There may be bleeding during the operation, which may need the intervention of an electric needle to stop it. In this case, a special sticker will be placed on your right arm which serves to close the electric circuit and prevent electrocution. If you have a pacemaker you should tell the surgeon so as not to stop it working during the treatment.
A few hours after surgery you may notice some bleeding. This usually comes from the disappearance of adrenalin injected with the anesthetic. It is important to distinguish between a bloody secretion coloring the bandage red and bleeding that soaks the bandage with blood flowing outside it. Bloody secretions are common to all surgery. It is nothing to worry about and needs no intervention. However, when you are bleeding, the external bandage should be changed and you or someone else should put uninterrupted pressure on the wound for 15-20 minutes.
If the bleeding does not stop, repeat the pressure and if that still doesn’t work, contact your surgeon or the hospital (your discharge letter should have the relevant contact numbers.)
Sometimes, you may see bruises under your eyes, mostly on the side operated on but sometimes under both eyes if the surgery was focused more in the center of your face. This side effect is caused by the tissue under the eye being absorbent and therefore absorbing the blood remaining in the tissue or slight bleeding after surgery. This is perfectly normal, nothing to worry about and should disappear within 7-10 days.
Nerve damage during the operation can cause disorder in your sensations around the affected area, and in rare cases even weaken the muscles in the area. In most of the cases in which the tumor is very close to a significant nerve, the surgeon will explain the ramifications of continuing the surgery in light of the expected damage to the nerve and receive the patient’s approval to continue. Smaller nerves may also be damaged but they are responsible for small areas and any damage will not cause any significant disruption in functioning or feeling. In most cases, sensations around the affected area will return to normal after a few months.
The local anesthetic itself may cause side effects, if the patient is allergic to the specific anesthetic. The mixture also contains adrenalin, which helps the veins contract in the affected area and prevent the anesthetic spreading as well as reducing bleeding from the tissue. Although it is a very low concentration, some patients may react with increased heartbeats and a sense of anxiety. These symptoms are normal and pass quickly.
In rare cases there may be an infection in the surgical wound. This may need drainage or antibiotic treatment. Symptoms are pain, localized or widespread heat, redness around the wound or swelling. In cases in which the length of the operation, the circumstances, the size or location of the wound are likely to increase the risk of infection, the surgeon will instruct the patient to take preventative antibiotics immediately after surgery. Of course, if an infection arises during your antibiotic course, inform the surgeon immediately.
In even rarer cases, healing can be very slow, delayed or abnormal. In these situations, contact your surgeon. In most cases, the solution is straightforward and the final result will be very good.
Some of the above complications may be accompanied by localized pain or discomfort. If your pain does not go away, does not respond to drugs or becomes more acute, contact your surgeon. He or she will either prescribe stronger drugs or call you in for a check-up.
It is important to know that no treatment can promise 100% cure for skin cancer and there is a very low rate of tumor relapse after Mohs surgery.