Before Your Procedure
Listed below are some general risks associated with skin surgery. Your dermatologist will discuss these risks and any additional potential problems associated with your case.
- Complete removal of the skin cancer may create a blemish larger than anticipated. Tumors may be larger than surface appearance indicates. Scarring will occur at the site of removal. Although every effort is made to obtain optimal cosmetic appearance, the primary goal is to remove the entire tumor.
- At times, healing is slow or the wound may reopen because of bleeding, poor overall physical condition, diabetes, smoking, or other disease states. Grafts and other repairs to the wound may fail to heal.
- You may experience loss of movement or feeling because of impaired nerve function. Many types of skin cancer are near or on important structures, such as the eyes, nose, or lips. Portions of these structures may be removed with resulting cosmetic or functional deformities. Your dermatologist will let you know if this is a possibility.
- The wound may become infected. A small number of surgical wounds (less than 5%) may become infected and require antibiotic treatment. If you are at higher risk for infection, you may by given an antibiotic before surgery.
- You may experience side effects to medications. Your dermatologist will carefully screen you for any history of problems with medications, but you may develop new reactions
- In some cases, the tumor may regrow after surgery. Previously treated tumors and large, longstanding tumors have the greatest chance for recurrence.
- You may experience possible numbness or loss of feeling. Skin cancer frequently involves nerves, so there may be a loss of movement or feeling. Frequently, skin cancer invades nerve fibers that must be removed during the surgery. Also, nerves adjacent to the skin cancer may be severed or injured during the reconstruction of the skin defect.
If you experience numbness, sensation will usually, but not always, return. In most circumstances, nerve function will return over a prolonged period of time, up to 24 months. In some cases, numbness may be permanent. If a motor nerve is involved, you may be unable to move the muscle. For example, you may be unable to wrinkle your forehead. Prior to your surgery, your dermatologist will discuss any major nerves that may be near the skin cancer.
Every technique that results in the destruction of skin cancer can result in the formation of a scar. Scarring is part of the process of healing. Scarring evolves and matures over 6 months to 2 years, depending on the location of the treated area. Some locations scar better than others. The face heals better than the back, chest, or shoulder. In addition, different biopsies, surgical techniques, and treatment options will result in different shapes of scarring.
Sometimes scarring can be improved. Raised scars can be surgically leveled with dermabrasion or the use of a laser, or they can be flattened with corticosteroid injections. Any surgery will result in some scar formation; however, your dermatologist will place the cut so that the resulting scar will be within the skin line. During the healing and maturation process of the scar, it is important to protect the area from the sun since sun exposure can result in a brownish discoloration of the scar, making it difficult to treat and fade over several years. Rarely, soft tissue augmentation in the form of injectable collagen is used to improve depressed scars. A laser is also sometimes used to treat broken blood vessels and redness associated with the scar. Use of multiple over-the-counter products, including silicone patches and gels, as well as daily massage can help improve and speed the maturation process. Your dermatologist will discuss with you the most appropriate products to treat your scar.