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What Should I Do if I Have a Large Lump After Mohs Surgery?

asked 3 years ago by L.S. in Great Falls, MT
Latest answer by Andrew Kaufman, MD
Question viewed 4,217 times
Tags: bumps, recovery, side effects

I had Mohs done on small basal @ center forhead. I was left w/ a concave wide white scar, deep brow furrows, and a 10mm lump where final sutures were done 2yrs ago. One steroid injection helped flatten the lump some, but refused anymore. Taping flattens it but puffs up again after 1 hr.

Three derms & three surgeons won't help - they all said nothing will work on furrows & only offered more cuts to fix lump. The Internet says small injections will flatten lump w/ a spread out treatment.

Why can't I find someone to do this? Why no fillers for furrows? I even asked about fat filling, but I'd rather try a filler if the lump sinks in.

The lump looks like a big obvious zit! My hair is too fine to cover over.

Anyone have idea or referral? People suggest I should have it checked. Each Dr. gave different reason for why it's there. I have a small spot now on my cheek & I'm afraid to have procedure again.

8 answers to What Should I Do if I Have a Large Lump After Mohs Surgery?

+1

Cause and treatment of bump after Mohs surgery

The cause of the bump could be a thickened scar, a cyst, a reaction to suture material and even recurrence of the skin cancer. Because of this last possibility, I would recommend that you see someone to evaluate the possibility of skin cancer recurrence. This is most easily done with a small incisional biopsy. Most skin cancers occur in the first two years after surgery, and while Mohs surgery does provide the highest cure rate for skin cancer, nothing is 100% perfect. So I would... more
Andrew Kaufman, MD

Los Angeles Dermatologic Surgeon

www.dermatology-center.com

+1

Scar massage key to minimize post Mohs surgery scar

Scar massage should be applied diligently 10x every 4-6 hours starting 3 weeks after Mohs surgery. If the affected post-op area remains hypertrophic, judicious low-concentration cortisone injection may be considered 3 months after surgery.
William Ting, MD

Bay Area Dermatologic Surgeon
+1

Bump from surgery not from Mohs

The bump and deformities that you mention are really from the surgical closure that you had, not from having the Mohs procedure itself.  The bump coul dbe several things, a hypertrophic (thick) scar or extra skin that is bunched up after closing the wound.  The hypertrophic scar respond well to multiple injections, the extra skin requires a surgical revision.  You describe an indentation as well which would require a surgical revision to correct.  Noone wants to have... more
Edgar Franklin Fincher, MD, PhD

Beverly Hills Dermatologic Surgeon
+1

Bump After Mohs Surgery

There are a few reasons for a bump after mohs surgery. One of the most common is a suture that is being extruded and this is easily fixed. Another is a pucker from a rotation flap- again, very simple to fix. Keloids or hypertrophic scarring can also give a bump and this can be treated with either injections or laser. The most significant reason why people get a bump after Mohs is a recurrence of the skin cancer. While rare, it can occur and it may happen when a skin cancer is like a cluster... more
Kenneth Beer, MD

Palm Beach Dermatologic Surgeon
+1

Lump after Mohs surgery

I would suggest that you discuss this lump with your Mohs surgeon. It is most likely that your lump is not indicative of a recurrence of your cancer but more indicative of scar tissue. As such the scar tissue can be treated so that it is worth discussing with your Mohs surgeon. At the same time, he or she can reassure you that this is normal and hopefully not reflective or any residual cancer.
Steven Hacker, MD

West Palm Beach Dermatologic Surgeon

www.palmbeachdermasurgery.com

+1

Facial Plastic Surgery Consult

Without seeing your problem, I can't comment on the best option for repair. I would suggest visiting a facial plastic surgeon since they focus on cosmetic and reconstructive surgery of the face only.
D.J. Verret, MD

Dallas Facial Plastic Surgeon
+1

Re-excision seems to be the simplest solution

The most simple solution sounds like the one that has been recommended, which is re-excision of the area. This should be done to achieve 2 results: 1. To remove the lump in the area 2. To better evert the edges of the skin so that the final surgical line is no longer indented and blends in well with the skin in the area. Please be sure that you seek out a Fellowship-trained Mohs surgeon or a plastic surgeon or a facial plastic surgeon to do this repair.
Shawn Allen, MD

Boulder Dermatologist
+1

Please see nan ABPS surgeon

Since I can't see exactly what you are talking about, I really can't give you a specific answer. However, if you would please go to the best American Board of Plastic Surgery certified surgeon in your area or in Phoenix, I am sure you will get a straight answer of what your treatment options are.
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

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