56 yo female. I had a pimple like spot on the end of my nose for 26 months prior to Moh's. The first 13 months my general practitioner thought it was related to my rosacea. It failed to respond and grew slightly larger, and bleed off and on. Around 13 months, I went to see a dermatologist, he instantly recognized it as basil cell and ordered a biopsy. Around 14 months of having this small cancer spot, it was first treated with freezing, then 4-5 months later it was C & D. Both failed and the cancer came back and continued to grow. About 26 months after first discovering the cancer spot on the tip of my nose, I went to see a skin cancer specialist that also does plastic surgery reconstruction. He performed the MOH's procedure on Nov 11, 2015 followed with reconstruction Nov 12, 2015. I will update as time passes, since I just had my surgery 3 days ago. There is lots of swelling, but no pain. I had no pain during the MOH's surgery nor any following thus far. Slight discomfort, but not worth mentioning. Updated on 16 Nov 2015: A little less swelling. More bruising showing. Starting to itch a bit. No pain. I shower normally. Pat face with soapy wash cloth, rinse well with shower water. Pat dry, then completely dry bandaged area with hair dryer on low setting. Updated on 19 Nov 2015: My nose has been rather twisted to one side, causing one nostril to semi-collapse while the other nostril is stretched from twisting upward. I'm quite sad with the results, but, I still have my nose and I have not seen the doctor yet since surgery. I have another 5 days to go before stitches come out. Updated on 24 Nov 2015: I got my stitches out today, and though my nose is still a little crooked, and the nostrils don't match yet....the doctor said my nose will straighten out and the nostrils will return to normal shape. The curve to my nose and the misshape to my nostrils is directly related to swelling. I go back in 90 days as most of the swelling should be gone by then. Doctor assured me not to worry, my nose will return to normal. Which is so amazing considering the work he did to fix the defect that cancer created on my nose. As of right now, I am 100% happy with the progress of healing, and I will send more updates every couple of weeks to see how my nose progresses. Updated on 24 Nov 2015: Thought I would add a couple more pics to see what my nose looks like now that the stitches are out, as of today. Nose is still swollen, and doc expects it to straighten out within the next 90 days as the swelling continues to go down. Updated on 3 Dec 2015: Here is a photo of my nose at 3 weeks after reconstruction. Will update again in a week or two. Updated on 23 Dec 2015: It's been six weeks since I had MOH's surgery on my nose. I massage my nose every night now for about 10 minutes to try and smooth out the scar tissue from all the incisions. Nose gets a little tender from massaging and a little swollen. Still healing well. Nose still has a curve to it, the end is not uniform, and one nostril is still larger, but overall, I am still happy with the progress, and thankful I still have my nose. Updated on 12 Jan 2016: Nose is still healing. It is getting straighter, the tip is a little bit rounder, but the nostrils still do not match. No one even notices I had anything wrong with my nose. I will return to surgeon end of Feb to see if my nose will need surgical touch-up.
She did a fantastic job softening lines on forehead, around eyes and upper lip with Dysport. She also used .5 syringe of Restylane for smile lines at corner of mouth. I will definitely do it again. For me there was pain (I am a wimp)with Dysport on upper lip, but it was fast and no lingering pain afterwards. The area around mouth was a little swollen. Tiny bruises(easily covered with concealer) for 2 days after.
I'm 41 and the mother of 2 daughters, ages 7 and 10. I have always, always felt self-conscious about my belly. My weight during my adult life has ranged from 115 to 160, average being 130. Regardless of what weight, that belly has always been there. The idea of being able to do something about this feels like a dream come true. I imagine the impact that this will have physically and emotionally, and how it can boost my self-confidence. I had breast reduction in my late teens and my emotional discomfort was just a fraction of what it is with my belly. Breast reduction was such a great thing for me. I can only imagine the impact that TT will have. I'm having lipo in addition.
Mike, As your doctor likely discussed with you following surgery during the discussion about the treatment options available for the wound, many wounds will heal if left alone. Most wounds left to heal on their own heal will do so with worse scarring than if they are surgically closed immediately - however the forehead is one of the few areas that does tend to do ok and in some cases does brilliantly. The longer a wound remains open, typically, the worse the scarring. We know that wounds that have not healed by 21 days tend on average to heal with thicker scarring than those that heal before that (we know this from the burn literature). Smoking, nutrition and general health all affect wound healing. In addition to an unpredictable cosmetic outcome, secondary intent healing is limited by inconvenience to the patient (long time to heal); infection is very, very rare in such wounds on the face. Most of the doctors who perform the Mohs procedure are dermatologists and many do great work. There are seven of us worldwide (myself included) who are formally trained in Mohs surgery and are also board certified plastic surgeons; the advantage is the highest cure rate from Mohs, followed by immediate cosmetic reconstruction. I prefer to close wounds since I feel the result is predictably better when I surgically limit the number of factors/hurdles I am asking the wound to overcome. That being said, I wasn't there for your cancer removal so I can't comment on the depth or what your doctor had in mind. I would trust your doctor (you chose to go to them in the first place) and know they have a plan in mind to ensure the wound heals in an optimal cosmetic fashion; I would certainly encourage you to contact them with any apprehension or concerns that you have; I would give them the benefit of a doubt that they would want to know of your thoughts and concerns and it would likely help you both to discuss it. An unsightly scar after secondary intent can typically be addressed down the road to make it look better as well and a suboptimal result doesn't mean anything was done wrong - sometimes it takes a few steps to get to the final result. The wound healing cascade takes 9-12 months during which scars tend to soften, lighten and become flatter and more supple so patience is also a virtue.
