What do I do about my recurring Basal Cell Carcinoma (ulcer) that is on the side of my nose near the tip?

I was diagnosed with BCC on nose in Nov 13 treated by curettage & cautery. In Aug. 14 a new ulcer appeared next to the scar of the old one. Mohs and reconstructive surgery seem my best option. I live in Jordan and it is only treated with excision by plastic surgeon who sends the tissue to the lab AFTER he finishes the procedure. I can travel for Mohs and reconstructive surgery but how can I find the right surgeons and not waste time? The surgeon told me there would be a lot of deformity. Scared!

Doctor Answers 6

Recurrent skin cancers

Recurrent skin cancers on the face are best treated with Mohs micrographic skin cancer surgery. 

West Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Basal cell carcinoma on the nose

With any type of basal cell carcinoma on your nose, let alone a recurrent basal cell carcinoma, Mohs surgery is hands-down your best surgical option. It has the highest cure rate of any modality that you can do, and to boot it also leaves the most normal skin behind, what we call tissue sparing.

Make sure you find a dermatologic surgeon who is a member of the American College of Mohs Surgery. Not all skin cancer surgeons are created equal, and by finding someone who is a member of the ACMS you are ensuring that you have one of the most elite and most highly trained dermatologists you can find. Do not be fooled by the American Society of Mohs Surgery, this is not the same thing and does not require additional fellowship training like the ACMS. 

Oculoplastic surgeons, facial plastic surgeons or plastic surgeons can also sometimes be involved in the reconstruction, but is your dermatologic surgeon who plays the main role in getting rid of your tumor with the highest cure rate, and in general a dermatologic surgeons is going to do more of these skin cancer reconstructions than anybody else and tend to be your best bet for reconstruction.

Your dermatologic surgeon will also discuss other treatment options with you, some of which may be nonsurgical, but none of which have the same cure rate that Mohs surgery does.

Cameron Chesnut, MD, FAAD, FACMS
Spokane Dermatologic Surgeon
4.9 out of 5 stars 105 reviews

Moh Surgery

Hello Helen2014, 

Thank you for your question. 

This can be a scary thing.  Often basal cell carcinoma of the nasal region can only show the tip of the iceberg so to speak.  

Without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of any treatments it is difficult to be comprehensive.

I recommend you find a mohs surgeon with a great relationship with a facial plastic surgeon such as myself who can guide you in what is most likely to be a complex repair based on what you describe and in the setting of recurrence.

There are several qualified individuals in Ann Arbor.

Good luck, 

Dr. Shadfar

Scott Shadfar, MD
Edmond Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Moh's Surgery and immediate reconstruction

Moh's Surgery and immediate reconstruction could be your best option. The combination of a Moh's Surgeon and a dermatologist is ideal. 

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Recurrent Basal Cell On The Nose

Seek a MOHS specialist, we would gladly see you.  Likely you will need a flap or graft for reconstruction based on what you are describing, if you have surgery.  An alternative is radiation treatment, which may give you less of a deformity.  Contact the company for a provider in a location that is easy for you.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Treatment options for recurrent basal cell carcinoma

Mohs surgery is the best option for a recurrent basal cell carcinoma. See a fellowship trained Mohs surgeon by going to the American College of Mohs Surgery Website. Mohs maps out the entire perimeter of the removed tissue helping ensure the entire cancer is removed. 

Omar Ibrahimi, MD, PhD
Stamford Dermatologic Surgeon
4.8 out of 5 stars 26 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.