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Moh's Surgery & Reconstruction


Tuesday, April 21, 2009

The biopsy of a tiny lesion on my nose revealed a basal cell carcinoma, and the recommended treatment was Moh's surgery to remove any remaining cancer, followed by plastic surgery to close up the open wound left by the Moh's surgeon.

My family called yesterday "Nose Job: Day 1". The dermatologist does Moh's surgerys on Monday afternoons. A pathologist is set up in one of the rooms to look at the slides, so the results are immediately available.

Here's a link to a great graphic of how they do the procedure:
www.nhskin.com/cfml/mohs
_steps_1-3.html


My nose was very numb, so the only discomfort was the doctor's assistant pressing down on my nose to create a flat plane. He took a conservative first slice, and I sat in the waiting room for about 20 minutes while the pathologist looked at the tissue. The first layer had a small area of cancerous tissue, so he numbed my nose even more & took another layer, which came back all clear.

At that point, I went back to the exam room so the doctor could cauterize the surrounding tissue really well. There was a little mishap there, where the current from the electro-cautery machine went through both the doctor and me, and where his pinkie was resting on my forehead, I got burned! I have a little red mark the size of a pencil eraser where the current went through.

Two weeks ago I had a consult with the plastic surgeon and last week I had the pre-op appointment. There was no telling how large the hole from the Moh's would be, so in case it was large & required a skin graft, he wanted the surgery to take place in the hospital outpatient surgery center. At the pre-op appointment the surgeon handed me a hand mirror so I could get a side view of how my nose would look afterwards. If the hole had been big, he could have shortened my nose a little; how it was when I was younger (who knew that our noses get longer as we age?)

Today was "Nose Job: Day 2". I opted for a local anesthesia, so I was able to drive myself. I had the normal prep: B/P, temp, blood saturation monitor, IV and then they wheeled me in to the OR. My nose was still a little numb from yesterday, so I didn't even feel the injections today. Since the area was small, it only took about 15 minutes for the entire surgery. I'm guessing I have about 10-12 stitches. He said the closure is mostly vertical & follows the contour of my nose. I was in recovery for about five minutes & came home. I need to take it easy for the next couple of days...especially no bending over.

The big reveal is on Thursday afternoon.
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Member Comments About This Blog Post:
CAROLYN0107 4/23/2009 3:44PM

    Judy, I'm so glad I spotted your blog entry today. Thanks for sharing about your surgery in detail. I went to the website on Moh's surgery as well. I'm sorry that you are having another "bout" with cancer.
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I'm on a modified SparkBreak, trying to get lots done before I travel to the States. This week that included the painting of the inside of my house, all but the office. The office will have to wait about two more weeks. My house is now soooo clean (walls) and dirty) stuff sitting out every where, stuff I had to take out of the cupboards. Bit by bit I'll get the house back to a better condition that it was in. I'm trying to get rid of stuff.

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