› Forums › Cutaneous Melanoma Community › WLE Post Op Day 2
- This topic has 21 replies, 5 voices, and was last updated 10 years, 7 months ago by
Leslie’sHusband.
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- October 10, 2014 at 5:37 pm
My surgery went "well" according to the surgeon who spoke to my companion that brought me. In the recovery area I pulled up the gown and gazed down on my left upper arm and was shocked by the sight of the incision. It was bigger and it curved here and there. My diagnosis 2 months ago was 1A.
I have waterproof "glue" instead of stitches in the top layer of skin. I was told the underlying layers contain stitches, and the good news is that I don't have to have anything removed. Presumably the glue wears off, and after a 2 week post op check, I see my surgical oncologist twice more at 6 month intervals to confirm there is no new growth at the surgery site.
I understand the mechanics of the WLE, with the primary lesion being excised with 1 cm of good skin surrounding it, then an oval shaped area is cut, to make the closing of the wound smoother, flatter with no bumps or ridges. Still, I was/am distressed by the length of the scar (3 1/2 inches) and the way it looks carved out.
Possible interpretations are; This is normal, the surgeon found something he didn't expect, melanoma excisions aren't supposed to be pretty, straight or asthetic. No one cares about the excision unless it's on your face, and then a plastic surgeon would be called in.
The surgeon told me during the office consult that the depth of epidermis removed is down to the muscle. I thought I had completely understood everything before I went in. Maybe it's post op blues or just a revisiting of the initial diagnosis when I realized I have cancer. This makes it "real."
I have the ability to use a secure website to ask questions, however the Nurse Practioner that has answered two prior inquires did not even look at my chart before answering. So that avenue is unreliable.
Thank you for any and all responses.
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- October 10, 2014 at 7:47 pm
Hi Resilient4Life. I'm four days post WLE for a lesion on my back. My dermatologist got me in for the procedure just a few days after the diagnosis so I don't know that I've processed everthing, either. My incision is about four inches. It is bigger than I thought it would be. But it's on my back so I'm just not going to care. They also did a scrape biopsy on my cheek for a second suspicious lesion.
How are you feeling? How is the incision? I also developed some irritation around the incision sights that are a bit uncomfortable and slightly itchy.
Hang in there.
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- October 10, 2014 at 9:00 pm
Hi Twistermom3,
I like your comment, "I'm just not going to care." That opened up my options! My incision is without seeping blood after 2 days and the pain level is more manageable than I expected. Decided not to get into opiates, since I have enough trouble without them. Not itchy, but feeling very squuezed and tight. Two places are raised with lumpy swelling, but that's OK. Having a fresh site on your back has to be tough, comfort wise. You sound like you've had a pretty speedy progression from discovery to surgery, so it will take some time to process. Thanks for sharing your experience.
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- October 10, 2014 at 9:00 pm
Hi Twistermom3,
I like your comment, "I'm just not going to care." That opened up my options! My incision is without seeping blood after 2 days and the pain level is more manageable than I expected. Decided not to get into opiates, since I have enough trouble without them. Not itchy, but feeling very squuezed and tight. Two places are raised with lumpy swelling, but that's OK. Having a fresh site on your back has to be tough, comfort wise. You sound like you've had a pretty speedy progression from discovery to surgery, so it will take some time to process. Thanks for sharing your experience.
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- October 10, 2014 at 9:00 pm
Hi Twistermom3,
I like your comment, "I'm just not going to care." That opened up my options! My incision is without seeping blood after 2 days and the pain level is more manageable than I expected. Decided not to get into opiates, since I have enough trouble without them. Not itchy, but feeling very squuezed and tight. Two places are raised with lumpy swelling, but that's OK. Having a fresh site on your back has to be tough, comfort wise. You sound like you've had a pretty speedy progression from discovery to surgery, so it will take some time to process. Thanks for sharing your experience.
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- October 10, 2014 at 7:47 pm
Hi Resilient4Life. I'm four days post WLE for a lesion on my back. My dermatologist got me in for the procedure just a few days after the diagnosis so I don't know that I've processed everthing, either. My incision is about four inches. It is bigger than I thought it would be. But it's on my back so I'm just not going to care. They also did a scrape biopsy on my cheek for a second suspicious lesion.
How are you feeling? How is the incision? I also developed some irritation around the incision sights that are a bit uncomfortable and slightly itchy.
Hang in there.
-
- October 10, 2014 at 7:47 pm
Hi Resilient4Life. I'm four days post WLE for a lesion on my back. My dermatologist got me in for the procedure just a few days after the diagnosis so I don't know that I've processed everthing, either. My incision is about four inches. It is bigger than I thought it would be. But it's on my back so I'm just not going to care. They also did a scrape biopsy on my cheek for a second suspicious lesion.
