Get the real deal on beauty treatments—real doctors, real reviews, and real photos with real results.Here's how we earn your trust.

POSTED UNDER Mohs Surgery REVIEWS

No Scar Answer to my Skin Cancer

ORIGINAL POST

During my visit to the dermatologist I pointed out...

User Avatar
francine
WORTH IT$1,000
during my visit to the dermatologist I pointed out a red spot on my nose that seemed to scab over easily, but never quite heal. The derm told me it was a squamous cell carcinoma, the kind caused by sun damage. While squamous cell cancer won't usually kill you, if left untreated it does spread, and it can create big ugly areas. It could have eaten away my entire nose. I saw some photos of that. I decided it was best to have it removed when it was new and small. I went to a skin cancer specialist in Moh's surgery. Moh's surgery is a subspecialty of dermatology, and not everyone does it. But I wanted it, because the alternative was to be disfigured. My skin lesion was on my nose, so I didn't want somebody cutting a big piece off it. Mohs sounded like the perfect solution, because it's done with local anaesthesia, and the surgeon removes the skin layer by layer, or slice by slice, sending each slice to be biopsied while you are still in the office and numbed. You stay until a layer comes back clean. So they only take off exactly what's necessary to "get' the cancer. It's a cure about 98% of the time. And then you are sent to a cosmetic surgeon. In my case, because this was on the bridge of my nose, they had to do a skin graft (they can't just sew up that area, because there's hardly any extra skin.). So they took some skin from my shoulder and grafted it on to my nose. They held it in place with a cotton ball that they sewed into the nose as well. Several days later, they removed the graft. You can hardly tell it is there. There's no hole in my nose, and no real scar. This surgery is WORTH IT. I will look for some photos I took during the procedure, and if I find them, I'll post them.

Replies (47)

May 10, 2008
Recently diagnosed with a couple of basal cell issues on my face of which one is fairly large. I am seeking a practicioner of MOHS and Cosmetic surgery. Can you help or recommend? My thanks in advance. Bob Neese
October 24, 2008
I had Mohs surgery three years ago for a tiny spot on my cheek. I had no idea the dermatologist was going to cut into the length of my face or I would have asked for a plastic surgeon to be involved. I have had two scar revision surgeries because my face was so badly sewn. Beware if you have ANY size of cancer spot on your face, the Mohs procedure tends to result in overexcising (cutting)so the Dr. is sure he got it all, so INSIST a plastic surgeon is involved from the beginning. Don't ever let anyone cut on your face who is not a board certified physician. Symmetry and sewing skills are critical.
February 24, 2011
I had two mohs procedures performed. One on the side of my nostril and one beneath. I don't agree a plastic surgeon is necessary, just a competant doctor! Results of both my procedures left little evidence of scarring. Get referals and check out the doctor.
September 4, 2011

I agree. My Moh's surgeon was highly recommended by my dermatologist. They both said I wouldn't need a plastic surgeon. The nasty scar I have says they were wrong. Always get a plastic surgeon.

August 22, 2012

I too have just had a Moh's procedure and was not advised that he would have to cut down my face because there was not enough skin to pull over. He never looked carefully at my face when I went for his expensive first consultation and only after he had got the cancer out and I was put back on the table did he draw a big back to front tick on my face and say he was going to have to make a flap, what could I do, he wasn't asking my permission he was just telling me what he had to do. I came away from there utterly shocked. The days after the op I was in severe pain which I presumed was the normal thing, but I couldn't stand it any longer and went to the Emergency Department who admitted me straight away. I was on 3 days of IV antibiotics and all the staff at the hospital were shocked and all asking me who did this and this was even on a plastics ward where they are used to seeing bad things. I have to go to the Plastic Surgeons clinic to have the stitches removed as they could not do them in the Hospital as they are so tight in the area where the skin cancer was Oh ! and did I say that the Plastic's surgeon at the hospital has said she thinks the skin has died in the area where the skin cancer was removed. So if he had done a graft I would not have this huge scar on my face. BEWARE, BEWARE, BEWARE is all I can say to people.

(unregistered guest)
February 7, 2009
I agree to make sure you have a plastic surgeon on hand. I too had a red dot on my nose and stressed I am pretty vain already getting botox injections and laser to remove dark pigment. My nose is horribly scarred from the scalpal slicing he did AFTER THE SURGERY to yank skin this way and that to cover the hole. I never should have trusted my "expert" and should have demanded a plastic surgeon be there to close me up. Now, I have to try and find someone who thinks they can correct what this guy did.
March 7, 2009
I agree. I am so grateful to have had a plastic surgeon do reconstruction on my Mohs site. After two weeks the scar was noticeable, but fairly normal looking. My surgeon was shocked at what the Mohs surgeon was planning to do to close the wound--it would have caused serious disfiguring on my nose. Find a good plastic surgeon and get in and do the Mohs before the cancer gets bigger! (I waited almost a year--NOT a good idea)
April 16, 2009
I have to agree: get a Plastic Surgeon involved. I had 2 procedures done each closed by a Plastic Surgeon. One required a skin graph from behind my ear. It had the same effect as a "mini-face lift".
June 14, 2010
I have had 9 MOHS surgeries done by a dermatologist/plastic surgeon. The object of MOHS in the first place is to minimize scarring. My experience has been that they surgeon will numb the spot, take a small layer and have it biopsied.If the margins are all clean, you will be stitched up and you may leave. If the margins are not clear they will numb you again and take another thin layer. Sometimes you can sit in the office 3 or 4 hours until they get all the cancer. I have had to go back into the surgical suite three times but I am thankful that the doctor does not just cut a chunk out. He takes the time and excises as little tissue as possible and still gets all the cancer. His stitching technique is superb.
December 31, 2011
The problem is you don't know how good or not a Moh's surgeon is until after he scars your face. My Moh's surgeon was highly recommended by my regular dermatologist.
If you have anything done on your face get a plastic surgeon.