What to Expect:
o Normal swelling gets worse for 2-3 days before it reaches its peak and starts to decrease.
o Sometimes there is bruising that lasts a couple weeks.
o There will be either resorbable or non-resorbable sutures at the site of the biopsy.
o Long-acting numbing medicine is placed at the site of the surgery, so it is usually numb for 4-6 hours after surgery.
Activity:
o The patient should rest quietly in a safe place today. No vigorous exercise for 1 day. It’s ok to return to school/work in 1 day. You should not drive a car or operate machinery or sign legal documents when taking narcotics.
Diet:
o Advance diet slowly from clear liquids to bland/soft foods and then back to a normal diet. If there is an upset stomach or vomiting, then wait 30-60 minutes before starting with clear liquids and slowly advancing back to normal foods. Clear liquids include water, popsicles, apple juice, tea, cola, and breast milk.
Pain Management:
o Ibuprofen and acetaminophen products can both be taken, unless there is an allergy. They can be alternated or taken at the same time. Please follow the over the counter instructions.
o Very few people actually need to take a narcotic pain medicine. Narcotics have real risks and side effects such as nausea and vomiting, constipation, drowsiness and addiction. However, if there is severe pain that is not well controlled with ibuprofen and Tylenol, then we can prescribe a small amount of prescription pain medication. Take the narcotic pain medication exactly as prescribed to avoid a complication.
o Never exceed the maximum daily dose that is described in the over the counter instructions.
Non-pharmacological pain management:
o Ice packs or a frozen bag of peas can be placed on the area during the first 24 hours to help with pain and swelling.
Skin Wound Care:
o It’s important to take good care of the surgical site so that it has the best possible chances of healing well without a noticeable scar.
o Wait 24 hours before cleaning the area with soap and mild water. Make sure to pat dry the area. Do NOT rub on it.
o DO NOT soak/submerge the wound underneath the water in a bathtub, hot tub, pool, lake, stream, river, or ocean.
o Resorbable sutures usually dissolve and fall out 7-14 days after surgery.
o If non-resorbable sutures were used, they will be removed in the office setting anywhere between 5 and 10 days after surgery.
o Skin glue leaves a protective coating on the skin. The glue sloughs or peels off over the first 1-2 weeks after surgery.
o Use a light coat of antibiotic ointment (bacitracin, neosporin) twice a day for the first 3 days after surgery.
o After 3 days, please switch to plain Vaseline.
o You want to avoid letting a lot of scabbing build up.
o Use a q-tip with water to gently roll off any scabs.
o If you are having a hard time getting the scabs off, do your best and we will look at the area together at the follow up appointment.
o If things are healing normally, then we will review the use of a q-tip with a mixture of water and hydrogen peroxide 50:50 and gently dab the dried blood (scabs) to help dissolve them and prevent them from building up.
o Avoid direct sunlight as much as possible and use sun screen or a hat whenever you are outside for the first 6 months after surgery. Sun burns are really bad for the healing process and can cause unwanted scarring.
o After 3 weeks of healing, if things are going well, then it is generally safe to start massaging the site with some vitamin E oil or cream. Over the counter scar products can also be started at this time.
o You can start using over the counter scar sheets at this time (3 weeks).
o A little bit of redness on the edge of the site it normal during the first week.
o If there is concerning redness or swelling or any drainage of foul-smelling liquid, please contact our office. You will need to be put on an antibiotic.
Hypertrophic Scarring (abnormal):
o A scar that is thickened, wide, and often raised, but if isolated to the original injury/incision.
o Can develop 1-2 months after the injury.
o Can be treated with steroid injections and laser therapy.
Keloid Formation (abnormal):
o A raised, thickened, widened scar that grows beyond the boundaries of the original injury/incision.
o Can develop months to years after the injury.
o Can be treated with steroid injection and 5-FU injection and laser therapy.
Results:
o Usually, it takes 7-14 business days for the Pathologist to finalize the results. We will discuss the pathology results in person at your follow up appointment.