How does a skin graft tend to look after Mohs surgery 10 days later? Is this normal? (photos)

Question

Is this normal? One side is healing nicely while the other looks more and more black. It's been ten days since surgery!

Raffy Karamanoukian, MD, FACS · Answer

Moh’s surgery on the face often requires surgical repair and reconstruction to reapproximate the skin edges. Flaps or direct closure techniques are used. It is important that you optimize scar healing during this phase in order to reduce longterm scars. For red scars, we use Vbeam laser, followed by fractional laser for scar topography and contour. We recommend Plato’s Scar Serum twice daily for the immediate postoperative period. Fractional laser is safe for scar laser therapy. 
There are treatments for swelling and edema of the scars. If there is residual sutures or edema, we advise you to follow a scar treatment protocol that can minimize the time to recovery. Our office specializes in scar revisions for Moh’s surgery. 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Ariel Ostad, MD · Answer

Hello and thank you for your question.  It is difficult to fully assess a skin graft without looking at it in person.  However, based on the photos you provided, it does not appear that the graft 'took' and is alive.  At this point (ten days later) the wound should be a mix of red and purple in color.  I would contact your surgeon immediately for a proper follow up. Regards,Ariel Ostad MD PC

Inessa Fishman, MD · Answer

Your photos suggest poor healing of the skin graft, likely due to compromise in blood supply.  Please contact your surgeon for evaluation as soon as you can.

John McCann, MD, PhD · Answer

Hi sarahmbower,

Thanks for your question and photos. Looking at the picture, I have some concern that the skin graft may be not receiving enough blood supply. I would contact your surgeon today and get their opinion.

I hope this helps!

Richard P. Rand, MD, FACS (retired) · Answer

In person exam by your doctor is critical but it doesn't look like the skin graft is "taking" ie surviving. You may need further reconstruction so see a Board Certified Plastic Surgeon for other options such as a forehead flap.

How does a skin graft tend to look after Mohs surgery 10 days later? Is this normal? (photos)

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