July 1, 2014 - MOHs Surgery on Nose - 45 Year Old Female - Phoenix, AZ

I'm scheduled now for MOHs and reconstruction, I'm flying out today. Really nervous, but more excited to get it down. My procedure is August 21.;)

Hi everyone....I had my MOHS Surgery today! It went better than I expected. The doc only took a smallish shallow section (I did not see it). He used a skin graft from the inside of my right ear to cover the wound. The skin graft was left open to heal, covered with Polysporin and a telfa dressing. Instructions to use a mixture of vinegar and water to cleanse the graft site, then Polysporin, etc.. There is a cotton ball sewn to the nose, over the graft, to provide pressure, and that will stay on until the stitches come out , in one week. I was very happy that they got the tumor all in the first slice! I will be anxious to see the actual graft next week, and hope it heals well. If it is bumpy or whatever, they will do dermabrasion later on. Will keep you posted, and will include pics when I figure it out ! WinnerL

Sorry, My first comment was a bit unclear...the donor graft site on my ear was left open, covered with Polysporin, a small patch of telfa, and tape to cover it. They said it would take about 8 weeks to heal that. It was recommended to use a vinegar-water solution to soak it once a day, followed by poly, and telfa etc. It is hard for me to see it in the mirror. The nose hurt a bit yesterday, only extra strength Tylenol for pain, and not so bad today. Hard to yawn! There was a bit of bleeding under the dressing yesterday, hope it is ok. The pressure dressing stays on til next Wed when I go to get the stitches out. I imagine the graft will be much lighter in colour than my nose, hopefully with time it will blend in. Will keep you posted as to how the graft takes.

Thinking of you today and your procedure. Prayers for the best results possible and a speedy recovery! Please let us know how you are doing.

Great news! Glad to hear it was better than expected, as I am sure that was a huge relief! Post some pics when you feel up to it, and until then, relax and take care of yourself :)

Thank you so much!!! Been out of the loop, just arrived home from my trip, Ky to CA, for my mohs and reconstruction. Everything went smoothly. First set of margins with 5mm, allowance seems to have gotten it all. Will get definitive pathology end of the week, but didn't think it was any thing different but insitu.;) About a quarter size maybe slightly bigger on my cheek, used a rotation flap to pull skin from my jaw forward. The incision is very smooth. We counted 38, extremely uniform and closely spaced stitches. Will send pics or post when I get settled in. Overall excellent experience, Dr. Kaufman and his staff were great!! God is so Good!! Thank you, FL2AZSUN for sharing all your scars because it's a very humbling place. I felt more prepared mentally because of you!

I just posted my review, look under mohs Lentigo melanoma reconstruction to find me in a few days when they review and post it. Thanks for everything!

My Pics are posted. ;) I'm doing good, stitches are out and I'm applying a silicon based ointment. My pathology all came back good, melanoma insitu. Praise God!!! Being patient and healing is tough. There are so many changes as it heals. Some people dont notice right off. Everyone says it's going to heal nicely , I agree, but it's a slow process. ;)

Hello, I am a 66 year old female who had MOHS surgery in exactly the same place on my nose on February 4th of 2014. I had to have 2 cuts to remove all the cancer. My surgeon did the repair immediately afterwards. She created a bi-fold flap and closed it with internal stitches. Even though the full healing takes a year or two, I am extremely thrilled with the results. I don't have any stitching scars and the color match is perfect. There is still some swelling from the internal stitches so the surgeon advised me to use special cream, silicone bandages and massage. It has only been a few days since I've been doing this regimen and I can already see amazing results. No one seems to notice my nose at this stage. I think I had to keep the bandage on for about a week or less only when I went outside. Your doctor will give you specific instructions. It appears that each doctor has their own suggestions for recovery. Mine suggested Aquafor usage and I was thrilled with this over the counter product. Some doctors suggest Vaseline. Even though petroleum jelly is the major component of Aquafor, it also has other ingredients that made my entire face very smooth and moisturized. I, too, was very fearful of looking like a monster after looking at all the photos on the Internet. I was happy that I educated myself but even happier that my defect was small compared to the ones I saw online. Every day I feel so lucky to wake up cancer free after a relatively simple excision and no chemo or radiation. I know without a doubt that your worries will be over soon and you will resume your life in full. Best Wishes, Beverly

Thank you for posting this. It is good to read about positive results. I do not think Aquaphor is available in Canada, I checked for that product before, for something else. What are silicone bandages, and where do you get them? Also, I am curious about the initial dressing changes, I was told I will need to do them twice a day til the stitches come out. Was it difficult to make a dressing to cover the nose? I have a supply of Telfa 2x3 (non-adherent dressing), sterile gauze 3x3, and various tapes. My skin is quite sensitive to adhesives, so have tested a few of them. Hopefully the clinic will direct me a bit on this. I am prepared to have to deal with a sore, red nose for this winter coming up. Here on the prairies in Canada, we have extreme cold for at least 4 months. Any info is most appreciated. Cheers!

