Swollen and Hard After Mohs Surgery

Had mohs 12 days ago. almost all swelling completely gone. 1cm Wound on side bridge of nose closed in linnear type fashion. Stitches from upper side bridge of nose down to crease of ala. Swelling near gone but left with a very hard swollen area begining under skin from bottom of orig 1cm wound (side of nose) extending down to begining of nosolabial fold just above ala. Can push on it and its pliable...but well defined and quite hard. Feels like a hard fish oil (omega 3) gelcap under skin!!!

Doctor Answers 4

Mohs surgery for skin cancer and reconstruction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Lumps under scars from reconstruction could represent normal swelling, palpable dissolvable suture early in the post operative period and dissolving reactions later in the course, hematoma which is blood that has collected focally, or an infection. If you're not having pain in the area, the firm area will probably resolve in time, but you should see your doctor for reassurance and they may suggest some treatment to hasten the resolution.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

What to expect after Mohs.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Mohs' surgery is a method of removal of cancerous tissue in the skin. It is not a method of reconstuction. In nearly all cases, some form of reconstruction is performed to close the wound after the cancer is removed. This can be extremely simple, such as putting in a few stitches, or very complex requiring more than one surgery. Depending upon the reconstruction that is performed, one will expect different results and different after care.

In any case, your surgeon should discuss with you what is expected and what not to expect after surgery. Anything that is "not expected" should be reported to your surgeon.

That being said, the following list below constitute a general list of side effects that should not substitute the instructions given to one by their surgeon. These are listed for illustrative purposes only.

Common expected side effects of any surgery include:

  • minor bruising
  • mild pain at the surgical site
  • mild spotting of blood at the surgical site
  • mild swelling

Other side effects that should be reported to one's surgeon:

  • allergic reactions to tape and bandages --itching at the site with red rash and/or small blisters
  • any bleeding
  • infection--redness, warmth, drainage, discharge
  • moderate or severe swelling.
  • Separation of the wound or stitches falling out.


Robert S. Bader, MD, FAAD
Boca Raton Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Mohs surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Wounds can heal with scar tissue that is hard to touch. However, I would recommend that you show the wound to your surgeon and discuss to make sure you are healing as expected.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon

Go talk with your surgeon

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

In the post-op period it is not uncommon to have swelling and strange sensations.  Scar tissue can leave "hard spots" under the skin, but for that to have developed in 12 days seems implausible.  It could be a hematoma (blood clot) under the skin.  A picture would be helpful. I would strongly suggest going back to your surgeon and expressing your concerns. 

Brent Spencer, MD
Frisco 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.