Is this a normal appearance for 1 week after a Mohs graft on nose? (photos)

I had a SCC removed a week and a half ago. The dermatologist did a delayed repair (5 days after the Mohs procedure). It is now 1 week after the graft and when getting the stitches out today the dermatologist wanted to keep the lower stitches on for another 5 days to make sure that the bottom part of the graft took. He thought it looked dark/shadowy. Is there a reason why the top portion would take faster than the bottom? Is there still a high likelihood that the entire graft will take?

Doctor Answers 3

Appearance of skin graft after Mohs reconstruction

Skin grafts go through an evolution of color changes during the first several weeks and months after surgery as the new blood vessels grow into and integrate within the graft. At 1 week, grafts can often have a similar appearance to what you show in your photos. There is always a chance that a portion of the skin graft may not survive, but in many cases even when this does happen, the final outcome ends up okay as the rest of the tissue heals in from the undersurface. I would recommend continuing follow-up with your surgeon in the first several weeks after the graft if you have ongoing concerns.

Milwaukee Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Is this a normal appearance for 1 week after a Mohs graft on nose?

Yes it is pretty normal. I do a ton of these Mohs reconstructions. That skin graft will take months before it really looks the way it should look. It will go through lots of changes over the next 6 weeks. The early phase of wound healing is the inflammatory phase and that is why it looks so angry. It will slowly grow new blood supply and change over the next several months so just be patient. I know it is hard because it is your face, but rest assured it will get better. Sincerely,DrRickAZ

Richard J. Brown, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 40 reviews

Skin graft question...

Skin grafts are fragile repairs that simply take a bit more time to heal than other methods.  Overall yes I think the graft looks fine and the darkness that you are seeing is common and will most likely resolve.  Think of the graft like planting a piece of sod is harvested from somewhere and placed somewhere else.  In the process, the graft must recreate its root system and "take" to the new location.  There may be a few parts of the graft that struggle a bit more but overall I think it looks like it will be ok.  Be sure to follow your instructions, which likely call for keeping it greased up with Vaseline (or similar).

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.