Basal Cell Carcinoma - Mohs Experiences?

[missva]

I have what is likely a basal cell carcinoma on my face under my eye in the upper cheek area (waiting for biopsy to confirm, but doc said he's pretty sure that's what it is). They are recommending Mohs surgery to remove it once confirmed. HAs anyone has experience with this - how long were you there during the procedure, what is the scarring like, how long to heal? Thanks in advance!

[mrsslocombe]

My husband had a Mohs surgery for melanoma on his cheek.

The surgery took less than an hour, he was awake for it. They had to leave the incision open for 3 days (covered in gauze) while they waited for test results to conclude they removed all the cancer, so that was uncomfortable. Then 3 days later he went in and they sewed him back up, took less than an hour.

He wasn't in a huge amount of pain, it was more annoying to have the bandage on his face. While the wound was "healed" in a couple weeks it took a very long time for the scarring to fade-I want to say at least 5 years. And it didn't heal particularly well. He had an option to bring in a plastic surgery to close the wound and in retrospect, he should have done that, the scarring might have been more minimal. He did use the recommended vitamin serum and stuff like that for a little while but stopped bothering, maybe if he had kept it up it would have been better? but really the problem was the sewing job wasn't great and his skin didn't behave the way they thought it would.

[Jalapeñomel]

My dad had some removed on his nose—-it was outpatient, maybe an hour, but he does have some pretty significant scarring.

[mae0111]

I haven't, but friends and family have. Some opted for a plastic surgeon and others didn't. There was a huge difference in the scarring. Definitely opt for a plastic surgeon to close the wound if you can, especially near your eye.

Good luck - I hope all goes smoothly.

[mcmel]

I don’t have any experience other than I used to watch a lot of Dr. Pimple Popper videos and any time someone had this surgery I was always astounded at how good everything looked. It’s amazing how they can make it look so seamless.

[ssmjlm]

My dad had it on his hand. It wasn't a big deal except for them making sure they got it all because it wasn't the first time the spot had come back, which is why he ended up with the Mohs.

The scar is pretty small, but it's also his hand hear his thumb.

[lab7979]

I had to have a Moh's procedure on my face when I was around 24. I had basal cell carcinoma on my cheek about halfway down very close to my nasolabial fold. You are awake during the procedure and they numb you well. They go layer by layer. If your cancer is shallow, its quicker. They test each layer so that takes some time. They keep going until all margins are clear. I think I had at least two maybe three layers removed. Mine was all completed in the same day. Once complete, what was a pea sized or smaller spot on my face was probably a quarter sized wound. I wasn't completely prepared for that. I had a really good doctor who had done tons of these procedures. He made my wound a little larger and football shaped so he could close it into a clean line and hide the scar within my nasolabial fold.

I have a fair complexion and I tend to scar well. I have a thin white line where I had the surgery but most people don't even see it. I barely notice it half the time. I had stitches for about two weeks and had to keep the bandage on during that time. Once I had the stitches removed and everything was healed, I used Mederma religiously on my scar. My doctor also recommended massaging it because he said it helped break up the scar tissue so it wouldn't be raised. I did that and my scar is completely flat. I also used Vitamin E oil to help fade the scar. It look about a year or so for it to really start fading. I could hide it reasonably well with makeup during that time. The first month was the worst looks wise and then it got better.

I was worried that removing that skin would pull my mouth to one side. He said it was a possibility but that with time it would stretch back out and look pretty normal if that were to happen. In the end, I didn't notice a difference. If you are worried about how it might make your face look besides any scarring (for example pulling down your eye or pulling your face to the side) then I'd talk to your doctor about that and if you don't like what he has to say, maybe ask about getting plastic surgery involved.

[jamie.1022]

My husband had the surgery to remove a spot from his eyebrow. I would also recommend a plastic surgeon. We were there for a while because they cut, test while you wait, then go back to surgery if the margins weren’t yet clear. He had to go back in twice I think. The worst part was getting more local anesthesia in an already open wound. Other than that, he got stitched up and sent home. Good luck!!!

[liverandonions]

My husband has had it twice - once on his shoulder, which has a scar that is noticeable, and this summer on his scalp that was closed with 10 staples and is hardly visible. Definitely seek personal reviews if doctors. Our neighborhood facebook page is a good resource for reviews like that.

[Covergirl82]

I had a basal cell carcinoma removed on my upper arm 13 years ago. I have an almost-1" linear scar from the surgery (not Mohs, just took a conservative margin of error around the spot), which was done by a dermatologist. If I had needed to have surgical removal on my face, I would also opt for a plastic surgeon, as others have suggested.

