What Should I Ask About Nodular BCC on my Ala?

asked 3 years ago by Susan in MN in Saint Paul, MN
Latest answer by Andrew Kaufman, MD
Question viewed 3,449 times
Tags: nose, skin

I have a nodular basal cell carcinoma (BCC) on my nasal ala. It is 5mm across and primarily flat. I will be having Mohs surgery in a couple weeks to remove it. I am a 46-year-old woman, and this is my third BCC The last one was diagnosed 7 years ago. I've had one on my back and one on my shoulder. I am concerned about reconstruction and would like to know what questions you might recommend that I ask my surgeon about it. Thanks!

6 answers to What Should I Ask About Nodular BCC on my Ala?

Find a Doctor that You Trust

The best advice I can give you regarding the reconstruction is to find a doctor that you trust. Nobody can say what type of repair is best because nobody knows how large, how deep or what shape your skin cancer will be. Talk to the doctor about their experience and training and pick the doctor that you feel will give you the best cosmetic and functional result the first time. Fellowship training in Mohs surgery or plastic surgery are good qualifications but beyond that you need to feel... more

Andrew Kaufman, MD
Los Angeles Dermatologic Surgeon

www.dermatology-center.com

Nodular BCC and Mohs Surgery

One way to help gauge whether your Mohs surgeon does good reconstructive work is to ask for before and after photographs. You can ask your surgeon how long he or she has been performing Mohs surgery reconstruction. The reconstructive options depend on the size of your final surgical defect and whether or not the underlying cartilage is involved. Your surgeon may or may not perform all of the reconstruction procedures him/herself. More frequently, however, for more complicated repairs,... more

Bryan K. Chen, MD
San Diego Dermatologist

Mohs on the nose

If you have a fellowship-trained Mohs surgeron they will be experts in removing the cancer and reconstructing the area. If you are still concerned after verifying their credentials, you should ask for before and after pictures to see what their work looks like. In general, if they were trained in a one year fellowship for Mohs surgery, they are required to be experienced in this area and should be able to do the work you need in the outpatient setting with local... more

Shawn Allen, MD
Boulder Dermatologist

Basal cell carcinoma on the nose

The best treatment for basal cell carcinoma on the ala of the nose is mohs surgery. This is because Mohs will enable the surgeon to conserve tissue, confirm removal and give you the highest cure rate. Another option not as effective for small basal cells in cosmetically sensitive areas would be Aldara cream. In general small lesions that undergo Mohs surgery often heal great with no repair, in other words, secondary intention healing. I prefer this to any repair given the natural result.... more

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon

www.palmbeachdermasurgery.com

Basal cell carcinoma of nose

I'm assuming that this is a histolological diagnosis in addition to the clinical diagnosis(I can't see a biopsy site in your pic). This is a difficult 3-dimensional defect to reconstruct without leaving a bridge or web, and is usually dealt with by a plastic surgeon working with the Mohs surgeon.

Barry H. Dolich, MD
Bronx Plastic Surgeon

Leave It Up To The Mohs Surgeon

Mohs surgery is the most effective means of removilng a basal cell, especially in potentially tricky spots such as where yours has planted itself. I would leave it up to your Mohs surgeon. If it turns out that if your basal cell is not that extensive, he or she should be able to perform the repair quite easily. Otherwise and the talents of a plastic surgeon are required, then your Mohs surgeon would know which plastic surgeon would have the best expertise in that area. One other... more

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

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