Nathan Cleaver, DO

I can certainly understand your concern as this is your first time receiving botox.  If you read the medication insert for tylenol, there will be enough side effects listed to keep you up at night!  Every procedure has its own risks and benefits.  The best way to minimize the risks is to have an experienced injector perform the procedure.  A very small amount of bruising may occur at the site, as well as headache following the injection.  I always tell my patients these are the most common side effects, but greater than 95% of patients will not experience any of these.  I also tell my patients that the very rare side effects include lid ptosis (inability to raise lid) and allergic reaction.  I have never experienced any of these results, nor any of those who I have worked with.  However, appropriate consultation should include all risks and benefits.  Botox does not 'shoot off in different directions'.  It targets the specific muscle that it is injected into.  The reason that you may have lid ptosis is due to the result of an improperly placed injection.  This is another reason that injector experience is so important.  Botox is the most popular cosmetic procedure in the world.  You will enjoy the results and realize that after the fact that maybe tylenol is more risky than botox :)  All the best!

I completely agree with the previous statement here.  Melanoma is the most aggressive form of skin cancer, often spreading to the lymph nodes and elsewhere in the body.  The overall mortality from melanoma is directly related to the depth of invasion of melanoma.  If you have a known diagnosis of melanoma, the sooner that you can have this removed, the better your overall prognosis because you are limiting further invasion.  Basal cell carcinoma and melanoma are two very different skin cancers in their behavior and their prognosis.  I certainly would try to open your schedule and have this treated at the first available appointment, or at least that would be my suggestion to a family member or one of my patients.

Thank you for your question.  It is difficult to assess the bumps based on the pixelation of the photo.  If there were no sutures placed at that site, and the bumps arose after the procedure - I favor that you have developed a secondary allergic reaction at the surgical site.  If you are using neosporin or polysporin, I would recommend switching over to plain vaseline or aquaphor.  It is possible that you are having an allergic reaction to the tape that you are using as well.  If you develop streaking redness, warmth at the site, significant amounts of drainage, or any systemic symptoms such as fever or chills, I certainly would recommend that you have the site re-evaluated by the physician that performed the procedure.  All the best!

That is an excellent question.  The most likely etiology is a hypertrophic scar or keloid if the firm area is overlying the area of previous surgery.  The other concern is that there might be a recurrence of the skin cancer.  Mohs has an extremely high cure rate when performed correctly, but still something to consider.  This is certainly something worth to have re-evaluated by the surgeon performing the procedure.  Osteoarthritis and rheumatoid arthritis can present on the digits, but if the only area is overlying the site of previous surgery, it is less likely that this is the underlying etiology.