My skin graft changed appearance overnight. Is this normal? (photos)

Question

I had Mohs surgery and a skin graft for a BCC on my nose 16 days ago. Until this morning my graft looked mottled purple. Today I woke up and found that half of it was pink and half was kind of brown. It is Christmas Eve and I can't contact my doctor until probably next week. I am hoping for some reassurance that everything is okay. And if it's not, is there anything I should do immediately. Thank you.

Keith M. Blechman, MD · Answer

Thanks for your question.  It's not unusual for the color and texture of a skin graft over a Mohs site on the nose to change during the first few weeks.  This is due to a combination of bruising and blood stains resolving, as well as the new ingrowth of blood vessels allowing the graft to "take", or heal into place.  The photo looks like healthy pink skin graft towards the right that's taking well, and on the left there may still be some bruising that needs to resolve.  I don't think your doctor would do anything right now other than reassure you that the appearance is normal, it will probably end up healing fine, and that you should continue keeping the site moist with whatever your doctor prescribed.  Good luck!

Michael H. Gold, MD · Answer

Thanks for your
question and thanks for sending in photos too – they help.  What they help is to tell you that from them,
everything looks fine.  The pink color
usually means that the area is healing well, and the darker areas really show
that there is further healing going on here. 
I do think everything will do fine.

Having said that,
you must have a method of connecting with your surgeon or the surgeon on call
24/7 – this is a must so if you were not given an emergency contact number,
that would surprise me.  Call your doctor
anytime, that’s what they are there for – and don’t be afraid to do so.

Josef Hadeed, MD, FACS · Answer

Generally speaking, skin grafts do change colors as they heal.  However, if you have any concerns you should contact your physician's office and bring it to their attention.

Kate Ross, MD · Answer

Judging by the picture, your graft looks fine. I don't see any cause for alarm. If you still feel uneasy about how it looks after the weekend give your dermatologist a call to be seen.Thank you for your question and for sharing your picture!

F. Victor Rueckl, MD (in memoriam) · Answer

I do not see anything that causes me alarm from your photo. What you probably had before was a lot of bruising (very common in the nose) and so that is going away. The pink tissue is new skin forming and the graft (good signs) and the brownish goo, is that part still healing. I would continue to keep the site clean (obviously) and well moistened with Vaseline or Polysporin or whatever your surgeon suggested. But I do not see anything that is alarming or would cause me to tell you to rush to be seen. I think it looks like a well-healing Mohs site. "This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."

My skin graft changed appearance overnight. Is this normal? (photos)

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