Mohs Surgery and Reconstruction Via Paramedian Forehead Flap - New York, NY

Dr. Hooman Khorasani - Miracle Worker On July...

Dr. Hooman Khorasani - Miracle Worker

On July 5, 2012, I received a call from my dermatologist telling me that a biopsy on my nose had come back indicating squamous cell cancer. Twenty years ago, I had cancer in the same place on my nose and Mohs surgery was performed. It was scary but not terribly invasive and since I had no visible symptoms of the current cancer, I figured the Mohs procedure would be relatively simple with a couple of “swipes”. Nevertheless, I decided to look at all options relative to who would be the best person to do the job.

The Mohs surgery was scheduled for July 17; it was not the simple procedure I had hoped for. The surgery began at 9:45 a.m. and was completed at 5:45 p.m., after the sixth biopsy had finally indicated clean margins. Never once during this long day did Dr. Khorasani ever indicate anything but total confidence that we were going to “get” this thing and then make my nose ok, in spite of what I knew was becoming a larger and larger cavity. He gently soothed me with his words, with his comforting pats on my head and his assurances that I should not be worried. In fact, after the fourth biopsy around 4:00 p.m., as I was wondering just how much more they were going to have to take off and out of my nose, he brought his lunch out and sat down with me to explain the next situation we were going to deal with…….that of reconstruction via the Paramedian Forehead Flap.

Dr. Khorasani was exhausted after a full day of surgery and yet he came out and sat with me – one of many patients - to try to give me courage and to make me feel better. How many doctors do that these days? And by the way……his explanation of the next steps did indeed give me the strength to get through the process because he gave me hope.

The first phase of reconstruction began on July 25. Lots of lidocaine shots, preventive pain meds, a little valium and we were ready to go. All through the surgery, I felt his expert hands performing what needed to be done. At one point I knew that he was carefully taking measurements of what I imagined must be the hole in my nose and of how much skin he needed to cover it. I must tell you that at no point was I frightened or worried that I was going to be “botched”. The man is simply a genius.

The first night I started to bleed – more than I figured I should be bleeding. Dr. Khorasani told me to apply pressure to the bleeding area until it had stopped and indicated that I should come in the next morning to be repacked. Two days later, I took the pressure bandage off and with it came what seemed to be a critical bandage covering the newly redone flap. Being very frightened, I took pictures, emailed him and waited. He called (on a Saturday) and told me not to be concerned, but suggested that I come in on Monday morning where he reassured me that everything was fine.

The first sutures came out on August 1 and on August 15, I had more surgery. No valium, no vicodin but plenty of lidocaine and once again we were ready to proceed. This phase of the reconstruction was the procedure to disconnect the tube of skin from my forehead which had been providing a blood supply to the still growing flap on my nose (it kind of looked like a shuttle because it was riding on top of my nose). As Dr. Khorasani was “sewing me up”, there was total silence and I could tell that he was concentrating on making the repair as perfect as he could.

On Wednesday, August 22, the last sutures were removed. We will now wait a few months for my body to heal and then I will receive laser treatment to further reduce the inevitable scarring on my forehead and nose. However - and this is important for anyone who will be having this procedure - if nothing further were done from here on out and I were to live with the scars I have now, I would feel as if I were one of the luckiest people on earth.

A Tribute to Dr. Khorasani - One year later

One year ago today, July 17, Dr. Khorasani performed Mohs surgery on my nose and successfully removed all of the squamous cell cancer that had invaded it. In order to "get" all of the cancer, it was necessary for him to remove a significant portion of my nose.

Thus began the miraculous journey of watching this magnificent doctor reconstruct my nose, using the pedicle flap procedure and following up later with dermabrasion and laser correction. Every step of the way, he patiently explained each procedure and gave me the confidence to know that - in the end - everything would be alright.

Dr. Khorasani gave me back my nose and my life. There are simply no words to express my gratitude to this man.
New York Dermatologic Surgeon

I did research on the internet and simply had a good feeling about this surgeon after reading about him. He looked so young I was wondering how he could have such outstanding credentials so early in his career. The minute I met him and observed how he examined me, I was totally assured and understood why he is where he is. How does one ever know if you’ve found the right doctor? Well I am one of the lucky ones; I did. I found Dr. Hooman Khorasani and I want to share my experience with others who may be in the same situation I was in a few weeks ago. Dr. Khorasani is the Chief of Mohs and Reconstructive Surgery at Mt. Sinai Medical Center and I was able to get an appointment with him relatively quickly. My decision to choose Dr. Khorasani made a huge difference in my life. Not only is he an outstanding surgeon, he is a vibrant, gentle, reassuring, precise, responsive, and patient man. There are no words to describe how grateful I am to Dr. Khorasani for his magnificent work. As far as I’m concerned, he has performed a miracle.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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Comments (4)

WOW. What a story. I was holding my breath as I read how many HOURS it took to finally get to the bottom of this terrible thing. What a kind and gentle physician, exemplifies all that represents good in this world. So happy for YOU. You look sensational!!!
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Thank you so much! On my second anniversary, I wrote a tribute to him, but I didn't put it online. I guess I was too embarrassed to praise him over and over. You have inspired me to put it here: It’s been two years this July since Dr. Hooman Khorasani performed Mohs surgery on my nose. A second operation to reconstruct my nose and several other operations got me to where I am today. Time keeps moving on and my nose has gradually gotten even better; in fact, it’s nearly perfect. Dr. Khorasani’s skillful management of the gaping wound which was no longer my original nose enabled me to have a new nose courtesy of the pedicle flap procedure. Part of my forehead is now my nose; I can still see little hairs growing on the tip of it because he had to use part of my scalp to make it all work. But who cares? Each little hair is a reminder of how lucky I am to have been a patient of this wonderful doctor. I will never stop being grateful – at this time of the year, in particular - for the miracle Dr. Khorasani performed. His magic touch will be with me forever. Doris Holloway
  • Reply

You look fabulous! Thank you for updating us on your progress. :)

  • Reply

Welcome to RealSelf and thanks for sharing your experience, Dori. I'm so glad to hear your surgery went well.

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