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Wide excision on the face: what the scar will look like | CION Cancer Clinics
A wide excision on the face will leave a scar, but surgeons can often place and close it so it is much less noticeable once it settles. The final look depends on the cancer's size, which part of the face it is on, your skin and how the wound is closed. Removing the cancer fully always comes first. This page explains what shapes the result, how scars change, and what to ask. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Will a wide excision on the face leave a visible scar?
- Does it matter where on the face the cancer is?
- How does a facial scar change as it heals?
- What usually helps a facial scar, and what does not?
- What do families often believe about facial surgery?
- What should you ask your surgeon about the result?
- Common questions about excision on the face
The short answer
Will a wide excision on the face leave a visible scar?
Yes, there will be a scar, but on the face it can often be placed and closed so that it is much less noticeable once it has settled. How it finally looks depends on the size of the cancer, the part of the face, your skin, and how the wound is closed.
Removing the cancer comes first
A wide excision takes out the cancer with a rim of normal-looking skin around it, called the margin. On the face, surgeons plan that margin very carefully, because skin is limited and every feature matters. But the margin is set by the type and depth of the cancer. Taking less to keep the scar smaller raises the chance the cancer grows back, and a second operation usually leaves a bigger scar than the first.
Why the face heals differently
The face has a rich blood supply, so wounds there often heal well. Its natural lines, creases and the borders between features give the surgeon places to hide a scar. On the other hand, the eyelids, nostrils and lips pull out of shape easily if skin is closed too tightly.
This page explains what shapes the result. It cannot tell you how your own scar will look. Your surgeon, who has examined the area, can give you a far better idea.Area by area
Does it matter where on the face the cancer is?
Very much. The same size of wound behaves differently on the forehead and on the nose.
Forehead, cheek and temple
There is usually more loose skin here. Smaller wounds can often be stitched along natural lines, such as forehead creases or smile lines.
Nose
Skin on the tip and sides of the nose is tight and thick. Even small wounds often need a local flap or a full-thickness graft to avoid pulling the nostril.
Often discussed
- A flap from the cheek or forehead
- A graft from behind the ear
Eyelids
Eyelids must still close fully to protect the eye. Surgery near the lid margin may involve an eye plastic surgeon, and the plan puts eye protection ahead of looks.
Lips
The border of the lip needs to line up exactly, or the mismatch shows. Lip function for eating and speaking matters as much as appearance.
Ear
Ear skin sits close to cartilage. A wedge-shaped removal can leave a slightly smaller ear that is rarely noticed once hair and glasses sit over it.
Not sure whether this applies to you?
Ask an oncologistOver time
How does a facial scar change as it heals?
-
Right after surgery
Expect swelling and bruising, which can spread around the eye even when the wound is elsewhere. It looks worse than it is. Sleeping with the head raised helps.
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When the stitches come out
Facial stitches are often removed sooner than on the body, because the face heals quickly. The scar is pink and may look raised or lumpy at this stage.
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The next few months
The scar often looks its worst here: red, firm and sometimes tight. This is normal remodelling. Flaps can look puffy before they flatten.
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Around a year and beyond
Most scars fade, soften and flatten slowly. On darker skin, a scar may end up paler or darker than the skin around it. Any decision about further scar treatment is usually made after this settling period.
Helping the scar
What usually helps a facial scar, and what does not?
Usually helps
Usually harms or does nothing
Keeping the wound clean and dressed as advised
Pulling off scabs or picking at stitches
Sun protection with a hat and sunscreen once healed
Direct sun on a new scar, which can darken it
Gentle massage once the team says the wound is ready
Home pastes, bleaching creams or turmeric on the wound
Stopping smoking and tobacco chewing
Smoking, which slows healing and harms flaps
Asking about silicone gel if the scar thickens
Expensive scar creams bought without advice
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Commonly believed
What do families often believe about facial surgery?
"We should wait until the spot grows before operating on the face."
A skin cancer on the face does not become easier to treat by waiting. The bigger it grows, the more skin has to come out and the harder it is to close neatly. Early surgery usually means a smaller scar.
"Only a cosmetic surgeon should operate on the face."
What matters most is removing the cancer with the right margin and closing the wound well. Surgical oncologists, head and neck surgeons, dermatologic surgeons and plastic surgeons may all be involved. Ask who does which part.