im so glad you are happy with your results and your surgeon. They all seem to have different ideas as to what to do regarding closing or not closing etc. Sometimes I wonder if they wantit to close and heal on its own because they arenot sure of their ability. Mine after three weeks still is a dark hole - I keep it filled with ointment and covered twice a day with new. I have another that will be done in two days on the other side and this one looks like it was just done...... Im so tired of these mohs surgeries.

My surgery is set for Aug. 22, MOHs for lentigo melanoma in situ, which means it's not invasive at this time Praise The Lord. My Dr. has a video which describes his aftercare kit. He recommends cleaning sutures with hydrogen peroxide with cotton tip applicators . This prevents scab formation which causes scaring. Drying and then applying polysporin ointment, and covering with telfa. He says keep it clean moist and covered. Hope I'm ready for all this. Easy to say till it's your face.;)

I can totally understand and relate to be nervous leading up to the surgery, as I was a bundle of nerves and in tears the entire night before and the morning of. So, don't beat yourself up about that. I have had great results with the healing. It seems that once the stitches came out, it sped up the healing process. Of course, there are layers of stitches underneath, so the swelling and redness are still there a bit, but it has improve immensely. At 9 days after surgery, and just 2 days after the stitches came out, I had to go to a customer meeting. I was beside myself worried, but I put on some makeup and it didn't look half bad. I apologized for my "crusty" nose and they said they did not notice, and I actually believe them. For the bandaging, it was a challenge, I must admit. I had to cut down the telfa strip and gauze and take it the best I could. After a couple of days, I realized that just the tefla strips covered with two bandaids was much easier and less bulky. It may take a couple of tries, but you will find what works best for you. KEEP IT MOIST and KEEP IT COVERED!

Good luck ORN93.... Where on your face is it? The more I read the more scared I am, as I can feel where the lumpy part is on my nose, just to right of centre and towards the nasal. on the right side, and I think it is at least the size of a dime, if not more. Nothing visible on the surface really, but for the change in color over the past couple yrs. kind of whitish. It is also a bit numb and spongy feeling. I have not met the surgeon yet, I only see him the morning of! So no idea at all what I will be dealing with. I only pray I don't need a pedicle flap! I would still like to see pics or video of how folks make the dressing to cover the nose, and best ways to tape it down. I need to get more tape and telfa. I don't think the clinic here provides anything to take home. My anxiety levels are really high, friends say not to worry! How to do that? One breath at a time....

Please keep us posted on your surgery and how you are doing afterwards. And, try not to worry yourself too much between now and then, but trust me, I totally understand. I think using the peroxide is probably good and wish I would have. My doctor said only soap and water, but I did have some scabs near the suture holes, and think peroxide would have helped. YES, YES, YES on the ointment and covering. I am not covering mine any longer, but as soon as I get my makeup off after the workday, I grease up my nose with Vaseline. It is a little gross, but supposedly it really helps.

Thanks FLA2AZsun for helping us all share in this. It helps not to feel so alone. I'm vacationing in Fla now and feel like an odd hermit or a vampire in my huge hat and sunglasses and 100+SPF sunscreen. ;) I feel like a sunphob since mine is right on my cheekbone, definately solar damage. Pool at night is great, and my hubby can't sleep in because we have to get out before the worse rays. It's really sweet how they are being sensitive about it. I'm so glad that your healing well and people aren't noticing as much. I know that mine is already good size probly two pencil erasers wide, so I'm hoping either is not really deep or my Dr. Can hide it well in my smile lines next to my eyes. (Sounds better than crows feet).;) and with all things time does heal:) thanks for the encouraging words!!!!

So sorry it took me so long to get back to you. Aquafor is sold on eBay and Amazon so is the silicone tape called Mepitac, which is made in Finland. The silicone cream is BioCorneum, which I got from the surgeon but you can also buy it on eBay. First I rub on the ointment, wait 15 minutes and then put on the tape. It has made a big difference. It has been 9 months since my surgery. My nose is still a little puffy and itchy but the color match is perfect when it is completely healed (it does take years) it won't be noticeable at all. Actually, no one notices it now unless I point it out. When I am out in public, I completely forget about it. I chose not to get dermabrasion because it would create a texture and color difference where there is none now just a little raised area. I will post a photo as soon as I figure out how to do so. I hope by now you are resuming your life with no complications. Best wishes, Beverly

