I had MOHs to remove basal cancer on my left nostril. Surgeon suggested it heal in for 2 weeks, does this make sense? (Photo)

He said being fairly large he thought doing a 2 step flap the day if was too close to the bottom of my eye and might distort or pull on the lower eye skin so he convinced me to wait for it to heal in for 2 weeks. I am a week in and nervous. I don't know if he's planning on going a graft from another area or a flap from skin right around it. Should I demand to go back sooner or let it heal in? Is it less scarring to do a flap or graft and where should the skin come from?

Doctor Answers 3

Moh's repair

You should discuss your concerns with the surgeon.In general, in this location, a flap from nearby skin is often useful in producing a closed wound. On occasion a secondary procedure may be needed to get the best, most natural result. Skin grafts are not usually used in this location.


La Jolla Plastic Surgeon
5.0 out of 5 stars 1 review

MOHs

Thank you for your question. It sounds like he was planning to have it heal in secondary intention which can take awhile to heal and needs to be properly cared for to heal appropriately. I always advise the wound to be covered at all times with antibiotic ointment on the area. It would be best to return to your surgeon to clarify what his plan is for the wound. Additionally he can go over the proper care for the area for appropriate healing. 

Lenore Sikorski, MD
Orange County Dermatologist
4.3 out of 5 stars 24 reviews

Second intent healing of Mohs defect

There are many ways to "repair" a Mohs surgical defect, including doing nothing at all.  The ala and alar crease can heal very nicely, so long as caution is taken to ensure that the lower portion is sturdy enough to retain its shape.  I assume that he/she is following you closely to watch this.  To answer your question quickly, yes it can be a great way to let this heal in...there are many ways to correct this.  Like everyone, many Mohs surgeons have their unique and favorite ways to reconstruct various defects...options for this may include allowing it to heal via second intent, skin graft, bilobed flap, 1 or 2 stage interpolation flaps, etc...there are many ways to fix this and so long as it heals nicely then they can all be right.You should have strict instructions on how to care for this as that can greatly affect the healing process.  As I tell my patients, if you are anxious then you should always be able to go back in to ask and discuss.  You can always change your mind also and have it repaired should you decide.

Joshua E. Lane, MD, MBA
Columbus Dermatologic Surgeon

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.