Upper Eyelid Mohs Surgery - Springfield, IL

I am scheduled for Mohs surgery of the upper...

I am scheduled for Mohs surgery of the upper eyelid on Nov. 19th and reconstructive surgery on Nov. 20th. I am disappointed this isn't going to be done in one session. I had my consult with the Mohs surgeon on Monday. This is a nodular BCC on upper right eyelid, but it is near the lash line. Dr. thinks it's pretty 'contained', but I understand you don't know until you get 'in there'. He has already told me I may lose some of my eyelashes permanently. I have been on the internet the last two weeks and I have seen photos of this, so I was 'sort of' prepared. I meet with the oculoplastic surgeon tomorrow, I really don't know how much he can tell me until HE sees the extent of tissue lost. I have seen some photos of where they can 'graft' or do a flap that may contain some lashes, but it all depends. It's not just a cosmetic issue (well, it mainly is), but the lashes do protect the eyes from dust, debris, etc.. I have what I would call prominent eyelids, my eyes are not deep set where you might not notice some of this. I go between being OK with all this to being upset. I have been a fanatic about suncare for the last 40 years (I'm 61). Never tanned.I was the one using zinc oxide/titanium oxide sunscreen, wearing hats, wearing sunglasses 365 days a year, rain or shine and now I have this in a very obvious spot. I asked the surgeon how in the h*ll did I get something like this and he said "You got this when you were a little 8 year old girl playing in your backyard" That actually made me feel a little bit better. At least I know I have done the best I could. The pictures of the Mohs surgery are very upsetting, but from what I seen posted, most people look OK after a couple of months. My family doesn't really get this. My sister is taking me to the surgery and she said "oh we'll probably be out by noon, won't we?" I have been EXPLAINING what Mohs is and how it works, but I don't think anybody's really getting it - or listening. Thanks for letting me vent. mslincoln

surgery done

Had the mohs today, it look a total of 8 hrs. After first tissue sample was taken, it look 4 hrs to get results, to see if the border was clear - it wasn't. Took another piece of tissue on an outer corner. I still have eyelashes. It looks like a 'gash', about an inch long and 1/2 inch wide. set to have skin graft tomorrow. not really painful during procedure, they give you about 4 shots total in lid, and they pulled and stretched the lid constantly while working, but when the numbing wears off, it IS painful, but that subsides after a while. my eye is all bandaged up, so please excuse my typing. everybody else in the 'waiting area' was in their 70's & 80's. They all said the same thing "doc told me I got this 50 years ago". not looking forward to the skin graft, I have read the donor site can be more painful than the actual graft itself, but I cannot wait to get this wound dressing off!!!

Skin graft done

I had the full thickness skin graft done today on the eyelid. It is a piece of skin, basically about the size of a large kidney bean, grafted right along the lash line, stitched into place. The donor skin was taken from the same eye, along the outer edge of the eyesocket, it is stitched also, but the scar from it should like follow the contour of the eye, so I don't think it will be noticeable. I don't know quite what to expect with the graft. It looks pretty graphic right now. I was told to expect a lot of swelling and bruising, so am on an ice pack regime right now. I can't say any of this has been extremely painful...just periods of discomfort, but I definitely would not want to go thru this again. I sometimes think this was blown way out of proportion, but I know I hadn't done anything, I would have had major problems down the road. It is still hard for me to believe this came out of a little dry scaly patch, no bigger than a grain of rice that popped up several months ago. To anybody who's going to go thru this...don't freak yourself out looking at pictures on the web too much, BUT do be mindful that this IS surgery and don't let anybody make light of it for you. I think my sister, who accompanied me the last 2 days, really got a shock.

Healing & cleansing

I think the healing is coming along OK (?) The graft looks very gross. The donor site where the donor skin was taken is very sensitive, it's stitched. It feels like it's tight, so maybe it's healing. I have come across something that makes cleansing face easier when you have these areas on face that need to be handled VERY gently. I have been using a little 2 oz. mister - this is the type that comes in the travel packets with other 2 oz. jars, etc. that are approved for FFA travel. Can get them at any Walmart/Target,drugstore. It puts out a very fine mist. I use it to wet the area, rinse the area, etc. I can't stand the thought of even dabbing a washcloth on this and it's a little more 'targeted' than just splashing water all over. I found this very helpful. Good luck to all who are dealing with these issues. I have a follow-up with the plastic surgeon next week.

What's normal??

