In the right place, a wound left to heal on its own gives a better result than any repair. Recommended and supervised by Consultant Plastic Surgeon Miss Rakhee Nayar.
Women in the UK dual-trained in Mohs and plastic surgery
of 36 patients would recommend Miss Nayar (PHIN, September 2026)
A deliberate choice
What is Secondary Intention Healing?
Healing by secondary intention means the wound is not stitched closed. It is dressed and allowed to fill in and close on its own, from the base upwards and the edges inwards.
It is a deliberate surgical decision, not a lesser option. Miss Nayar recommends it where the natural contour of the area will do a better job than a flap or graft.
Choosing the repair
When is a Wound Left to Heal Naturally?
Secondary intention works best in areas that naturally curve inwards, where a healed wound sits in shadow and blends with the surrounding skin.
It also suits shallow wounds where closing the skin would pull a nearby feature out of shape.
On flat or outward-curving surfaces, the scar is more likely to be visible, which is why the site matters so much to the decision.
Concave areas such as the inner corner of the eye, the bowl of the ear and the temple.
Shallow wounds where closing the skin would distort a nearby feature.
Patients for whom a longer operation is not advisable.
Situations where it is better to watch the area heal before considering further surgery.
Planned around you
What Makes Natural Healing Work Well?
The wound contracts inwards as it heals, which can draw the edges together neatly in a concave site.
There are no stitches to remove and no donor site, and the area stays easy to monitor.
No Donor Site
No skin is taken from elsewhere, so there is only one wound to heal.
Moist Wound Care
Keeping the wound moist and covered, rather than letting it scab, helps it heal faster and scar less.
Easy to Monitor
The area stays flat and visible while it heals, which makes it easy to check.
Revision Still Possible
If the final result is not what you hoped, scar revision remains possible later.
Clinical background
Why Choose Miss Rakhee Nayar for Your Reconstruction?
Reconstruction is where the result you live with is decided. With over 20 years of surgical experience, Miss Rakhee Nayar brings training in both skin cancer surgery and plastic surgery to the same operation.
One Surgeon, Start to Finish
Miss Nayar is one of fewer than 10 women in the UK dual-trained in both plastic surgery and Mohs micrographic surgery.
That means the surgeon who checks your margins under the microscope is the same one who plans and carries out the repair, knowing exactly what has been removed and why.
The Dual-Specialist Advantage
This combination means the person who removes your cancer is the same person who plans and carries out the repair. Miss Nayar is accredited as both a Consultant Plastic Surgeon and a Mohs surgeon.
- Cancer removal with every margin checked
- Repair chosen for your face and your wound
- One consultant from consultation to follow-up
- Plastic surgery training (FRCS Plast)
Training and Appointments
Miss Nayar is a Consultant Plastic Surgeon at Mersey and West Lancashire Teaching Hospitals NHS Trust, and sees private patients at Fairfield Independent Hospital and Circle Cheshire Clinic.
- She chairs the Mohs Surgery Training Interface Group (JCST), the national committee for Mohs fellowship training in the UK.
- She holds an MBChB with Honours and an MD from the School of Cancer Studies at the University of Liverpool.
- She is a Fellow of the Royal College of Surgeons of Edinburgh (FRCS Plast) and holds the European Board of Hand Surgery Diploma (EBHS).
- She is an active member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) and the British Medical Association.
Where it is used
Where Secondary Intention Is Used
Natural healing is most successful in the face’s concave areas. Miss Nayar will explain whether your wound is in a site where it is likely to blend well.
Read about the other reconstruction options: direct closure, local flap, full-thickness skin graft, split skin graft, nasolabial flap and forehead flap.
The Inner Corner of the Eye
The Side of the Nose
The Bowl of the Ear
The Temple
Shallow Scalp Wounds
Request an e-Consultation
Miss Nayar offers a convenient e-Consultation service for patients seeking a specialist opinion from across the UK and overseas. This secure digital pathway enables remote assessment of skin lesions and concerns, providing a prompt clinical recommendation.
It is an ideal first step for those considering Mohs surgery or reconstruction before travelling for an in-person appointment.
Step by step
What the Procedure Involves
Most repairs are carried out under local anaesthetic on the same day as the Mohs surgery, once the microscope has confirmed the margins are clear. Each step is explained as it happens.
Years of surgical experience
Once the microscope has confirmed clear margins, the wound is checked for depth and position.
Any bleeding is stopped, and the wound is cleaned.
A dressing is applied to keep the wound moist and protected.
You are shown how to clean the wound and change the dressing, usually daily at first.
You leave with written instructions and a point of contact if anything concerns you.
Other options
Other Reconstruction Options
Not every wound is suited to healing on its own. Where the site or size makes a repair the better choice, these options are usually considered.
Direct Closure
A fine line of stitches, placed in the natural creases of the face. Read more
Local Flap
Neighbouring skin moved across on its own blood supply for a close match. Read more
Full-Thickness Skin Graft
Skin taken from a hidden donor site and laid into the wound. Read more
Split Skin Graft
A thinner graft for large wounds, most often on the scalp. Read more
Healing week by week
Recovery and Healing
Most wounds take between three and eight weeks to close fully, depending on size, depth and site. The wound gets smaller each week rather than all at once.
- Week 1: the wound produces some fluid and forms a soft yellow layer at the base. This is healthy healing tissue, not infection.
- Weeks 2 to 4: the wound visibly contracts inwards, and new pink skin grows in from the edges.
- Weeks 4 to 8: the surface closes over. The new skin is pink and delicate.
- Months 3 to 12: colour and texture settle and the scar pales.
- Keep the wound moist and covered rather than letting it dry into a hard scab.
- Protect the healed skin from the sun while it matures.
In Patients' Words
Patients Feedback
What Our Patients Say
Concerned About Skin Cancer?
Book a Specialist Assessment
Early assessment usually means a smaller operation and a simpler repair. Contact Miss Rakhee Nayar’s clinic for an assessment by a consultant dual-trained in Mohs and plastic surgery.
or Call Us Now
07740 306144
Circle cheshire Clinic
The Courtyard, Hall Ln, Wincham, Northwich CW9 6DG, United Kingdom
07740 306144
contact@mohssurgeon.co.uk
Schedule Your Visit
Where to See Miss Nayar
Miss Rakhee Nayar provides specialist Mohs and reconstructive surgery at Circle Health Cheshire Clinic. This modern, private facility offers expert care in a discreet environment for patients across Cheshire and the North West.
Frequently Asked Questions
We're Always Here to Help You
Is it painful?
Most patients find an open wound less uncomfortable than they expected. Simple painkillers are usually enough in the first few days.
How often do I change the dressing?
Usually daily at first. You will be shown how, and given written instructions and a point of contact if anything concerns you.
Does the yellow layer mean infection?
Usually not. A soft yellow layer at the base in the first week is healthy healing tissue. Increasing pain, spreading redness or a fever should be reported straight away.
Will I be awake for the surgery?
Yes. Most repairs are carried out under local anaesthetic, so you stay awake and can talk to the team throughout. It also avoids the need for a general anaesthetic.
How long will it take?
It depends on how many Mohs layers are needed before the repair, which cannot be known in advance. Plan to be at the clinic for at least half a day.
Will it leave a scar?
All healing leaves a scar. In concave sites, a scar from natural healing often sits flat and pale within the natural shadow of the area, and blends well over time.