What’s the difference between true risks and expectations of surgery?

Expectations are things that happen with every surgery, and are unavoidable. Scarring or the need for reconstruction are actually not risks, but expectations. Patients can expect with Mohs surgery, a high cure rate, small cancer recurrence rate, and improved appearance over normal excision surgery, but they can also expect some unpleasantness such as bleeding in the first 48 hours, swelling for the first 5 days after surgery, bruising, and scarring, and a recovery time of a year or more. Sensory nerves can also be damaged. They typically recover over 18 months. These are all expectations, and patients need to understand them as such. They are NOT true risks of surgery.

Risks are adverse events that may occur, and patients should be aware that there is a chance of its occurrence, but unlike expectations, they should not necessarily expect them to occur. Excessive bleeding causing pooled blood called a hematoma is one such risk, and this risk is higher for patients using blood thinning medication. About 1 to 4% of patients may get an infection if the surgery is in the head and neck area. Diabetics, or patients who have weakened immune systems or are otherwise prone to infections should be aware of these risks. Tissue necrosis is also another risk that smokers may be more prone to. Abnormal scars, permanent sensory nerve damage, and recurrence of cancer, are all considered potential risks of surgery. It’s important to remember that the risks of surgery need to be weighed against their benefits.

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Preparing for Mohs Surgery

A Comprehensive Guide to MOHS SURGERY
In this video series one of Canada's leading Mohs surgeons, Dr. Bryce Cowan explains the Mohs surgery procedure, expectation, and the facts and myths surrounding this advanced treatment procedure for removing skin cancer.