J. Daniel Jensen, MD

As specific details of your case are not available, I would recommend speaking to your Mohs surgeon and Ophthalmologist about this. They will have the experience and the details needed to make this decision. Part of it depends on when they can get you in... If one won't be able to see you for three months but the other can see you in three days, then I would recommend doing what you can when you can, as one won't affect the other with that kind of timeline. However, if they can both get you in tomorrow, then this becomes purely a medical decision (as opposed to a practical decision, as in the other case) and your surgeons will be able to guide you better than anyone on the internet. Hope this helps and good luck!

Dr Jensen

Thank you for your question. Usually most Mohs surgeons will perform the reconstruction after clearing the tumor completely. In general, Mohs surgeons are very experienced at this and do an excellent job. If your reconstruction proves to be too complicated to preform in the office (most Mohs surgeons know what their limits are) he or she will have a discussion with you about a referral to plastics or facial plastics for reconstruction. If you have significant concerns, there is no harm in approaching your Mohs surgeon and asking them their opinion. Thanks and good luck!

Agreed with above on seeing a Mohs surgeon for best chance of cure and smallest scar. Anyone who says they can make a smaller scar than that created with Mohs is potentially increasing the risk of recurrence down the road. Radiation can be good but in this location can result in cataracts and other complications, even when proper shielding is used... if you are under 65, radiation is probably not a good option. The eyelid actually heals extremely well and most Mohs surgeons are very good at repairs of these kind of surgical wounds... a plastic, facial plastic, or oculoplastic surgeon will likely do a similarly good job— this is highly specific to the individual doing the repair and not as specific to their specialty in this case. Bear in mind that a Mohs surgeon will likely do the repair in the office, saving you money on anesthesia and OR costs. A good mohs surgeon will know their limits and refer to another doctor for reconstruction if it is outside their ability to provide a good result. Hope this helps! Best wishes, Dr Jensen

Thank you for your question... there are a couple of things that may contribute to this subtle unevenness...Extrinsic aging from the sun and other external factors is often more pronounced on the L side of the face, as that is the side of the face that usually gets the most amount of sun exposure. Usually this occurs via sun exposure through a car window while driving. Car windows (side windows, at least) often allow significant exposure to UVA rays (they block most UVB rays), which are a principle cause of photo aging and are associated with melanoma. This increased sun exposure may, over time, result in noticeable differences in the skin when comparing L to R. Additionally, regularly sleeping on your left side may cause some of this unevenness. People who habitually sleep on one side or another may develop slightly uneven skin tone because they are pulling on their skin during ~1/4 to 1/3 of the day. I hope this helps. If this bothers you, I would consider consulting with a board certified dermatologist or plastic surgeon to see what options would be best for you. Hope this helps!

Best, Dr. J




 

As mentioned above, finasteride can cause decreased libido in a small minority of men... fortunately for most men, this decreased libido is temporary and will resolve after stopping finasteride. In a subset of men who experience decreased libido while on finasteride, this effect can be long term (this is called post-finasteride syndrome). This is pretty rare and is more common in men who have been taking finasteride for a long time. I would recommend another option to treat your hair and recommend consulting with your local dermatologist about your options. Hope this helps!

Dr. Jensen