I have been DX with basal cell on my nose and current dermatologist recommending MOHS. I am concerned about cosmetic result. Photo is 6 days post biopsy - can beam be localized or would I lose the mustache?
December 9, 2019
Answer: Correct treatment of basal cell The correct treatment of a nasal basal cell based on the picture you’ve shown is excision with or without Mohs surgery with a bilobed flap or skin graft. having radiation is not what I would recommend.Based on what your skin looks like a preauricular skin graft could be harvested it that matches your nose very nicely. I did one of these a couple of years ago. I saw my patient back this year. The area where the patient’s cancer wise looks pretty much like the rest of her nose. If you contact me directly I’ll forward you a picture of her.As long as the provider is good at what they do nasal reconstruction does amazingly well. If the skin color is matched and the contour is layed down accurately than the scars fade away and become virtually invisible. If you have a recurrence the radiated tissue will not tolerate reconstructive surgery well in the future. Why don’t you follow the recommendation of your doctor? i’m a board-certified plastic surgeon and I’m biased towards plastic surgeons doing better reconstructive work then our dermatology colleagues. Historically all complex facial reconstruction was done by plastic surgeons. Dermatologist have hacked away at our turf and now do more of these than we do. You’re probably not going to find a Mohs surgeon who will do the excision and then refer you to a plastic surgeon. Just follow your doctor’s recommendation.I’m sure if you talk to a radiation oncologist they’ll be happy to give you radiation as a treatment options and tell you why it’s a good plan of action. if you’re a hammer The world looks like a nail. Best, Mats Hagstrom MD
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December 9, 2019
Answer: Correct treatment of basal cell The correct treatment of a nasal basal cell based on the picture you’ve shown is excision with or without Mohs surgery with a bilobed flap or skin graft. having radiation is not what I would recommend.Based on what your skin looks like a preauricular skin graft could be harvested it that matches your nose very nicely. I did one of these a couple of years ago. I saw my patient back this year. The area where the patient’s cancer wise looks pretty much like the rest of her nose. If you contact me directly I’ll forward you a picture of her.As long as the provider is good at what they do nasal reconstruction does amazingly well. If the skin color is matched and the contour is layed down accurately than the scars fade away and become virtually invisible. If you have a recurrence the radiated tissue will not tolerate reconstructive surgery well in the future. Why don’t you follow the recommendation of your doctor? i’m a board-certified plastic surgeon and I’m biased towards plastic surgeons doing better reconstructive work then our dermatology colleagues. Historically all complex facial reconstruction was done by plastic surgeons. Dermatologist have hacked away at our turf and now do more of these than we do. You’re probably not going to find a Mohs surgeon who will do the excision and then refer you to a plastic surgeon. Just follow your doctor’s recommendation.I’m sure if you talk to a radiation oncologist they’ll be happy to give you radiation as a treatment options and tell you why it’s a good plan of action. if you’re a hammer The world looks like a nail. Best, Mats Hagstrom MD
Helpful