"A graft or flap means the face will look badly damaged."
Flaps and grafts are used precisely to avoid pulling features out of shape. They often look swollen early on and settle over many months.
"Laser or cream can remove it without a scar."
Some very superficial skin cancers can be treated without cutting, but most facial cancers that need a wide excision cannot. Using the wrong treatment can let the cancer spread under the surface unseen.
Being straight with you
What should you ask your surgeon about the result?
Ask where the scar will lie and roughly how long it will be. Surgeons often cut an oval shape so the wound lies flat, and the line can be several times longer than the cancer itself. Knowing that in advance saves a shock when the dressing comes off.
Ask how the wound will be closed
Ask whether stitches, a flap or a graft is planned, and what happens if the gap is bigger than expected. Ask whether a plastic surgeon will be involved, and whether closure might wait until the margin report comes back.
Ask about the edges being checked
On the face, some centres check the edges during the operation or use a layer-by-layer method such as Mohs surgery. Ask what is available where you are being treated, and whether it would make a difference for your cancer.
When it is harder
Large cancers, cancers that have come back, and skin treated earlier with radiotherapy are harder to close neatly. More than one operation may be needed. Your surgeon should tell you honestly if that is likely.
Did you know
Many facial scars look their worst a few months after surgery, not in the first week. If you are unhappy with how a scar looks early on, give it time and raise it at follow-up before deciding anything went wrong.
Questions we are asked
Common questions about excision on the face
Can the surgeon take a smaller margin on the face?
Sometimes the margin is adjusted near the eye, nose or lip, but only within what is safe for that cancer. Some centres check the edges during surgery to keep skin loss as small as possible. Ask your surgeon how the margin was decided and how the edges will be checked.
Will I be awake for surgery on my face?
Many facial excisions are done under local anaesthetic, so you are awake but numb. Larger operations, or those with a flap, may need general anaesthesia. Tell the team if you are anxious about being awake, because that can be part of the decision.
How long will the swelling and bruising last?
It is usually most noticeable in the first days and then fades gradually. Bruising can drift down towards the eye or jaw. Keeping your head raised and using cold packs as advised helps. Tell the team about swelling that keeps increasing, or any change in your eyesight.
When can I go out in public again?
That depends on the dressing, the size of the wound and how you feel. Many people return to ordinary activities once the dressing is small or the stitches are out. Avoid dusty places and strong sun while the wound heals. Ask the team what suits your wound.
Can I wear makeup or use face creams?
Not on the wound until it has fully closed and the team agrees. After that, makeup can help cover redness while the scar settles. Avoid bleaching creams, steroid creams and home pastes on the scar unless a doctor has advised them.
Can the scar be improved later?
Often, yes. Once the scar has fully settled, options such as scar revision, steroid injections for a thick scar or laser treatments may be discussed. Most surgeons prefer to wait until the scar has matured before deciding. The priority remains skin checks for the cancer.
Will the numbness around the scar go away?
Small nerves in the skin are cut during any excision, so some numbness around the scar is common. Feeling often returns slowly over months, but a small area may stay less sensitive. Tell the team about weakness in moving the face, which is different from numbness.
My mother is upset about how her face will look. How can we help?
Her feelings are real and worth taking seriously. Go with her to the appointment and ask the surgeon to explain where the scar will be. Ask whether the team has a counsellor to talk to. Many people find the worry eases once they understand the plan.
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Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
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Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
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Radiation Oncologist
Radiation Oncologist
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Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- American Cancer Society — Surgery for Basal and Squamous Cell Skin Cancers
- NHS — Non-melanoma skin cancer: treatment
- NHS — Scars
- National Cancer Institute — Skin Cancer Treatment (PDQ) - Patient Version
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Mohs Surgery: Is It Available in India?The layer-by-layer method often raised for the faceClosing the Defect: Direct Closure, Graft or FlapHow the wound on the face may be closedWide Excision for Skin CancersMargins and planning for basal and squamous cell cancersThe Emotional Side of Cancer SurgeryCoping with changes in how you look
Talk to us
Worried about surgery on your face?
Send us the biopsy report or call the helpline. A surgical oncologist will explain what is usually involved for a cancer in that area and what to ask. One helpline serves every CION centre.