I had upper lip MOHs surgery and reconstruction 3 days ago and I am still pretty swollen. How long for this to go down?

Lips take a while for the swelling to go down.  Its not uncommon for that to last a few weeks, depending on how deep the stages went.  I do lip augmentation surgery and that is similar, the swelling is the worst the first few days. You should have gotten good post-operative instructions from your physician.  If you have questions I would call the office and have them advise you as each doctor is particular about their at home care.  I advise patients to avoid exercise that increases heart rate or blood pressure till the sutures come out, this helps prevent a hematoma from forming, limits the swelling and bruising, and prevents the a worse scar.  I would take it easy and follow your wound care instructions for now till the sutures are removed.  Sleep on multiple pillows (head elevated) and use ice packs (frozen peas or corn).  I wish you the best of luck, Dr. Emer.

It really all depends on how deep the cancer had infiltrated and how much of the lip was removed and therefore if sutures extend into the muscle. If only skin was removed and sutured, then expect three days of major swelling and three months of decreasing swelling.Exercise is okay as long as you don't get your blood pressure very high which  could lead to more bruising or even bleeding. 

Swelling after Mohs and reconstructive surgery on the lip is entirely normal. It gets better after a week or so but residual swelling may take months to go down. I personally request all of my patients to avoid any activity for one week but I would check with your Mohs surgeon and see what their preferences are.