How are you feeling? How is the incision? I also developed some irritation around the incision sights that are a bit uncomfortable and slightly itchy.
Hang in there.
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- October 10, 2014 at 9:28 pm
In order to close a 1cm circular defect (your WLE site), the surgeon needs to extend that area to at least 2.5x the length in order to get it to close with out forming "dog ears". The length of the incision is merely due to the need to close a circle nicely into a line. I may be off on the 2.5x but it is close to that. You can google wound closure techniques if you are really interested.
It has nothing to do with your tumor, only how to close the hole after it was removed. Try not to read more into it. Curved incisions also are due to how the muscle fibers pull apart. By using these tissue tension lines appropriately, you can reduce the likelyhood of having your wound tear apart.
The golden rule in surgery for wound healing is that tension = tissue death or delayed healing and increased scarring. Your surgeon was using those forces of tension to their advantage. You can google plastic surgery wound closure techniques.
I have a lightning bolt on the inside of my wrist called a "Z" plasty. This closure relived tension over a very mobile joint, and works better than just a straight cut. It was also easy to hide in my skin folds / creases at my wrist. Little things like that are a mark of a surgeon who cares.
Your scar will become less evident over the next year, especially if you keep it covered from sunlight.
Hope that made sense.
KK
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- October 10, 2014 at 11:57 pm
Kim, thank you truly for the wonderful reply and specific information. I am totally relieved and it makes a lot of sense. I did research closures, but only briefly. This puts it perspective. I will be following your advice. Many thanks again.
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- October 10, 2014 at 11:57 pm
Kim, thank you truly for the wonderful reply and specific information. I am totally relieved and it makes a lot of sense. I did research closures, but only briefly. This puts it perspective. I will be following your advice. Many thanks again.
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- October 10, 2014 at 11:57 pm
Kim, thank you truly for the wonderful reply and specific information. I am totally relieved and it makes a lot of sense. I did research closures, but only briefly. This puts it perspective. I will be following your advice. Many thanks again.
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- October 10, 2014 at 9:28 pm
In order to close a 1cm circular defect (your WLE site), the surgeon needs to extend that area to at least 2.5x the length in order to get it to close with out forming "dog ears". The length of the incision is merely due to the need to close a circle nicely into a line. I may be off on the 2.5x but it is close to that. You can google wound closure techniques if you are really interested.
It has nothing to do with your tumor, only how to close the hole after it was removed. Try not to read more into it. Curved incisions also are due to how the muscle fibers pull apart. By using these tissue tension lines appropriately, you can reduce the likelyhood of having your wound tear apart.
The golden rule in surgery for wound healing is that tension = tissue death or delayed healing and increased scarring. Your surgeon was using those forces of tension to their advantage. You can google plastic surgery wound closure techniques.
I have a lightning bolt on the inside of my wrist called a "Z" plasty. This closure relived tension over a very mobile joint, and works better than just a straight cut. It was also easy to hide in my skin folds / creases at my wrist. Little things like that are a mark of a surgeon who cares.
Your scar will become less evident over the next year, especially if you keep it covered from sunlight.
Hope that made sense.
KK
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- October 10, 2014 at 9:28 pm
In order to close a 1cm circular defect (your WLE site), the surgeon needs to extend that area to at least 2.5x the length in order to get it to close with out forming "dog ears". The length of the incision is merely due to the need to close a circle nicely into a line. I may be off on the 2.5x but it is close to that. You can google wound closure techniques if you are really interested.
It has nothing to do with your tumor, only how to close the hole after it was removed. Try not to read more into it. Curved incisions also are due to how the muscle fibers pull apart. By using these tissue tension lines appropriately, you can reduce the likelyhood of having your wound tear apart.
The golden rule in surgery for wound healing is that tension = tissue death or delayed healing and increased scarring. Your surgeon was using those forces of tension to their advantage. You can google plastic surgery wound closure techniques.
I have a lightning bolt on the inside of my wrist called a "Z" plasty. This closure relived tension over a very mobile joint, and works better than just a straight cut. It was also easy to hide in my skin folds / creases at my wrist. Little things like that are a mark of a surgeon who cares.
Your scar will become less evident over the next year, especially if you keep it covered from sunlight.
Hope that made sense.
KK
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- October 10, 2014 at 9:45 pm
My WLE sounds a lot like yours. I was horrified at the appearance at first. But, I promise it will get better!!!! Using "glue" and no external stitches actually will give you way better long term scar results than external stitches would. Once you have healed up more and the Dr says it's ok, be vigilant about messaging the scar with vitamin e oil ( or other anti scarring agents, I use Palmers scar oil). The massage is important be it breaks up the scar tissue and will help even out your skin. Mine looked like I had a huge pointy shaped lump on my arm for months! I wouldn't see people unless I had long sleeves on. Almost a year out now, and it looks so much better. Just give it time. I know it's hard, but it will get better! Also, either wear sunscreen or keep it covered for the next few years for optimal scar results.
