Can Scar Be Fixed After Mohs?

Our office specializes in scar treatments, particularly after skin cancer removal. We would likely recommend a combination of lasers, scar surgery, and IIT> Best, Dr. Karamanoukian 

There is a long maturation for skin grafts. Many that get lumpy initially flatten over time and others that are flat can raise up. The surgeon can show you how to massage the area and sometimes, if it doesn't flatten, corticosteroids can be injected to make it flatter faster but there are risks that the surgeon can discuss with you.

Yes, the area (scar) can be revised but you should wait about 3 months after surgery before you do anything else.  I recommend consultation with an oculoplastic surgeon familiar with eyelid/canthus anatomy for reconstruction.

Dr Taban

Thank you for your
question. Good news, there are multiple options available to revise your skin
graft. I recommend that you make an appointment with a board certified plastic
surgeon to discuss your surgical options.

Yes, in most situations, scars after Mohs surgery can be improved ("fixed").  See your dermatologic surgeon and tell him or her your concerns;  so that he or she may properly evaluate the scar, discuss with you the various treatment options and formulate a plan for improving your post-Mohs Surgery scar.

Ten weeks is a relatively short period following reconstruction. As a general rule, it takes about 6-12 months to reach the final "result" after any type of surgery. However, there are some things that can be done at 10-12 weeks to "fine tune" your result, including injections of steroids to soften the scar and dermabrasion (a.k.a scarabrasion) to help blend in the scar with the surrounding skin. Talk to the doctor who performed the surgery about what your options are to improve the final cosmetic appearance.

You might benefit from a steroid injection to soften or loosen up the hypertrophic scar.  Time will also help the scar improve.  CO2 laser resurfacing would help smooth out the bumpiness and irregularity of the scar--this is usually performed about 6 months after the initial surgery.

~ 10 weeks out is still relatively early in the postop period for skin grafts.  It will improve over the next several weeks and months.  Revision is possible to help improve the appearance however.  If you are developing a medial ectropion then you may want to seek consultation with an oculoplastics surgeon. 

Facial surgical scars often look worse in the first few weeks (or months) and improve often dramatically with time.  This may account for the popularity of scar creams (patients tend to use them while the scars are spontaneously improving over time and then give credit to the cream!).  The trick is time.  I don't think you can judge the final outcome of the scar until about a year after surgery (some feel even longer).

 

There is a good chance that the redness, lumpiness and pulling all will improve over the next 9-10 months with no intervention.

If you want to intervene earlier, simple options include dermabrasion (with laser or by hand).  More complicated options (that restart the wound healing "clock") include removal of the graft and replacement with a flap - suggested by a colleague on this website.

This is a good case for a discussion with your doctor.  As you can see from the answers posted, there are a variety of approaches that the doctors on this site are recommending.  Don't forget the option of time though!

Based on your photos, I believe this can be drastically improved with a simple 5 minute procedure with superficial planing and manual dermabrasion.

Dr. Malouf