It just seems when it rains it pours. 1) I’m dealing with hair loss and went to dermatologist last week. Don’t have my blood work in yet, I went off Retin A and am increasnig calories. 2) I’ve been experiencing Premature Ventricular Contractions 3) Asked the derm about this thing on my nose that I’ve had over a decade. It’s been a whitehead…i squeeze, it comes back…over and over. I figured I’d damaged the pore, but in the last few months it acts differently and then bleeds. She said she thinks it’s skin cancer and wants to remove it.
I went to plastic surgeon (will go see another) and more than likely they will want to do a biopsy first. If it is cancer, they will do MOHS surgery…and of course we won’t know how deep or big it is underneath. Right now it’s circular, light and about 1.5 mm in diameter. I started asking him questions if it is cancer. He said sometime, yes, if it is big underneath they’ve had to take cartilage and I would have to have reconstructive surgery, but i was getting ahead of myself. You know the bulb of the nose? It is located on the side right where the nostril and bulb meet.but on the bulb side…so at least not on the tip of my nose…but still…
I am so nervous
And I thought I would be having upper blepharoplasty this year. Anyway, anyone had this procedure done? It’s tissue sparing and the best.
I had Mohs surgery on my neck. I was lucky, and they only had to do one pass. My boss had it on her nose. It’s a very standard surgery, and there are some surgeons who do mostly that.
I had 2 Mohs procedures that were on my scalp. One was pretty far forward, so cosmetics were important. I think the Mohs procedure assures that the doctor gets all the cancer while removing the minimum amount of surrounding tissue, which is what you want when cosmetics is a priority. I have had several basal cell carcinomas removed. It is “cancer” but fairly benign. You don’t want to leave it alone to grow unchecked, but it is not life threatening nor deserving of the typical reaction one gets from the word “Cancer”. Anyway, the basal cell on my upper arm was not worthy of the cosmetic considerations so they just hacked it out (not Mohs) and I have a visible scar on my arm above the elbow.
On the nose is a fairly nerve-wracking location, so I would ask a lot of questions and maybe get references for both surgeons. (Mohs, and the plastician).
Have had basel cell removed using Mohs near my eye. I will be having additional surgery later this year. Surgery was very easy, although you end up looking hideous for a few days afterwards.
I had it on my nose last October. Both spots were on the upper sides of the nose.
Had one spot that was squamous cell and that came off with one pass. One stitch closed it up.
Had another spot (basal cell) on the other side of the nose that required 2 passes, a cheek flap to reposition the skin, a bolster bandage to keep that in place. It felt pretty bad for a day or two and looked pretty bad for a few weeks. With Biocornium (a liquid silicon scar reducer) and daily massage to reduce the scar buildup it is barely noticeable now.
The MOHS surgeon was a dermatologist, not a plastic surgeon. She did both the MOHS and the restorative flap surgery in one morning. She was an artist. She was seriously concerned with the post surgery appearance.
Just recently, after hearing about Jimmy Carter, I was thinking how lucky I am to have had cancer and be rid of it so easily.
I was really worried before also. I won’t be too worried if I have any more spots pop up.
I have had it done twice including the side of my nose. My other spot was just above my upper lip. The lip area took 3 passes. The nose luckily just 1. The nose healed quickly and nicely with little pain. The lip took a longtime and was pretty painful and I had to get several cortisone injections to break up the scar tissue several months after.I was told the lip area is difficult because we have a lot of nerves in that area plus when you go into the lips you need someone good or it won’t look natural when it heals.
My dermatologist did a biopsy that came back positive. She sent me to a board certified MOHs dematologist. She had a day of the week that was devoted to MOHs. You don’t know how long you will be there depending on how deep or wide they have to go. I appreciated that my dermatologist sent me to someone well trained. I know in my area many dermatologist do MOHs but aren’t board certified. My good friend had a similar above lip MOHs done by a plastic surgeon.
I think a concern with certain areas such as nose or ear is how deep the cancer goes. It is is deep they will need to do some reconstruction.
Thanks everyone. So, I made another appt. with a more seasoned plastic surgeon (who actually takes insurance). He is recommended by the dermatologist and a family friend who is a physician and had something removed once (not MOHS).
Should I be seeing a MOHS dermatologist instead that is certified in this procedure instead of a plastic surgeon?