[calmcosmo]

I had Mohs for basal cell on my nose a few summers ago.

My only advice is to find a good plastic surgeon who works closely with your Mohs surgeon. At my consults we came up with several plans from best case scenario to worst case scenario and what the day would look like. WIth facial Mohs surgery obviously preserving the face (or in my case, my nose) was really important. The plastics options available to me really depended on how much they needed to take.

I had my Mohs in the morning and was awake. They then left the wound open, packed me up, and I went directly to a plastics appt where they did some more extensive work and were (thankfully) able to give me a few layers of stitches. I didn't need major reconstruction.

Overall only I can really tell it happened now that I'm a few years out. I have a small scar and some deformity that is hard to see unless you get really close. I got lucky and caught it early.

Advocate! Some Mohs surgeons are trained in plastics (mine was), but good ones will know whether they are the best person to reconstruct/fix. My surgeon wasn't confident on a nose so he helped me find a facial plastics person who was.

[snapoutofit]

My 82 year old mother had mohs surgery just over a year ago for a basal cell carcinoma on almost the exact spot you are describing. It took less than an hour and her scar is barely visible. I have to look hard to see it. The dermatologist who performed the surgery also did the stitches.

[ax2]

I had a removal in almost the same place, from the inner corner of my eye, down my nose about 1.5”. Like the others, I was awake for the procedure, but didn’t feel anything but some pressure. I sat there for a few minutes while they made sure the edges were clear then got stitched back up. They used two layers of tiny stitches, which was a bit uncomfortable but it really minimized the scarring. You’d never know unless I told you.

[waverly]

My mom had surgery on her BCC on her nose. I don't know if it was Mohs surgery. Plastic surgery did it, and there is no scar at all. Amazing.

[lahoagie]

I have had two spots removed with Mohs surgery. Both were on my forehead. The first one was pretty small and wasn’t too bad. I think I took just one day off of work. My second one was large and took two attempts to get it all. The area they removed was about the size of a quarter. I need a lot of stitches. The doctor said it was like a free face lift. Both of my eyes bruised and swelled shut and it was somewhat painful but I survived. Bags of ice were very helpful. I live in a big city so both times I was automatically referred to plastic surgeons who specialize in Mohs surgery.

They numb you so you don’t really feel any pain during the procedure. The biggest surprise for me is that they do carterize (sp?) the wound which I wasn’t expecting and didn’t smell the best.

After the second one I told people at work that I was attacked by a bird while hiking which was fun. I think I took 2-3 days off but I still had a huge bandage over the wound and two black eyes.

I now take nicotinamide and I haven’t had a spot since then (not sure if it helps but I don’t think it hurts).

ETA: I can still see both spots but other people tell me they cannot. At least not until I point them out.

[devonpow]

Yes - I had a basal cell removed from near my nose. I ended up having 5 stitches and you can’t see the scar now at all. The place I went to offered free laser treatments after 6 months if I wasn’t happy with the scar but I didn’t need it. I was really careful with keeping the scar moisturizer and sunscreened and I use a red light therapy mask every day which I think helped.

I was super nervous about the procedure but it ended up really being fine

[devonpow]

Oh I was there a few hours. They did the first removal then I waited for an hour or so while they confirmed they got it all, then they stitched me up. I went back a week later for stitches removal (they were SO itchy at that point so it was a major relief. Until the stitches were removed I was slathering it in Vaseline and kept it covered. After the stitches removal it honestly looked ok. Like, you could see the redness etc but I felt ok going out and about. I avoided makeup for a few weeks, I can’t remember how long.

[kath16]

my dad had it on his face and it wasn't long before the scar was almost invisible. it was several years ago now, but i do remember him being nervous that it would scare my then-toddler children, but honestly i think it was really only a few weeks that you could even see it and that is with like, zero care for it on his part.

[chickadee77]

Anecdotal experience.

My H had a basal cell carcinoma in the same area. They started his MOHS at 7am and didn't finish until well after 5pm - it took 7 surgeries to get it all throughout the course of the day. By evening, it was too late to see a plastic surgeon (though we had asked at the beginning of the day to have one on standby; an option they said was available) so they packed the wound and we spent the night in a hotel (too far to go home). Saw the surgeon mid-afternoon and got him patched up and home that evening.

