Upper Eyelid Mohs Surgery - Springfield, IL

Yes, thank you for taking the time to respond. I met with the oculoplastic surgeon today who will do the repair the following day. He made it all sound so 'easy-peasy' - "we'll either stitch it, pull 'this' together, pull 'that' together, do a graft, do a flap, I had enough residual skin above my eye, etc. etc. etc." But then he ends, of course, it all depends on how much is taken off. I guess my only saving grace is, he said it was found really early and what he sees is usually much larger. I felt better after meeting with him, but then I reminded myself this may not be how it goes at all. So I am cautiously optimistic. You are so correct, anybody who goes into this without checking it out is in for a BIG surprise. I guess it was good that yours was out in the first margin, but yes, I am shocked sometimes at how much is taken. Mohs is supposed to be the most conservative method, but sometimes I wonder. I hope this gets better for you. Was yours a basal cell? Did it start off small and grow? How long had you had it? thanks for your input, mslincoln

Hi again, my melanoma was Lentigo Maligna or brown freckle. I had the brown spot for at least 15 years but my dermatologist said I hadn't actually had melanoma for very long. The spot started out small and just slowly got larger. I had it checked several times my different dermatologist and was told it was just skin pigmentation due to Sun damage. The reason I suspected that something was wrong..it started itching and getting scaley. I'm trying something new that really is making a difference. The scar is flatter, less red and doesn't itch while I'm wearing it. Their called Scar Pads by Spenco, I found them on Amazon. I'm glad to read that you're doing good.

Thanks! your post is very timely. When I had my consultation with the plastic surgeon, I asked about scar management...he kind of blew me off..he may have thought I was putting the cart before the horse...he kind of mentioned some about using Mederma, the stuff you get at drugstore (which I have been told doesn't do much of anything). I did know that there was like these 'sheets' you could wear to help with scarring, but didn't have any specifics. Do you know if they are OK to use like on an eyelid? I will ask the plastic dr, again, when I see him next week what can I use.....thanks for the info, mslincoln

Oh you're welcome hon. I hadn't heard of them until my surgeon called me at home ( yes, you read that right ) and ask how I was getting along. I told him the scar itched and had a lot of pain too. That's when he told me exactly what to buy. These come in a 3 x 4" sheet that can be cut to size but I don't know if you could use it on your eye lid or not. I do know there are silicone gels that coat the scar. Once I started looking this stuff up..I found there's all different kinds. Ask your surgeon or his assistant ( they usually know just as much ) about using these. I hope this helps. Myra

The "this happened when you were a child" must be a standard thing they tell patients who obviously have been taking care with their skin. It made me smile a little. If that's the case, then most everybody of a certain age should have this!! But you are right, I don't think sunscreen was even an option when I was a child. Everybody was into getting a Coppertone tan!! (I wasn't, but it still didn't save me). I think this can be tricky when it's around the eye. I hate the thought of having this open wound, even if it's only for one day. I hope all goes OK with you too!! Good luck, mslincoln

I definitely think the healing is the hardest part of this. I had a follow up with the plastic dr today. He addressed a lot of my questions on the graft area...yes it will change colors - from a dusky pinky to even purple - as the blood supply grows in. Some of the 'discoloration' on the graft edge is actually stitching. Dr. brought it up again that it can take months to actually heal and see where you are as far as scarring goes. My scar area may be 'puffy' - he said no problem, they would just inject steroids to take care of that. Whoa! But I am not going to get the cart before the horse again. I just want it to heal properly and then will deal with the other. From what I've been reading, there are things that can be done to help with scarring, some laser treatments, and now steroid shots (?) I think a lot of this depends on where your surgery was done. I was told about the silicone sheets, I think they are very good, but I don't know that would work on an eyelid. If you don't mind my asking, where and what type was your cancer? Did they just close you with stitches or a flap/graft? I think my family is probably tired of me talking about this, LOL, but it sure helps to talk to others who are going thru it. When you mention that you had a skin cancer removed, most people just envision it being scraped or burned off. They have no idea.... Try not to get down, I know I looked at 'those pictures' on the net and scared myself to death, but most of them looked perfectly normal after a couple of months. It's a process, for sure. Ms.lincoln

Mine was Lentigo Maligna, right cheek. I ha the flap. Click my name at the top of my comments and it will take you to all the comments I've made. You can read more about his on my Nov. 22nd comment.

Yes, when I left after the Mohs procedure, I was "bandaged up" on that eye, had what they called a 'pressure bandage', which is basically a lot of gauze folded up and then taped into place very firmly on the face/eye to staunch any bleeding, and no, you can't hardly drive. I had trouble even walking as I wear glasses and obviously couldn't get them on my face afterwards. The Mohs surgeon took pictures of the wound when he was done and before it was bandaged up. He sent/emailed, forwarded the pictures to the plastic surgeon so he could review what was done and he would have time to decide how he would repair the next day. I also think my Mohs surgeon took pictures of me at the initial consultation so there would be a picture of me, in tact, in my file. These 2 doctors all work for the same clinic so they all have access to my file to see what was done. I'm kind of concerned about the part where you say your reconstruction dr. wants you to 'come by ' after the Mohs surgery. Your situation sounds a lot like mine. I would say you would be totally bandaged up after your Mohs surgery and that pressure dressing normally stays in place for 24 hrs.. I can't see your plastic surgeon undoing that pressure bandage to take a look at it ahead of time? - and then bandaging you back up again? Your Mohs surgeon is not going to send you home with a gaping wound uncovered on your face for overnight. That's why, in most cases, the Mohs surgeon is able to do the repairs after the procedure and you go home all stitched up - all done. But unfortunately around the eye, that is not the case. I would say to make sure your mohs surgeon and your reconstruction surgeon are on the same page. If there's some way your Mohs dr can get pictures of your open wound to your plastic surgeon before hand, you shouldn't have to be undoing any bandage for anybody. I take it yours is on an upper eyelid, near the lash line too? I;m just finding my way with this too, please keep in touch, mslincoln

