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So So I Had Reconstruction Surgery Today And The Area

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Posted on Tue, 24 Dec 2019
Question: So so I had reconstruction surgery today and the area reaches from my nose to my mouth! The area of squamous cell cancer was such a small pinpoint area.. why is the scar area so large? I will send the pics of the before and after.. will this leave a huge scar? I had the Mohs Surgery and they took only one layer off so it was not very deep so why the big line scar??
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Follow up: Dr. Dr. Kakkar (0 minute later)
So so I had reconstruction surgery today and the area reaches from my nose to my mouth! The area of squamous cell cancer was such a small pinpoint area.. why is the scar area so large? I will send the pics of the before and after.. will this leave a huge scar? I had the Mohs Surgery and they took only one layer off so it was not very deep so why the big line scar??
doctor
Answered by Dr. Dr. Kakkar (57 minutes later)
Brief Answer:
Regarding SCC and resulting scar from surgery

Detailed Answer:
Hello and welcome to ask a doctor service. I have gone through your query and viewed the image.

They have taken a flap from adjoining skin to make for the skin lost due to surgery. This would ensure optimal healing without any tension on the suture line and would give a cosmetically good result and a thin scar compared to if they hadn't filled up the gap from removal of cancer. No doubt post-operatively it looks like a big scar compared to the size of cancer but it would ensure close approximation of the surgical margins without any tension resulting in a thin scar and a cosmetically good outcome.

Hope I have answered your query. Let me know if you need any more assistance.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Dr. Kakkar (0 minute later)
Brief Answer:
Regarding SCC and resulting scar from surgery

Detailed Answer:
Hello and welcome to ask a doctor service. I have gone through your query and viewed the image.

They have taken a flap from adjoining skin to make for the skin lost due to surgery. This would ensure optimal healing without any tension on the suture line and would give a cosmetically good result and a thin scar compared to if they hadn't filled up the gap from removal of cancer. No doubt post-operatively it looks like a big scar compared to the size of cancer but it would ensure close approximation of the surgical margins without any tension resulting in a thin scar and a cosmetically good outcome.

Hope I have answered your query. Let me know if you need any more assistance.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr. Kakkar (1 hour later)
It is so swollen and tight feeling.. should I be putting ice on it? How often? He has me cleaning it 3 x daily and putting Vaseline on it.. shouldn’t I be putting something else on it? How soon will I see a better result than what I see now? Anything else I can do to speed the healing? Should I have gone with radiation instead? I am somupset at the way it looks..
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Follow up: Dr. Dr. Kakkar (0 minute later)
It is so swollen and tight feeling.. should I be putting ice on it? How often? He has me cleaning it 3 x daily and putting Vaseline on it.. shouldn’t I be putting something else on it? How soon will I see a better result than what I see now? Anything else I can do to speed the healing? Should I have gone with radiation instead? I am somupset at the way it looks..
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Follow up: Dr. Dr. Kakkar (3 hours later)
Also why are my teeth hurting? It is like I have sinus pain..what would cause that? Can I take aspirin?
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Follow up: Dr. Dr. Kakkar (0 minute later)
Also why are my teeth hurting? It is like I have sinus pain..what would cause that? Can I take aspirin?
doctor
Answered by Dr. Dr. Kakkar (19 hours later)
Brief Answer:
Regarding post op management of squamous cell carcinoma

Detailed Answer:
Hi.
The tight feeling is due to edema/ swelling which is a part of the healing process. You may ask your doctor to give you an oral trypsin, chymotrypsin preparation which would help reduce edema and pain. I won't advice aspirin as it is a strict no, before and after surgery, because it interferes with clotting. You may put vaseline or a topical antibiotic ointment like Mupirocin 2%
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dr. Kakkar (0 minute later)
Brief Answer:
Regarding post op management of squamous cell carcinoma

Detailed Answer:
Hi.
The tight feeling is due to edema/ swelling which is a part of the healing process. You may ask your doctor to give you an oral trypsin, chymotrypsin preparation which would help reduce edema and pain. I won't advice aspirin as it is a strict no, before and after surgery, because it interferes with clotting. You may put vaseline or a topical antibiotic ointment like Mupirocin 2%
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (30 hours later)
I just watched a video on skin cancer and the doctor talked about the type of lesion I had.. my sore was like a volcano crater..round .. in the video it talked about how the lesion mimic scc but it is not..the name is keratoacanthoma in 90 percent of the cases they go away on their own.. I was not given this option or correct diagnosis.. I am upset because now they have cut on my face and have left me with permanent scarring..
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Follow up: Dr. Dr. Kakkar (0 minute later)
I just watched a video on skin cancer and the doctor talked about the type of lesion I had.. my sore was like a volcano crater..round .. in the video it talked about how the lesion mimic scc but it is not..the name is keratoacanthoma in 90 percent of the cases they go away on their own.. I was not given this option or correct diagnosis.. I am upset because now they have cut on my face and have left me with permanent scarring..
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Follow up: Dr. Dr. Kakkar (1 hour later)
Could the lab have misdiagnosed the legion as scc? My legion was dome shaped with a crater in the middle ..I asked the Mohs doctor did he see squamous cells in the microscope and he said they only check to see if the margins are clear..not see if there are cancer cells ..is this true.. my margins were clear on the first cut..still thinking it was misdiagnosed as scc instead of Ka.. have you heard of this happening?!
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Follow up: Dr. Dr. Kakkar (0 minute later)
Could the lab have misdiagnosed the legion as scc? My legion was dome shaped with a crater in the middle ..I asked the Mohs doctor did he see squamous cells in the microscope and he said they only check to see if the margins are clear..not see if there are cancer cells ..is this true.. my margins were clear on the first cut..still thinking it was misdiagnosed as scc instead of Ka.. have you heard of this happening?!
doctor
Answered by Dr. Dr. Kakkar (27 hours later)
Brief Answer:
Regarding skin cancer

Detailed Answer:
Hi.
Your doctor must have considered the possibility of keratoacanthoma given its rapid progression and central crateriform appearance of nodule. Nevertheless, surgical excision with clear margins is the primary treatment for a keratoacanthoma wherever possible, since its biological behavior cannot be predicted. They may resolve but they may progress to invasive SCC too. The primary goal of MOHS surgery is to ensure clear margins which involves distinguishing normal from dysplastic skin cells at the margins.
Take care.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Dr. Kakkar (0 minute later)
Brief Answer:
Regarding skin cancer

Detailed Answer:
Hi.
Your doctor must have considered the possibility of keratoacanthoma given its rapid progression and central crateriform appearance of nodule. Nevertheless, surgical excision with clear margins is the primary treatment for a keratoacanthoma wherever possible, since its biological behavior cannot be predicted. They may resolve but they may progress to invasive SCC too. The primary goal of MOHS surgery is to ensure clear margins which involves distinguishing normal from dysplastic skin cells at the margins.
Take care.
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
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Dr. Dr. Kakkar

Dermatologist

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So So I Had Reconstruction Surgery Today And The Area

So so I had reconstruction surgery today and the area reaches from my nose to my mouth! The area of squamous cell cancer was such a small pinpoint area.. why is the scar area so large? I will send the pics of the before and after.. will this leave a huge scar? I had the Mohs Surgery and they took only one layer off so it was not very deep so why the big line scar??