“Waiting for Mohs Surgery After Unexpected Discovery of Bcc on Skin Fold Upper Right Lip - Melbourne, Australia”

Hello,

I had a spot on my forehead that I ignored for several years. It would bleed, heal and was a bit bigger in diameter than a pencil eraser. I went to a dermatologist clinic to participate in a clinical trial for a Clarisonic. Luckily a PA checked my face, told me he thought I had cancer and scheduled me for a biopsy the next day. That was in February. I had the MOHS procedure on April 19th. I went through four stages before they got it all..a LONG day. I was there from 9 to 5. So I still have stitches, they come out Friday. I think because it is on your lip I would be asking if plastic surgery would be needed. I would is from mid fore head to hair line, they stitched up and down. It was pretty deep and even now I don't like looking at it. My biggest gripe with this procedure is BEING AWAKE! I think I would have done much better with twilight sedation or something. Keep us posted.

Hi there, I hope you are doing well. I am guessing you had the V-Y (previously Island Pinacle)on your repair. I had two small bumps on tissue between my right nostril and upper lip (started as a small scaly red spot seven years ago). I had three stages of Moh's 8 1/2 weeks ago. Swelling and bruising first couple of weeks. My stitches were taken out at 6 days. Probably could have been out one day sooner to prevent rail road tracks I have. Quality of healing is partially determined by genetics. I still have a puffy pin cushion deformity which with massaging should improve. I hope you are a non smoker. Smoking impedes healing more than anything else. Eat healthy and drink plenty of water. My nose and upper lip were pulled to the right to cover the hole. Still pulling to the right but I have firm lumps underneath and hoping that as they soften the nose and lip will return to their original positions.
Take care! Hope to hear from you.

Hello again! I am feeling better about how it looks. Seemed to take a long time but in reality had it done 4/19/11 . Once I get my hair done (with bangs) I will feel "human" again. Hope you are well and I will post again soon. Peace!

Hi just had Mohs surgery on my upper lip on left side of cupids bow. They found no cancer at all but to repair the incision I have had all of my cupids bow taken and most of the central part of my lip.

I am totally disillusioned with the whole procedure. I was told a good Mohs result meant no drastic surgery but here I am feeling like there was absolutely no need to take what has been taken. I feel I look stupid so will probably have to have further corrective surgery. I hope yours is healing well.

I am sorry to hear about your Mohs surgery. I am very surprised that they did Mohs when biopsy result indicated no cancer. If you have just had it done then maybe wait a little for it all to subside. Mine looks amazing now. My doctor was so good and took extra time and care at closing to ensure a good result . Maybe it is just like anything you need to look around for a good Moh's surgeon to get the best results. My Moh's surgeon was also a plastic surgeon so maybe that is what the difference was. I hope that they can fix it because I know how it feels to have something like that done on such a vital spot.

Keep me updated on how you progress. If you are in Melbourne I can recommend Dr Alan Sheridan from the Victorian Dermotology Clinic.

Cheers

Hello to all. To Mitra333, I am sorry to hear about your experience. I too am very surprised they did what they did, not right IMHO. As far as my recovery I have gained new insight to this "Gold Standard" treatment. Let me share my thoughts...prior to my "procedure" I informed the staff that I had Fibromyalgia and told them stress is hard for me. At first the nurse offered a possible solution, Versed which is something that they had on hand. However when I met with the Dr. that was off the table. So I endured hours, slice by slice, of the MOHs procedure. It was horrific to got through 8 hours of their slicing and analyzing. Four levels later I had what they themselves described a wound looking like I had been shot in the head (upper forehead). The closure was awful, 2 people shoving and pushing on my forehead so the Dr. could then stitch it up. I know this I will never go through it again without proper education and the right medication. If this does not put your body and mind into shock then what would? Here we are so far ahead with medical technology and yet MOHs is done most of the time WITHOUT any thought to the COMFORT of the patient! I talked to a friend afterwards, she is a surgical nurse, and upon telling her what happened and the name of the Dr. she stated "He does things old school". Ya think?! Anyway I am healing alright but my level of trust is in the basement.