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- October 11, 2014 at 12:07 am
Lilo909, you must have ESP! My next concern was what substance to use to massage the area. Yes, I am a firm believer in breaking up the scar tissue because I had shoulder surgery 2 inches away from my new incision and didn't know any better at that time. I will continue to wear long sleeves, massage and keep the faith. I feel better able to cope knowing what to do and what to expect. Thanks for your reply.
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- October 11, 2014 at 12:07 am
Lilo909, you must have ESP! My next concern was what substance to use to massage the area. Yes, I am a firm believer in breaking up the scar tissue because I had shoulder surgery 2 inches away from my new incision and didn't know any better at that time. I will continue to wear long sleeves, massage and keep the faith. I feel better able to cope knowing what to do and what to expect. Thanks for your reply.
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- October 12, 2014 at 1:16 pm
My wife has a similar sized scar on her thigh from her WLE, as well as a couple more scars from the lymphadenectomy. She was concerned about their appearance, too, as they are sometimes visible when she is wearing shorts. She uses Mederma on them regularly, and they have lightened up a lot. She is getting to the point of not really caring about the scars, and if anyone sees them or not, which is exactly what I encouraged. I read somewhere on this site that "Scars don't form on dead people". Those who matter won't care, and those who care don't matter.
Don't be ashamed of the scar, it may just be the thing that opens the door to a conversation about Melanoma that saves someone's life.
Dave
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- October 12, 2014 at 1:16 pm
My wife has a similar sized scar on her thigh from her WLE, as well as a couple more scars from the lymphadenectomy. She was concerned about their appearance, too, as they are sometimes visible when she is wearing shorts. She uses Mederma on them regularly, and they have lightened up a lot. She is getting to the point of not really caring about the scars, and if anyone sees them or not, which is exactly what I encouraged. I read somewhere on this site that "Scars don't form on dead people". Those who matter won't care, and those who care don't matter.
Don't be ashamed of the scar, it may just be the thing that opens the door to a conversation about Melanoma that saves someone's life.
Dave
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- October 12, 2014 at 1:16 pm
My wife has a similar sized scar on her thigh from her WLE, as well as a couple more scars from the lymphadenectomy. She was concerned about their appearance, too, as they are sometimes visible when she is wearing shorts. She uses Mederma on them regularly, and they have lightened up a lot. She is getting to the point of not really caring about the scars, and if anyone sees them or not, which is exactly what I encouraged. I read somewhere on this site that "Scars don't form on dead people". Those who matter won't care, and those who care don't matter.
Don't be ashamed of the scar, it may just be the thing that opens the door to a conversation about Melanoma that saves someone's life.
Dave
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- October 11, 2014 at 12:07 am
Lilo909, you must have ESP! My next concern was what substance to use to massage the area. Yes, I am a firm believer in breaking up the scar tissue because I had shoulder surgery 2 inches away from my new incision and didn't know any better at that time. I will continue to wear long sleeves, massage and keep the faith. I feel better able to cope knowing what to do and what to expect. Thanks for your reply.
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- October 10, 2014 at 9:45 pm
My WLE sounds a lot like yours. I was horrified at the appearance at first. But, I promise it will get better!!!! Using "glue" and no external stitches actually will give you way better long term scar results than external stitches would. Once you have healed up more and the Dr says it's ok, be vigilant about messaging the scar with vitamin e oil ( or other anti scarring agents, I use Palmers scar oil). The massage is important be it breaks up the scar tissue and will help even out your skin. Mine looked like I had a huge pointy shaped lump on my arm for months! I wouldn't see people unless I had long sleeves on. Almost a year out now, and it looks so much better. Just give it time. I know it's hard, but it will get better! Also, either wear sunscreen or keep it covered for the next few years for optimal scar results.
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- October 10, 2014 at 9:45 pm
My WLE sounds a lot like yours. I was horrified at the appearance at first. But, I promise it will get better!!!! Using "glue" and no external stitches actually will give you way better long term scar results than external stitches would. Once you have healed up more and the Dr says it's ok, be vigilant about messaging the scar with vitamin e oil ( or other anti scarring agents, I use Palmers scar oil). The massage is important be it breaks up the scar tissue and will help even out your skin. Mine looked like I had a huge pointy shaped lump on my arm for months! I wouldn't see people unless I had long sleeves on. Almost a year out now, and it looks so much better. Just give it time. I know it's hard, but it will get better! Also, either wear sunscreen or keep it covered for the next few years for optimal scar results.
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Tagged: cutaneous melanoma
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