He is well recovered now (15 years out), though has to shave weird parts of his face (the reconstruction essentially pulls skin from the bottom of the face up to the eye) and his nerves have mostly recovered.

Glad he had it done, as waiting may have cost him his eye. But we would have been *much* more adamant about having reconstruction ready to go and probably used a different surgeon. If you're in Louisville, pm me and I can tell you who we used.

[missva]

Thanks All! I'm actually in Greenville, SC, but asking around about the best surgeons. For those of you who had the procedure, did you bring someone with you?

[minzy]

I know of a successful Moh’s experience (at the hairline) in Greenville - will PM you details as soon as I get them.

[lab7979]

Oct 28, 2024 13:00:23 GMT -5 missva said:

Thanks All! I'm actually in Greenville, SC, but asking around about the best surgeons. For those of you who had the procedure, did you bring someone with you?

I brought my mom with me.  I was glad I had someone there for support because I was nervous but I didn't actually need anyone there.  They just numbed my skin.  They didn't give me anesthesia or anything.

[bdubs419]

Yes! I had BCC removed from my forehead. I remember being super emotional about it because it was my face. Honestly it’s healed great and had no further issues. I will say right at first it didn’t look great but again, it healed very nicely over time. Now it’s barely noticeable.

[turbo]

Haven’t dealt with this and I’m sorry you have to, but I’ll just chime in on one thing - I had a really nasty head injury as a kid and the doctor wisely called in a plastic surgeon to sew up the gash (it was like 3” long, directly down the center of my forehead). I am so grateful they did; it’s not even noticeable. If you have the option to have a plastic surgeon do the work sewing your incision back together, especially if it’s in a highly visible spot, take it. If they haven’t suggested it, you could always ask.

[dirtyred]

I had it done last year on one between my eyebrows.  Only took one pass, so there about an hour.  There was a woman in the waiting room who had had three removals and was waiting for results on the last pass.  I have no scar; in fact, the incision got rid of my frown line on that side,so a small bonus there.

[calmcosmo]

Oct 28, 2024 13:00:23 GMT -5 missva said:

Thanks All! I'm actually in Greenville, SC, but asking around about the best surgeons. For those of you who had the procedure, did you bring someone with you?

My husband went with me and was in the room during the Mohs. He sat in the waiting room for the plastics portion.

I was glad to have him with me for both. While I probably couldn't have gone alone, Mohs is a little scary because you don't know how long it will take (how many layers they will have to take) until they do it. Mine ended up being quick, but it doesn't always turn out that way. I found the part where you're laying there waiting to see if they got clear margins the most nerve racking. For me, wondering how much of my nose they were taking was horrible . Having my husband there holding my hand and helping me talk through this was very helpful. I'm not sure I would have been in the best head space to drive emotionally after all of that. 

[sunshineandpinot]

MH had it on his cheek. He drove himself there and home. He was there much longer that he/we anticipated and he wished he would have brought some snacks, even a protein bar. The wound was significant; he still pulls up the pic and I shudder, but the surgeon was amazing and you really have to search for the scar.
GL! I'd bring snacks and good headphones, wear comfy clothes bc you may be there a while (but hopefully not!)

[mellymel]

I just had Mohs surgery last month to remove basal cell carcinoma on my face, where my nose meets my cheek. It was detected during a routine dermatologist appointment - I never even noticed the spot myself.

The surgical procedure took 5 hours. I had to have 2 layers removed, wait about an hour between each removal for testing, and then finally had to be stitched up which required more removal in order to get a straight “seam.” 🤮

One month later the incision is healing well and the scar is barely noticeable. I have been using silicone scar strips on it at night. During the day I cover it with tinted sunscreen as it can hyper-pigment very easily in the sun.

[missva]

Oct 28, 2024 20:46:10 GMT -5 mellymel said:

I just had Mohs surgery last month to remove basal cell carcinoma on my face, where my nose meets my cheek. It was detected during a routine dermatologist appointment - I never even noticed the spot myself.

The surgical procedure took 5 hours. I had to have 2 layers removed, wait about an hour between each removal for testing, and then finally had to be stitched up which required more removal in order to get a straight “seam.” 🤮

One month later the incision is healing well and the scar is barely noticeable. I have been using silicone scar strips on it at night. During the day I cover it with tinted sunscreen as it can hyper-pigment very easily in the sun.

Did you go to a plastic surgeon to do the stitching? 

[devonpow]

I also have pics I took of the first week/until I got my stitches out if you are interested in seeing - I was documenting for my friend who was also about to have Mohs