Mohs Surgery: Stories
Write a ReviewNo Scar Answer to my Skin Cancer
- francine
- posted 5 years ago
- updated 5 years ago
- Worth It
- Cost: $1,000
- Arizona
During my visit to the dermatologist I pointed out...
- 28 Dec 2007
during my visit to the dermatologist I pointed out a red spot on my nose that seemed to scab over easily, but never quite heal. The derm told me it was a squamous cell carcinoma, the kind caused by sun damage. While squamous cell cancer won't usually kill you, if left untreated it does spread, and it can create big ugly areas.
It could have eaten away my entire nose. I saw some photos of that. I decided it was best to have it removed when it was new and small.
I went to a skin cancer specialist in Moh's surgery. Moh's surgery is a subspecialty of dermatology, and not everyone does it. But I wanted it, because the alternative was to be disfigured.
My skin lesion was on my nose, so I didn't want somebody cutting a big piece off it. Mohs sounded like the perfect solution, because it's done with local anaesthesia, and the surgeon removes the skin layer by layer, or slice by slice, sending each slice to be biopsied while you are still in the office and numbed. You stay until a layer comes back clean. So they only take off exactly what's necessary to "get' the cancer. It's a cure about 98% of the time.
And then you are sent to a cosmetic surgeon. In my case, because this was on the bridge of my nose, they had to do a skin graft (they can't just sew up that area, because there's hardly any extra skin.). So they took some skin from my shoulder and grafted it on to my nose. They held it in place with a cotton ball that they sewed into the nose as well. Several days later, they removed the graft.
You can hardly tell it is there. There's no hole in my nose, and no real scar. This surgery is WORTH IT. I will look for some photos I took during the procedure, and if I find them, I'll post them.
pimple..the first time I saw this doctor he froze most
of what I had I guess it was pre cancer for the most of
what was on me..but anyway I would like to know why he
himself did not do the treatment..I don't know if this
guy who did it was board certified or not..I was not a
happy camper when he got through..as I had a panic or
anxiety attack when he put some thing over my face and
blocked my airway...and when I got home this thing was
bleeding so bad I called him and he said come back and
they will put a new bandage on..as this one looked like he did a lobotomy..this was done just short of 3
weeks and seems to be indented but not to bad,as I am
a man,and old but if I was a lady I would not go back
plus the area is still numb I don't have great luck so
I am just thankful that this was not malanoma..
I just had Mohs on my top lip for a BCC. I was told my the follow up plastic surgeon the best cosmetic result is a wedge incision taking most of my cupids bow.
The Mohs surgeon however told me on the day he would take such a minimal amount, no into the white part of my lip line, no into deep flesh. My results were no cancer at all. But then I am told on the day the plastic surgeon will still need to remove part of my lip. I ask why when there is no cancer there and I was told only a small part was taken. He said to trust him for a better cosmetic result rather than a graft. At the moment having lost all of my cupid's bow and the central part of my top lip...which wasn't even affected by the original BCC I am left pondering how this could be considered better cosmetically!!!
I get my stitches out on Thursday so will ask, how come I come away with such a perfect result but end up minus most of my top central lip? I felt like I was on a factory line and got the same treatment regardless of what my test result was!!!This just doesn't make sense to me if the BCC was going to disfigure me then the surgeons actually did a better job of it!!!!
Did you know that very few MOHS "Surgeons" are actually surgeons? Very few have surgical privileges at hospitals? Very few have gone through a Surgical Residency.
Through an obvious mistake in Medicare/Insurance rules, Plastic Surgeons who have trained in MOHS have a harder time getting paid for performing MOHS procedures than Dermatologists with MOHS training. We have to fight to change this.
Doesn't it make sense that you want a person who is skilled at reconstruction to also do the removal of tissue so they can keep in mind how they are going to reconstruct while they are doing the removal?
My personal experience has been horrible with MOHS. The first time I had a MOHS "Surgeon" (not really a surgeon at all) do the removal and reconstruction. The results were terrible. He cut in the wrong spot, completely missing the cancer. He left me with only part of an eyebrow and a noticeable scar.
The second time, I was not going to make that mistake again so I lined up a plastic surgeon to do the reconstruction after the removal. However, the MOHS "Surgeon" did such a terrible job of removing the tissue that the plastic surgeon did not have much to work with and I was left with a quarter sized scar.
The last time was only 2 days ago. Because the first surgeon "Missed the cancer spot", I had to go back two years later (it just reappeared as a tiny spot) and have it removed. Again a MOHS surgeon did the removal and a plastic surgeon did the reconstruction. Because the cancer had at least 2 years to grow, a lot of tissue was removed with little or no thought to how it would be reconstructed. The plastic surgeon did her best but I still can't stand to look myself in the mirror.
It is too late for me, I am permanently disfigured. But for the benefit of others, the rules have to change. Plastic surgeons have to be encouraged to do MOHS removal as well as the reconstruction of the face and hands. Additionally, dermatologists with MOHS training should be restricted to doing MOHS on less visible parts of the body when/if scarring is less important.
Kathy
Hi Kathy, I'm having the same procedure done on the bridge of my nose. Did you have a plastic surgeon close the area? If not are you happy with how it's healed? Thanks, Teri
thank you for your reply You can email pictures to: mmark5@mchsicom. I am still terrified about this surgery. Scheduled for Jan.2012
I have a large incision after removal on cancer on my face would love to see after pics of what to expect. Surgery one month ago. Had a plastic surgeon really nervous Looks so bad right now but he did stich me well Judy
If you have to return several times to the mohs surgeon, make sure you understand how much is being done and what you are going to look like