My apologies for the delayed reply, as I have not been online. I hope your recovery is going well. I am curious how your follow up went and If the scarring is minimizing with time. Mine is still very bumpy and red, but looking better, I suppose. I will have the abrasion in late September to smooth the skin back down, but I am a little worried about that, as well. I will post a pic on the weekend to show the four week progress. I hope this finds you well and healing nicely. This stuff really stinks, right :)

Question for all. I am paying for this mohs procedure out of my pocket. Have spent close to 3k so far. Not happy with the results of the mohs on my nose as the flap pulled away due to no fault of my own. A risk of the procedure i suppose? My question is this, should the surgeon be responsible for " cleaning this up" or should I be liable and have to pay for the second derma braising? Thank you all for your participation. This forum has been a great help to me. :)

Did your surgeon have you sign a document of any kind saying you were aware of the risks etc etc. I know I did this last time - I forget if I had to before but I probably did. It is too bad you dont have insurance coverage. I would certaily discuss it with your doctor but Im going to guess that they will just say that is a risk we take with mohs. I dont quite understand how Mohs is supposed to leave the lessor of the scars and cause the lease damage yet we know what sometiomes happens. We are hardly ever really happy with the results and are astonished as how big an area comes from a little pin prick place you find or simply a rough patch. None are what we would normally suspect as cancer and I have found most myself and brought it to the attention of the doctor. I can tell you that it will look better and better as time goes on and you will find that no one will notice but you. I have had one nasty place that I thought looked like I went through a windshield and barely visable to anyone but me. Give it time but in the meantime it doesnt hurt to talk frankly with your surgeon. If you have to get additional on your own maybe you should go to a plastic surgeon to see if a better result can be done at this point. Good luck. Im sitting here two weeks after my surgery and it looks the same on the side of my nose as the day after.........It will be a very long time before it heals - I just hope it fills in and Im not left unhappy .

Thank you for your encouraging words. Let me encourage you as well...you are not going through this alone. :) Thank you again! God bless you

I hope your healing is going well and curious which route you chose...plastic surgery or healing on its own. I met a woman who let hers heal on its own and she looks amazing. Kinda second guessing getting the flap because of the surface right now, but will have to give it more time. Prayers for a speedy recovery and hope this finds you well.

Had the Mohs surgery on my nose and I am 3 weeks out. Not real happy with the results as the flap has pulled away from the adjacent skin leaving a crescent moon shaped deep ravine in my nose. The doctor says we can go back after the incision has healed and do (derma brasion ) and it will lesson the scaring. Now looking back I would have passed on the surgery after the initial biopsy. But the down side of that decision would have been living with the risk of not have gotten the cancer completely. So there you have it! Still having to wear a bandaid over the tip of my nose as the scaring is quite disturbing and I deal with the public in sales everyday. Good news is that God has not allowed this to affect my sales! Thank you Lord! ;)

since the last one on the side of my nose that was closer to the crease healed so well I couldnt even tell it was ever done myself, I decided to go with the mohs surgeon advice again even tho it is a little higher up on the nose but still on the side. It has been two week and pretty much looks the same. It takes a very very long time for these to heal on their own.. at least a year so it is a close call as to which way to go. The other side of my nose had a very large one and I had a plastic surgeon close it. I dont think I would have wanted the mohs surgeon to do it. The doctor took tissue out of under my cheek and filled in this massive area (almost the whole side of my nose) I have a scar but seriously no one notices it unless i pointit out. Im hoping for the best on this one. I have another to do right under the big massive area that was done previously. Guess I will wait to see how large that is before deciding what to do about that one. By the way, sometime going down only once doesnt mean a small area.......the massive one was one time down -- they say the surgeon can often time tell as they go along because of the texture or softness or something. I personally think the doctor was in a hurry and had over booked and since he knew I had already decided on closing by a plastic surgeon , he just went for it . HE IS NO LONG WORKING AT MY DERMATOLOGIST OFFICE......why I dont know but I put in a big complaint at the advice of my plastic surgeon. Thank you for your good wishes........Ill post a picture again if I can figure out how when it shows some improvement. Right now it looks like in the distant future.

I am sorry to hear of your diagnosis, but glad that you caught it and getting it taken care of. I can definitely understand your "denial" as I was a mess leading up to the surgery, And, with you being a nurse, you have a lot of exposure to different scenarios. I pray that your procedure goes well and the excision is as minimal as it possibly can be. I think you will be surprised and how you are able to cope once it is done. I didn't think I would either, but stay positive and have faith. And, thank you for sending healing wishes my way. I will post another pic on the weekend which will be four (4) weeks from surgery. Seeing progressive photos of others really helped me prepare and understand more.