2 Days Post-op MOHS Surgery - How to Reduce Swelling?

Question

Dear doctors, I had a nodular BCC removed 2 days ago via MOHS - lateral to my right nostril in the nasal labial crease. Final incision extends from the right nostril following down the nasolabial crease, ceasing ~1cm from rt corner of mouth. I had no swelling the day after but woke up today with lots of swelling, no redness or signs of infections. I've been sleeping fairly upright, avoiding salt, lots of fluids. What else can I do to reduce swelling? Ice? OTC meds? Thank you!

Ron Shelton, MD · Answer

It is not unusual to develop significant swelling one day after Mohs surgery. Avoiding straining, lifting, laying flat and bending over helps. Ice packs can help even one day after surgery but check with your surgeon as to how long to leave the ice on and how frequently to reapply. Some doctors recommend taking Arnica montanna, an herb found in health food stores and pharmacies, as it may reduce swelling and bruising.

Andrew Kaufman, MD · Answer

You develop the greatest amount of swelling the first 48 hours after surgery. Ice packs for 15-20 minutes of every hour you're awake, elevating the surgery site, and minimizing activities during this time can help. If it persists or becomes worse, you should see your doctor.

Jeffrey Ellis, MD · Answer

Swelling after surgery can be normal, and it sounds like you are doing lots of right things.

	However, if you have any concerns, there is no substitute to visiting your surgeon for a quick postoperative visit.

Laurie Jacobson, MD · Answer

Your post-operative description sounds very normal and you are doing all the right things. Make sure to avoid exercise or anything that raises your blood pressure as that can easily contribute to even more swelling. Also, having a firm 'pressure' dressing can be helpful too. If it seems unusual to you in any way, always let your doctor know and s/he can evaluate in person. Swelling after Mohs surgery can often last a week or more depending on the size of the cancer and the size of the repair that is required after its removal.

Stephen Weber MD, FACS · Answer

What you describe is not unusual. As long as you don't have a hematoma (collection of blood under the skin) things will heal normally. If you're concerned about fluid under the incision, return to your surgeon for checkup. Otherwise, your swelling should steadily subside.
	Best,Stephen Weber MD, FACS

Purvisha Patel, MD · Answer

It sounds like you are doing all the right things. sleeping upright and keeping it clean helps. Taking an antihistamine also helps sometimes. I am sure you will be happy with the results.

Travis T. Tollefson, MD, MPH · Answer

Dear Eastwestgirl, you are doing all the correct things.

	
		Remember after facial plastic surgery,  swelling goes away, the result lasts forever, so be patient.
	
		 
	
		Post operative swelling is usually at its greatest at 2- 3 days after the surgery.
		
			
				Think about how your ankle swells after a sprain
		
	


	
		From your description of the area of swelling, it certainly could be normal, but keep in contact with your surgeon
	
		 
	
		Gel ice packs are helpful to be placed on the eyes and cheek in the first 48 hours, but we recommend that people would refrain from placing directly over a skin flap or incision   


	Best Wishes

Steven Hacker, MD · Answer

The first thing you shoudl do is let your surgeon know so he or she is aware and ask him or her if they have any preferences on how to treat and address their own post operative swelling. Common measures include ice and pressure bandages to the area, NSAIDS are controversial because they can exacerbate bleeding.

2 Days Post-op MOHS Surgery - How to Reduce Swelling?

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