I have two basal cells on my cheek & under my eye. My dermatologist wants to do Mohs surgery. What are my options?

I have two basal cells on my cheek and another under my eye. My dermatologist conducted a biopsy of the most recent one and wants to do MOHS to remove all of them. I am terried of scarring. Have a raised purple scars from prior surgeries also from burns and previous skin grafts. I am worried that MOHS will create large purple raised scars on my face. My dermatologist will set up an appointment with a plastic surgeon. Do I have other options? Is they anyway to know if the wound will scar?

Doctor Answers 6

Skin cancer treatments

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Complete surgical removal of skin cancers is the best, desired treatment for skin cancers, with highest cure rate. The most effective method is through Mohs surgery, which has high cure rate; in the technique, the Mohs surgeon removes the tumor layer by layer until it is all gone, as confirmed under microscope.  Other non-surgical methods to treat skin cancers include topical medications (such as Aldara), radiation, and photo-therapy.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Mohs surgery

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Two main goals are to completely remove the cancer but at the same time minimize how much tissue has to be removed to achieve this goal.  Mohs surgery is your best choice to accomplish both.  Sometimes the most difficult part for you is to not know how big the cancer is until after all the margins have been cleared.  Your Mohs surgeon can then discuss with you as to the best avenue to choose regarding repair.

Richard Asarch, MD
Englewood Dermatologic Surgeon

Mohs reconstruction options

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Mohs is the most effective and safest way to remove facial skin cancers. This technique results in the lowest risk of recurrence and the smallest possible defect. Following Mohs excision your wound can either be closed by a dermatologist or facial plastic surgeon. If you already have an appointment with a plastic surgeon as well I think you're in great shape. I hope this information is helpful for you.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Skin Cancers On Face

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MOHS has the highest cure rate and is usually used in very cosmetically sensitive areas.  After photos the dermatologic surgeon or the plastic surgeon usually are able to do a very good job of reconstruction.  If the basal cell is superficial, sometimes other options can be used such as topical immunotherapy or scraping and desiccation, but they don't have good a cure.  I suggest speaking with your surgeon for the options.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Scarring after Mohs

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Mohs is by far the safest and best way to remove these types of cancers, especially given the fact that the most minimal amount of skin and tissue will be removed. For those areas there is not another option that will be safer or provide better scar recovery. While you don't want scars (which I understand), not treating them will ultimately mean the BCCs become bigger and bigger and continue to grow, leading in the future to larger procedures and more scarring. Plus, not treating the one by your eye...could ultimately lead to blindness. So, treat them, with Mohs. It is your best and most minimally invasive procedure. All removals will scar. Follow the postcare instructions to a "T" and remember the most important thing here is to remove cancer growing on your face!

"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Options for Treatment of Skin Cancers

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There are many options for treatment of your skin cancers.
Mohs surgery will provide the highest cure rate (98.5-99% for previously untreated basal cell carcinoma) and preserve the greatest amount of surrounding healthy tissue. If you have Mohs surgery, the American College of Mohs Surgery recommends that you see a fellowship-trained Mohs surgeon. That person will have completed a 1-2 year fellowship in Mohs surgery, including Mohs surgery, dermatopathology and reconstruction.
Another option could be radiation therapy, which is useful for certain situations where the patient or the skin cancer location might be better served in a non-surgical manner. We have a radiation oncologist on staff at our center and provide a form of radiation therapy referred to as electronic brachytherapy as an option for our patients. Best option is to discuss the situation further with your dermatologist and tell him or her about your concerns. Good luck.

Andrew Kaufman, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 16 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.