. I am 32 and I am in marketing and I am very concerned about how I will heal on my own if my skin will come together properly or should i just get the stitches?
Allowing the wound to heal after Mohs surgery
Allowing the wound to heal by itself after surgery (a.k.a. secondary intention healing) is a good option in some locations but not for a surgical defect on the cheek. Secondary intention healing works best on the concave (i.e. slightly depressed centrally) areas of the nose, ears, eyes and temple but not over the cheek. The wound on the cheek should be sutured closed in this location. Talk to your Mohs surgeon about how they will be planning to repair the wound. They may not have a firm answer yet (i.e. side-to-side repair vs. flap) since you can't be certain as to the size of the wound until after all the skin cancer has been traced out. Ask questions. Good luck.
Web reference: http://www.emohs.com
Healing after Mohs surgery
A larger defect located on the upper cheek is probably best closed with stitches. A visible scar of some kind for this defect is inevitable, but can be minimized with a stitched closure. Depending on the tightness of skin in this location, a flap or graft may be appropriate for wound closure. Secondary intention healing (self-healing without stitches) can be a good option in certain locations, particularly where there is a concave surface.
If you are concerned about the final appearance of the scar, you may want to request consultation with a facial plastic surgeon for the wound repair.
I would talk to your surgeon
Typically, when cancers are removed on the cheeks, they are closed with sutures. Second intention healing (letting it heal without sutures) is acceptable at some locations, but I do not consider the cheek to be one of those locations (esp. in a 32 year-old). It is difficult to tell from your photos, but that appears to be a sizeable cancer just below your left lower eyelid. I would be very hesitant to let that heal in by second intention as you could develop an ectropion (pulling down of your eyelid) from the scarring. You may want to seek a second opinion of another Mohs surgeon or request that your current Mohs surgeon sends you to a plastic or facial plastic surgeon for repair.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.