When I was asking my dermatologist about scarring she could tell I was concerned and said, “I think you should see a plastic surgeon”, so I got the impression she knew I was wary of her stitching skills. She probably doesn’t do MOHS or I think she would have talked to me more about it. That’s how i ended with a plastic surgeon.
I think it makes sense to talk to the plastic surgeon, but I would suggest asking about MOHS in particular. The person I saw specializes in that procedure.
Conmama- I would definitely ask if their is a MOHs certified MD in your area. I would also ask around and see if you can get some recommendations from people in your area who have had it done.
I have noticed in my area that the female derms send their MOHs surgeries out to a specialist. Several male Derms in my area though not board certified do MOHs in office.
With MOHs they take the least amount of tissue that is needed because after each pass the Dr has a pathologist read the slide before they take more. The Dr who did mine had a pathologist come up from a larger city who was in office the day of surgery.
I had Mohs surgery about 15 years ago for a squamous cell carcinoma on a part of my body that’s usually covered by clothing (so whatever caused it, it wasn’t sun exposure), so I wasn’t too concerned about appearance. But the scarring was minimal and not really even noticeable. It was a bit stressful having to lie there and wait each time for them to check to see if more needed to be removed, but it was worth it in the end. And I’ve had no recurrence.
I had it on my forehead for basal cell cancer. It was very easy. They needed two passes (in one day) to get it all. The scar is not at all obvious. Mine was done by a dermatologist.
I’m really feeling better about this reading all of your posts. Who would have thought so many people would have had this done? I was hoping just one person would be able to respond, so reading everyone’s success stories calms me a little.
Also went with a derm, who does a lot of these, and not a plastic. (I ain’t that pretty.)
Easy-peasy, since mine was not too deep. Three passes and out the door. The doc did most of the digging from a current crease/wrinkle, so it all blended in when the swelling subsided.
Take a book or several magazines, since it may take awhile.
I had Moh’s surgery on the part of my nose that sounds very similar to where your spot is. My Dr. biopsied it and the result came back a few days later and was positive for basal cell. I had been told that it was no doubt basal cell but the insurance companies will not approve Mohs without the pathology report. The soonest possible date was about six weeks off. It took 3 tries to get it all, with the wound going to the cartilage on the bottom and the diameter of a penny on top. I had chosen my dermatologist carefully, board certified, Johns Hopkins trained, etc. I had asked about closure and was assured that he was fully capable of any reconstruction needed. He did a skin graft with skin taken from in front of my ear. In less that a week I had a black disk on my nose the size of a penny. He kept saying we just had to wait and I went every week to be told to wait some more. At three weeks the graft fell off, leaving a deep hole. He said we again had to wait and see how it would heal. This was the point where I said forget this and went to a plastic surgeon, who scheduled me for his first available surgery spot to do a bilobed flap. They artfully cut and stretch the skin to cover the wound with this.
My bilobed flap has healed, it’s still pinkish but I’m told it will fade eventually. The problem now is that the cartilage was compromised and no longer supports my nose, it sags at the tip. At my six week post op my surgeon suggested a reconstructive rhinoplasty to give my nose the support it needs. That procedure is scheduled a week from today.
The Mohs is always done with local anesthetic but my other procedures were/will be general anesthesia in an outpatient surgery center. I highly advise being asleep for the parts that you can. Feel free to PM me if you have any questions. I know band aid tricks!
I had a one pass one done on my nose. I can’t even see the scar unless I go looking for it. I had another one done on my arm, also one pass, but a much more noticeable scar. I’m actually pretty prone to scarring so I was very happy with the nose procedure.
I hope yours turns out as well as mine, though it sounds like you have a bigger area to worry about.
This is a personal thing, but I’m NOT a fan of biopsies, unless it is something that is difficult to remove whole as I would rather not break into and release bad stuff. I’d rather just take it off, and have done so, several times. It is also cheaper than doing the biopsy first, if you can just take it off (obviously, if it is something that cannot be removed whole without additional work, then maybe you do so).
I have never had Mohs; she just cuts them off and if questionable, sends them off for lab examination. They were not large , I’d say under pencil eraser size. They were on my face. I have no scars, as my dermatologist is very good at this. However, the skin under where they were is a bit lighter (since it isn’t old like the rest of me!), which only shows if I get some sun.