I Am 49 Years Old. Diagnosed with BCC on Bridge of Nose, What's Best for Least Scarring?

Question

Skin cancer specialist advised marginally removing BCC, send me home with a hole in my nose, back next day, if biopsy ok, wound closed like an icecream cone, extending down the side of the nose and zig zag up between the eyes. This allows the skin edges to be drawn together. The plastic surgeon said that he would remove skin from my check and graft it to my nose. I see a dermatologist re MOHS surgery next week. For the least scaring, what's best?

Sam Naficy, MD, FACS · Answer

There are a number of elements that need to be considered in deciding the best technique for reconstruction of the nose.  Photos of the defect are the most helpful.

Monica Halem, MD · Answer

The best treatment for a BCC on the nose is Mohs surgery. Mohs surgery controls the skin cancer by using a microscope to check the margins during the day of the procedure. It gets rid of the skin cancer and leaves behind as much normal skin as possible leaving a much smaller defect. A smaller defect after taking the skin cancer out leads to a smaller reconstruction with a better scar. Dr. Halem

Elizabeth F. Callahan, MD · Answer

Mohs surgery is the best choice for skin cancer on the nose - it has the highest cure rate for the treatment of skin cancer -- up to a 95 -99 % cure rate.

	In addition Mohs conserves as much normal tissue as possible as the Mohs technique examines 100% of the tissue margins -- all the lateral (wide) margins and the deep margin (the base) are examined. 

	 

	I recommend a fellowship trained Mohs surgeon with (American College of Mohs Surgery).  Also the Mohs surgeon not only performs your surgery, but also examines your tissue under the microscope.  The type of repair and the size of the scar will depend on how much tissue was taken.  I wish you the best of luck.

Steven Hacker, MD · Answer

The treatment of choice for skin cancer on the nose is Mohs surgery. If you want to minimize scar, this is also best option and have closure by dermatologicsurgeon skilled in reconstructive surgery.

Richard Ort, MD · Answer

I agree that Mohs surgery is the best treatment option for the basal cell cancer on the nose. That should give the highest cure rate with the least amount of tissue removed. The wound will need to be reconstructed afterwards and the exact reconstruction depends on the size and depth of the wound and the location on the nose. I agree that most of the time, the nose heals very well, particularly in women. Men who have very oily, sebaceous noses with enlarged pores sometimes heal with more visible scarring on the nose.

I Am 49 Years Old. Diagnosed with BCC on Bridge of Nose, What's Best for Least Scarring?

Answers (7)