I have my second follow up with the plastic dr tomorrow. Honestly, the donor site looks 'rough'...it's still red and the incision looks rough and bumpy. It's only about an inch long and about in the middle of it, there's a dark spot. I thought this was going to blend in with contour of the eye, but now I'm not sure. The graft itself looks pretty good, but yes, it looks puffy on the eyelid. I know it's still really early regarding how any scars will look. Glad this went well for you. Some of the ones I've seen involving the nose look very involved. Best of luck.

I had never heard of the "Mohs" procedure until I was referred to a dermatologist to check out a pimple on my nose with a hard center that would not go away. I was referred by my PCP and by the time I got into see the dermatologist 3 weeks later, I also had one on the other side of my nose. She removed them and one was a squamous cell and one was a basel cell. That was then it was recommended I under go the Mohs procedure. So that was set up about 2 weeks later but then I delayed it for 3 weeks longer as I was having family visit during that time. Anyway, I had it on Dec. 11th and had 2 surgeons who specialize in the Mohs. I was extremely nervous as of course I looked at all kinds of websites and images online and saw all kinds of things that really frightened me. But fortunately they only had to take one layer of each area and I had clear margins, so had very little damage to the nose. I was offered the skin graft, and after it was explained to me I agreed to it. I was only at the office for about 3 1/2hours and everything went well. After the initial pinprick of the first shot I felt absolutely nothing and had 2 diazepam during the surgery to relax me and took 1 Tramadol after it was over. Have not had to take any pain pills since. I feel very fortunate after reading and seeing what others have had to undergo. I do think it takes awhile for scars to heal especially for older people. And I am happy they were able to take my skin graft from the area near my hairline, so I can hide the scar if I need to. At this stage of the game and my age and the fact I am a breast cancer survivor (hate that word), I am blessed to still be here and able to handle it. And of course, I would not be able to without the help of God and trust in my doctors.

Your story rings a lot of bells with me..I looked at all those sites too and have seen some pictures on here that are serious, but most people seems to heal well. I agree with the age thing (I'm 61). I probably wouldn't heal as quickly as a younger person. I don't want to make too much of the scar issue, if I was younger, it would matter more - maybe. You have been thru a lot, but it sounds like you are doing fine and have a great frame of mind. I find everybody's stories very encouraging and supportive. Thanks for yours! ms.Lincoln

I had what they called 'twilight sleep'...I was sedated, but I was still kind of aware...I think I started humming songs at one point. It was an IV in my hand. I didn't feel a thing, but I do remember them telling me they were going to tying my wrists down so I couldn't reach up and 'swat at them', LOL, I guess people do as you are not totally unconscious, I do remember hearing the words morphine and propofal being said. This is only the 2nd time I have been put out. I had all my wisdom teeth out 6 years ago, it was an iv in hand, and I was totally out for a short time. I can see where your procedure is more complicated, so they may want you totally out - don't fear it, I think it's a blessing. I know exactly what you are talking about when you mention grafting lower lid onto upper eyelid - I think it's called a Butler flap/graft (?) they make a horizontal slit in your lower lid and pull the lower eyelid skin thru that slit onto the upper eyelid. I spent WAY too much time looking at stuff on the internet and I did come across this. I hope you get a separate graft, my dear. The whole eye area is tender, but the donor area is more so, it feels like it is pulling, so I'm hoping that's a sign of healing, it has bled a little bit, I have read it is normal for the donor site to give you more trouble than the actual graft. The graft is very bizarre looking, like a patchwork quilt. The only thing I was prescribed was a little tube of antibiodic salve to put on graft/donor site. put it on with a qtip, I get kind of a strange sensation of 'numbess' - if that makes any sense, when I touch the graft area. This basically started off as a little tiny dry 'scale' on my right eyelid and if I didn't sit in front of a magnifying makeup mirror every morning putting on eyeshadow, I would never have noticed it. it was probably half the size of a grain of rice, and the eyeshadow would 'collect' on it. This probably came on about 10 months ago. But this past summer, I got to 'picking' at it, I thought there may have been something in it and I picked it to an open sore, ...twice. I saw a derma dr about the same time for another issue, and she said 'what's that on your eyelid?" I said it's nothing and she said if that doesn't go away to come back. a couple of weeks later, I got some redness around the lash line, so I went back. derma dr said well the redness was just dermatitis, BUT while I was there, she'd like to biopsy that spot. She said it's probably nothing, not to worry, but then on my way out the door , she hands me a brochure on the Mohs procedure....she already knew... I worked in the public too, but I retired the first of the year, so at least I don't have to deal with that....sorry this went on so long...it helps to talk about....please contact me anytime, ms lincoln