Great to find this page with comments. I have just undergone surgery for bcc tip of nose (9 days ago) Had full thickness skin graft from neck to nose. Depth 5mm (sorry we aren't imperial measure anymore in Oz) and covered an area of a man's thumb print on my nose removed. All under GA with surgery from plastic surgeon. Wonderful bed side care at private day surgery - (all worth the expense). I woke up and it was all over.
Given excellent verbal debriefing with husband before leaving clinic and written instructions with Surgeon's direct mobile if t any issues (infection, bleeding etc). All care was taken that I did not feel any stress or physical pain before during and as much as possible, after. I had a large area removed and would take at least 12 months till end result.
I'm not 100% sure that the graft has completely taken, I'm just going by the fact that he took the stitches out and dressed the area again, but I know grafts this size can take time. Next visit he said that generally his nurse takes off final dressing, but to make an appointment so that he would do that. Physically, I know when I look down to my nose, after the nasal bone the last half of flesh is not there (the divot is that large) but at this stage I am very glad cancer is gone. I might add, that this all began as a small lesion less than grain of rice. I noticed for a year it would come go bleed. While it appeared the skin was healing above, the bcc was spreading larger below. If anyone is reading has this type of lesion, please please have it checked out by specialists.
All up costs consult f/ups, surgery,anaesthetist, $A2,700 after medical rebates.

I am having MOHs surgery soon for a BCC (morphied type). It is very close to one side of my mouth. I have no idea how much swelling to expect. has anyone had surgery there?

My surgery was very close to the right side of my mouth with some of my lip being cut out. My surgeon was very particular when closing the site to ensure the best result later. I had a little swelling but nothing really major. From my experience I had quite alot taken out about the size of a 50c piece and now you wouldnt even tell anything was there. I can tell a little because I know where it was but do alot of after care and make sure you stick to what they tell you. Most of the graphic things you see on the internet are not the greater percentage of what happens. I wish you all the best try not to stress to much and if you need email me any time afterwards . I have some before and after pics that will hopefully make you feel better. cheers :)

Just to correct my earlier comment. A BCC was diagnosed on my lip through a biopsy. I was then recommended to go for Mohs surgery as I was told it was a way of saving my lip especially if, by chance there was no further cancer found. On the first cut no cancer was found however, because too much was taken on the first cut I then had to have the large area of my lip cut to correct what was taken. I fully appreciate that it is great not to have found any cancer but for someone like me, it seems upsetting to then still have such drastic surgery!!! As I put to the Doctor they certainly need to come up with a better way of detecting the spread of a BCC rather than just slicing away at one's body or face. I will also give credit where credit is due and the plastic surgeon did do a good job from what was taken. My lip is healing well and I guess I am coming to terms with my new look!!! Just remember everyone though they can do everything in plastic surgery but replace your cupid's bow. Perhaps it seems insignificant but when its gone it sure is missed!!!!!

Thank you ! You are reassuring. I am a registered nurse and I still don't like the look of this ! I am in Sydney in good hands (and will be back in Melb next year.) So if I end up with an excision the size of 50 cents I will not be alarmed. Thanks for the offer of the photos which I will ask for if I get concerened.

I had my surgery yesterday and fortunately for me I only needed one layer removed.I have very little discomfort.The suture line is quite long but in line with my natural creases on my cheek so I expect in time it will barely be noticible.

Hi All, I was just diagnosed with have a BCC on my upper lip and am scheduled to see a MOHS surgeon on the 3rd of Jan. My dermo said it was roughly 5mm across, its quite raised and feels like an eraser size ball inside. I'm just wondering what to expect, is the MOHs surgeon always the reconstructive surgeon? I read your post Melbourne Girl and would be grateful for any further info regarding location, size of your BCC. Thanks!

Dear Jillydog,

If it is on your upper lip the Moh's surgeon will take thin slices within the margin of the BCC until he has taken out all the cancer. If there is more left after the initial cut he then has to go deeper. You do need to be aware and ask the surgeon how much might be taken and you need to have organised a reconstructive lip surgeon for the best results and also talk to him about the outcome before you proceed and how you will look. I had a wedge taken out of my upper lip and they took most of my cupids bow (which no one at this stage can reconstruct) I wish I had of asked more questions and had more information. Also when signing the medical procedure contract be specific. It is just like any other contract. I was told they would stay within the margins but on the day he went out of them because he thought he should. However, as I previously said no cancer was found and I ended up with disfigurement anyway. I am sorry if I scare you but you need to have all the information and I don't believe as in my case things turn out always terrific!!!!So be educated and ask lots of questions before you go ahead,

I had my surgery late October at one side of my face, near my mouth.The suture line is barely visible now. I had a rounded excision approx 9mm x 11mm which has shrunk to a 4.5 mm long scar since the sweling has gone down.The surgeon has repaired my incision vertically along the natural fold on my cheek.My surgeon was a MOHs surgeon/ dermatologist.You may need more than one "layer" removed if the lesion is deep.With private insurance I only paid $500 extra to the surgeon.All other costs were covered for a day surgery facility and also for removal of stitches.

Correction !

My incision was approx the size of a 20 cent piece.
9mm x 11 mm sounds too big .

Thanks Wookie, just a few more questions...how was the corrective surgery done, did they do a flap, or were you just stiched? How many days went by between the MOHS procedure and your surgeon repairing the incision?