One of my doctors had had a couple of Mohs procedures done on his face, and said that at my age, and with this location, Mohs was the only way to go. I made an appointment with a very highly recommended doctor, Dr. Thomas Breza, Jr. Before my appointment, I of course consulted "Dr. Google" about all of the possibilities. "Dr. Google" told me that my outcome didn't look so great, and that they may very well just lop my entire nose off. I was left feeling terrified, and was pretty positive that this diagnosis was going to be the end of my modeling/acting career. I couldn't remember ever seeing a casting for a girl with half a nose.
After my first visit with Dr. Breza Jr., I felt so much better. He talked me through the procedure, thoroughly. He promised that I would not be leaving his office without a nose. He specified the difference between Mohs, and a regular removal. He explained that Mohs allows him to personally check every millimeter of the lesions' borders for remaining cancer- as opposed to sending the slice off to someone else at the lab.
We went over the possibility of reconstruction, should I need it. He explained that he could do the reconstruction himself, right then and there, or that I could choose to see a plastic surgeon. I had already made my decision about that aspect- Due in part actually to an article I read on this very website. It was an article written by a Plastic Surgeon, regarding reconstruction following Mohs surgery. In the article, he was trying to convince patients that it would be insane to have your dermatologist perform the reconstruction. He was saying, (and this is just paraphrasing the gist of it...) "They're just dermatologists! They do the dermatology stuff. WE are plastic surgeons, and we do this for a living, all the live long day". Funnily enough, that very article is what convinced me to go with the exact opposite decision. My dermatologist specializes in Skin Cancer removal, Mohs, and the reconstruction of it. It's what he does. All the live long day. I'm pretty sure that Dr. Breza Jr. has more experience putting these specific types of wounds back together than a plastic surgeon who does boobs, and tummy tucks, and face lifts. If I need one of those procedures, I will seek a plastic surgeon- But when dealing with the reconstruction of a facial wound, from a Mohs procedure, I unquestionably decided to stick with the skin cancer expert.
I was scheduled for the procedure a few days later. He cleaned up the area, and numbed it up. I thought it was a magic needle, because I didn't even feel it go in. He removed the first little "slice". I don't remember exactly, but I'm pretty sure it was 3mm. He didn't want to remove any more tissue than what was absolutely necessary. About 15 minutes went by, and he came back with the results. There was still some cancer on the border- but he was able to pin point the exact location and direction it was growing. I was thrilled to have chosen Mohs- because otherwise, I would have had to have another "slice" around the entire diameter of the first one. Now, He only needed to remove another slice in the area that he had found the remaining cancer in. He took the second tiny slice, maybe a millimeter or 2, and came back 10-15 minutes later. The tissue was clear of cancer.
I asked to see it before he sewed it up, and it was this tiny little baby hole, that ran right along the crease of my nostril. He sewed it shut with a few stitches, and put a bandage on it. When the numbing medication wore off, I did feel some soreness, and a small stinging sensation. Not enough to warrant anything more than some ibuprofen, though. The pain was gone completely by the next day. I removed the bandage the next day, and was so happy. I didn't have any bruising or bleeding. All I had was this tiny little line of blue stitches, sitting perfectly on the crease of my nostril. If I was standing more than a few feet away, you wouldn't have even been able to see it. Seven days following the procedure, I went back in to have the stitches removed. I could barely tell that the stitches had even been there at all. It healed beautifully, and almost one year later, the only mark I have is a tiny, maybe 2-3 mm one, that is thinner than a fishing line, that sits right along the crease of my nose. The only was I can see it is in a magnifying mirror, without any makeup on. Even then, it's hard to spot.
My overall experience with Mohs, was a great one. I would never consider doing anything else if I were to experience another BCC. I didn't have half of my nose lopped off, and I am beginning to think that "Dr. Google" is a quack.