How do you know what is ''normal'' when you are healing? You get a long list of instructions of aftercare when you leave, with signs of what constitutes an emergency...but how do you know what is just normal healing. My graft looks discolored in places, along the very edge of lash line and maybe the right and left edge of graft. Only place I don't see any discoloration is at the very top. And it looks 'puffy'. And the eye is itching, not the sutured areas but like in the inner and outer of corner of eye. Is this just the process of healing? Thank goodness, I am seeing the plastic dr tomorrow for followup. I realize everybody would heal differently, but if they would just kind of give you an idea of what to expect the first week or two, it would sure help. I've looked all over web and nothing really outlines the stages of healing. I tend to worry (Obviously, LOL)

Con't healing

The healing appears to be coming along well....have had one follow up with plastic dr. He said it all looked normal..he removed any remaining stitches from the donor area. It looks a little 'red' but is starting to scab. The graft itself looks surprisingly normal, no drastic color changes, it looks red around the edge of the lash line, but it is ok. It is starting to scab on some edges of the graft. I have to keep the antibiotic salve on it for next 2 weeks when I have another follow up with plastic dr. All in all, this has not been bad, Drs. McGinness and Su appear to really know their stuff. I am hoping it all continues well. If anybody else is facing something like this and has any questions, please let me know. Thanks, Ms.Lincoln

Graft healing

It's been 4 months since my surgery/graft on my eyelid. I am still seeing my oculoplastic surgeon who did the graft. IDK, I AM happy with the results and of course, relieved to be cancer free, but I realize now I will always have this reminder on my face. The donor incision is easily hidden by concealer and this does help protect it from the sun. But the graft is rather prominent, I didn't realize how prominent until I tried to wear eye makeup (shadow) on it again. I have been wearing mascara for about a month with no problem, but when I went to put shadow on, it will not "take" on the graft itself and collects around the edge of it, particularly if it's a darker shadow. I always thought eyeshadow/base provided a little bit of protection from sun. The plastic dr says "put sunscreen on the lids", but I can't stand that, it gets in eyes and burns. So I will rely on a powder base and neutral shades of shadow for protection and I ALWAYS wear my sunglasses, rain or shine. The plastic dr discussed a couple of options that could improve the graft. In a couple of months he can try a steroid injection into the graft that 'may' help flatten it some and help with the redness. After a year, they can try 'something else' - I think it may be a laser- on the area. IDK how much of this "tweaking" my insurance will cover, so I have to be mindful of that. I hope this doesn't come across as shallow or vain, but I was left with more of a reminder than I anticipated, but the plastic dr says it takes a good year to really see what you have......

ALSO, I am scheduled for a checkup with my regular derma dr in a couple of weeks and I'll be ***** if I don't have a spot now on my other eyelid, down by the lash line!!! I just keep thinking this CAN'T happen again, can it?

Eyelash growth cycle?

My surgery left a spot along the upper lash line (about 3/8 of inch long) where I only have 5 lashes left - the Mohs surgeon was able to spare them. They did grow back, but there is this sparse area, but it looks OK and I am able to wear mascara on them. Interestingly over the last week, I noticed a couple of the lashes fell out and there was this noticeable 'gap'. Upon looking at it closely, I guess the lashes are 'life cycling' and I can see new ones coming in. I can see this really clearly as there is only 5 lashes in this area. I guess normally you have enough lashes that you don't really notice where you've lost one. So this is something that will be a part of this eye now.

Steroid injection

About a week ago, I went to the oculoplastic surgeon for my follow up on the eyelid graft. We had talked on an earlier appointment about maybe getting a steroid injection in the graft area to kind of "smooth it out" make it lay a little flatter. When I wear a darker eyeshadow the graft area stands out and makeup won't adhere to it (a minor issue, I know). But I was offered this injection as part of the scarring treatment, so I took advantage of it. It wasn't just one shot, but a series, maybe 6-7, of small injections around the perimeter of the graft. The graft is about the size of a large kidney bean right at the lash line. The eyelid was numbed with numbing cream and then they held an ice pack to it right before the shots. I didn't really feel anything, but when the needle was pulled out from one site to another, it would 'stick and pull' sometimes, and I could feel that. Dr. said I may have some bruising/swelling/drooping of eyelid, but all I had was a little bruising. It has been a week now. I DO think the graft is flatter than it was. The injection was a combination of a steroid with lidocane to help with inflammation and thin out the skin a little bit. I see the Dr. in another 6 weeks. I think I am nearing the end of my treatment. All in all, I am pleased with the appearance of eyelid and of course, being cancer free. I see my regular dermatologist every 6 months now for an all over body check. I will probably post one last time after my next appointment with the plastic dr. as I expect to be release from his care then.

Good luck to anyone who is facing something like this -there are a lot of us - this site has been a blessing.

No change?

The steroid shot in the eyelid graft really did not do anything that I can see...I don't see any flattening or thinning of graft - but I am OK with that. However, the donor incision scar (about 1 1/4 inches long taken from the same eye above the eyelid area seems to be more sensitive in the last couple of weeks? It looks a little redder and I have some white bumps (like whiteheads??) on it. Just saw the oculoplastic dr yesterday and he really didn't think there was a problem - the redness and bumps are just part of the healing, which he now says will take over a year...??? So I'm not really sure what to think?? I have been putting Mederma on it most nights and dr just says I can keep doing that for up to a year, but I don't really think it's making a difference now, maybe the Mederma is irritating it? IDK? I have a follow up appointment in 6 months, but I am not sure if I am going to keep going. I WILL still see my regular derma dr for body checks every six months.

I've probably reached the end of my posting days. The site has been a huge help to me, I hope my postings can be of help to other people.
Dr. Jamie McGinness and Dr. Grant Su

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