Reconstructive Plastic Surgery

Management of lymph node metastases

The RPS surgeons will determine the role for surgery for management of metastatic melanoma. This will usually be undertaken as part of a specialised Melanoma multidisciplinary unit review. It may be necessary to perform a form of lymph node surgery such as a parotidectomy and or other forms of nodal dissection to clear melanoma. Your RPS surgeon will discuss this form of surgery with you and can usually offer you this surgery as part of your surgical management.

When does cancer spread to the lymph nodes?

Secondary cancer in the lymph nodes is when cancer cells have spread to the lymph nodes from a cancer that started somewhere else in the body. The cancer travels via the blood stream or the lymphatic system.

If a surgeon removes a primary cancer, they often remove some of the nearby lymph nodes to see if the cancer has spread.

The risk of the cancer coming back may be higher if the nearby lymph nodes contain cancer cells. Your doctors may suggest you have more treatment after surgery to reduce the risk.


Curing Melanoma with Surgery

A wide local excision of a melanoma will minimise recurrence and will assist with determining the need for additional surgery and ongoing management.

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Recovery and Rehabilitation

After surgery you may have stitches until the wound heals. One to three weeks is an average healing time, however if the wound is larger or you had a skin graft it may take longer to heal.

After your wound heals you may have a scar, which should fade with time.

You may experience some pain around the site of the wound after surgery and your surgeon may recommend some over-the-counter medication or prescribe you some pain medication.

It is common to have one or more surgical drains after lymph node surgery (except sentinel lymph node biopsy) and advice will be given to you as to how long these will be in place and how they are to be managed in the post-operative setting. If you need to go home with drains in place, then at-home nursing visits may be part of your post-operative management to make the recovery process easier.

You will receive post-operative instructions outlining when you can get back to normal activities and how to care for the wound.

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More information

What else you should know

The Difference Between Melanoma and Other Skin Cancers 

Melanoma is more serious and less common than basal cell carcinoma (BCC) or squamous cell carcinoma (SCC).

In most cases (95%) melanomas are shades of brown. In 30% of cases they begin in previously ‘normal’ moles and in 70% of cases they begin as new moles.

Identifying and treating melanomas early is vital as they are dangerous and can be life threatening.

How do I care for myself at home?

After returning home from surgery you should follow the post-operative instructions provided by the Reconstructive Plastic Surgery Melbourne team.

Remember, everyone recovers differently, but you can follow these general steps to optimise your healing.


  • Always speak with your surgeon to find out when you can recommence taking your existing medication and before starting any new medicine they have prescribed.
  • Always consult your surgeon before taking new medication, even if it’s over-the-counter.
  • Always follow the instructions provided with the medication.


  • When you have stitches, always check with your surgeon before returning to your normal activities.
  • After a skin graft, any exercise that stretches the skin should be avoided for at least three weeks.

Caring for your wound

  • Your wound will have a dressing covering it to help it heal and protect it from outside elements. If you had a skin graft you may need to change your bandages. Your post-operative instructions will outline how to care for your wound.
  • If you have stitches, your surgeon will let you know when or if you have to return to have them removed.
  • Wash the area daily with warm, soapy water and pat it dry. Ensure you don’t use any alcohol or hydrogen peroxide which can slow down the healing process.
  • After 24 to 48 hours you may shower, try to keep the wound as dry as possible. If it gets wet, always pat dry the wound. Baths shouldn’t be taken for at least two weeks or until your surgeon advises it’s safe.
  • If you have a surgical drain (or drains), you will be advised about how to care for them and it is common to have at-home nursing visits every 1-2 days to help manage the drains until they are ready to be removed.
  • If you had a skin graft, be sure not to rub over the wound for at least three to four weeks.

Follow-up appointments

Follow-up appointments are essential after having a melanoma removed.

What are some of the risks?

Like any surgery, there are risks and complications associated with removing melanoma.

Risks of surgery to remove melanoma include:

  • infection
  • scarring
  • bleeding
  • rejection of the skin graft.
When should I call for help?

Notify your health care team immediately if you experience any of the following symptoms:

  • nausea, vomiting or diarrhoea
  • fever/high temperature – 38°C or higher
  • your stitches become loose or your wound opens
  • increasing pain that doesn’t improve with medication
  • increasing warmth, swelling or redness around incision site
  • pus coming from the incision site
  • heavy bleeding from incision site
  • red streaks leading to the incision site
  • you can’t pass stools or gas
  • signs of a blood clot including pain in your calf, back of the knee, groin or thigh, redness or swelling in your leg.

If you pass out or are short of breath call 000 for emergency care.

Dr. Michael Findlay

Our Melbourne specialist

The team at RPS Melbourne are committed to providing you with the best possible outcome.

The extensive specialist skills of our surgical team ensure that you are provided with surgical options designed to maximise form and function.

Dr Michael Findlay holds an impressive array of academic credentials, extensive professional experience and a personal commitment to patient satisfaction.