I Am Told to Wait 8 Weeks After Biopsy for Squamous Removal from my Lower Leg. Is This Really Wise?

I learned today it is squamous cell on my lower leg close to my shin and to wait until the first wound heals 7-8 weeks before surgery to cut out the squamous cells and then have two layers of stitches. 1 Is it wise to wait so long? 2 Should I find a Mohs doctor? 3 Is there enough skin fortwo layers of stitches? And 4 what kind of scaring should I anticipate?

Doctor Answers 4

Squamous cell removal from lower leg

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It's not necessary to wait for the initial wound to heal before performing the excision, so it's not necessary to wait 7-8 weeks, but it is also OK to do this if that's what your physician's schedule permits maybe. I very much doubt you would need a Mohs in this case because Mohs is only required for skin cancer removals where you need to preserve the most tissue you can, such as the face, nose, ears, sometimes hands or feet. It's not necessary to do Mohs on the back, torso, arms, legs, etc. in most cases because there is more than enough tissue to cut a safe amount of skin out, and then suture the area closed. Two layers of sutures is just fine and there is much more skin there than you realize. Two layers allows the area to remain closed better, and it's common in almost any procedure like that to do two layers of sutures. One stays under the skin and dissolves and the other is on the top and then those are removed. Follow your doctor's post care instructions to minimize scarring, but you should expect redness, and most likely a small straight scar.

Treatment of a squamous cell carcinoma (cancer) on the leg

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The wound does not need to heal before it is treated. Depending on the size of the squamous cell cancer, it might require Mohs surgery by a fellowship trained Mohs surgeon who is a member of the American College of Mohs Surgery. Some squamous cell cancers are more aggressive than others so it depends on the biopsy report how urgently it should be addressed. If you have concerns call your dermatologist who did your biopsy and let them know. 

Omar Ibrahimi, MD, PhD
Stamford Dermatologic Surgeon
4.9 out of 5 stars 29 reviews

Waiting For Surgery After Biopsy??

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The best thing you could do for yourself is find a good Moh's Surgeon.  The goal is to get all the cancer out, then worry about reconstruction afterwards.  Don't wait.   Best wishes!

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

Squamous Removal After Biopsy

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Thank you for your question. There is typically no reason to wait to have surgery after a biopsy is performed and a tissue diagnosis has been made, unless there are other complications such as infection that might compromise a surgical procedure and closure. Options for removal are variable, depending on the size of the tumor, and are best determined by either a Board Certified Dermatologist or Mohs surgeon. Issues and specifics of wound closure and scarring are also dependent upon tissue availability and tumor size. These again, are best made by a professional, after examination of the patient. I hope this helps.

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.