Anyone here have Mohs surgery? My wife has a basal cell CA on the inside edge of her left nostril. She's scheduled for Mohs surgery but none of paperwork they gave her describes the actual procedure. I know it entails taking multiple slices of the area until you reach normal tissue. After this a plastics guy comes in and does the "reconstruction". They say it takes most all day but how much of that is waiting around? How long between slices. Any discomfort? Appreciate knowing someone's experience.

I've had it on my cheek. The removed skin layer is not deep. And the multiple cuts are progressively making the circle bigger until the edges of it no longer show the cancer cells. Mine ended up being bigger than a quarter in the end. But again, not deep. The same doc did the cleanup work for me, and then I was done I had a gruesome big stitched area. Two actually, because I had two areas of it. But the bigger is the quarter sized one.

Once it was totally healed, you could hardly tell, or perhaps couldn't tell at all unless you were looking. Basically, it was a pretty ok experience. Lots of waiting between cuts. Can't remember how long I was there. Perhaps a few hours.

My FIL had it a few years ago here in NOVA. It is definitely the way to go.

The time in between cuts is time for lab to test and ensure all margins are good, and no cells remain.

They only take what is needed, and most importantly, get all that is there.

Otherwise, they take a chunk, and you don't know whether they got it all or not.

I believe we waited 60-90 minutes for results from lab between each cut, when we did it.

We were there 6 or so hours.

I’ve had Mohs done on my face, chest and left arm.
The ones on my chest and face were deep rooted.
I’m a coward, but it wasn’t bad. The doc hit a nerve on my forehead, my Crocks shot off my feet,& made my eyes cross & water up.

The doc will slice off little sections, run it to their lab, he had to come back a couple times to remove more of my hide, slicing a bit deeper, until he came back and said, “all done, got it all.”

They gave some ointment to put on my stitches and that was it. I got 2 black eyes from the surgery on my mug but all healed up well.

I have to return every 6 months for follow up, for the last 2 years. I worked outside most of my life and never thought about skin cancer way back when.

I had MOHS a couple months ago. It went well, didn't require any reconstruction. Took about 10 minutes with a 30 minute wait while they verified the borders were clear.

I am presently recovering from Mohs. Previously on my face, back, arms and neck. This trip, left forearm (squamous cell), left leg (basal cell) and right leg (squamous cell). The one on my right leg, about 4 inches above my ankle, was really big and deep.

My wife had it done to the side of her nose too. She said They numbed the area and removed a small slice. Then sent it to lab for analysis. Came back and did it again. Then had a couple stitches and bandages.

The results? I can’t see any indication it was done. She did go back one time because the end of a stitch popped out and they removed it.

Strangely enough, I am going through this procedure at this very moment. They just finished the fifth cut on my ear... ready to get this over with.

Not unpleasant, no pain, just tedious.

Going on 2-1/2 hours. Pro tip: Use sunscreen.

Had it done on the top of my head. Needed two scrapes, about 30-45 minutes apart. Worst of it - it felt and sounded like (thru the bone) they were scraping my skull and the smell of my own burning flesh as they cauterized blood vessels after each scrape.

I have had it done twice - on side of nose and on cheek near the nose.

I got a whole brochure on the procedure. Though not painful a bit weird having surgery while I am awake. I had my eyes covered and I think that was the best for operating on my face.

I could not feel the actual MOHS surgery at all but I could feel the tugging while stitching. They did a lot of cauterizing during the procedure. It is important that she tell the doctor/surgeon right away if she feels any pain as the local anesthetic can wear off kind of fast during the stitching. I could start to feel the cauterizing and they were happy to give me more numbing to keep it pain free when I mentioned it.

Depending on where the tissue removal is and how much, the incision for a "skin flap" and stitching can be pretty extensive rather than simply stitching closed the area where the tissue was removed. This is done though to have the best possible cosmetic result of the face when healed. A graft is another possibility in some case which is what I had when the tissue was removed from my nose and the "donor" area was taken from my cheek area right by the lower part of my ear.

It is very important to follow post of instruction instructions at home on care for the would area to keep it clean and moist for best possible healing. They had me use Vaseline to keep it covered after gentle washing by splashing water over wound and patting dry.

BTW make sure that the MOHS surgery and any possible reconstructive surgery is approved by your insurance. The first time my insurance paid for the MOHS surgery but not the reconstructive surgery, I had a skin graft, because no pre approval was done. The medical office filed an appeal and it was finally paid for but it is best to get that all taken care of ahead of time. Talk to the medical office doing the surgery about that as they will have the CPT codes of procedures then need to be done or may need to be done.

Good luck.

quote:

Originally posted by mttaylor1066:
Strangely enough, I am going through this procedure at this very moment. They just finished the fifth cut on my ear... ready to get this over with.

Not unpleasant, no pain, just tedious.

Going on 2-1/2 hours. Pro tip: Use sunscreen.

Ended up with 7 cuts… but as the wife said, “better get it over with now…”

quote:

Originally posted by mttaylor1066:
Strangely enough, I am going through this procedure at this very moment...

This is the craziest place! LOL! Glad it went well.

Yeah, don’t ya just love this forum!

I had mohs surgery on my nose for squamous cell carcinoma. I had to have a plastic surgeon close and reconstruct it afterwards. Wasn't a big deal at all.

I had it done on my nose.

Should have had a plastic surgeon close it up but I didn't know better. I guess I look more rugged.

Not a lot of pain.

Everybody waiting had bandages on them...

quote:

Originally posted by r0gue:

quote:

Originally posted by mttaylor1066:
Strangely enough, I am going through this procedure at this very moment...

This is the craziest place! LOL! Glad it went well.

I see several references to a plastic surgeon above... I am seeing one today as my dermatologist took a pretty good chunk out of my ear. More than I expected going in.

I would advise anyone having Mohs to have your dermatologist give you a very good idea of how much he/she may have to cut before you let him/her start cutting. Of course, they never know just how much beforehand, but if it's a very visible part of the face/body you want to have expectations set and maybe a plastics consult in advance.

I don't consider myself very vain, but my job requires some media appearances and public speaking. I don't really want the attention to be on my ear. Hence, today's trip to the plastics doc.

Another option is go to a good Plastic Surgeon in the first place. He/She can remove the cancer, do a frozen section at that time, and do the reconstruction then and there!! Just a thought. This is the route that I chose.

I decided against the plastic surgery when they took a chunk from my cheek. Now all I have to do is wear an eye patch and Arrgh! Matey

I've had it at the edge of my right nostril and a second time near the lateral canthus of my right eye.

It was a very survivable experience both times; I would not hesitate if needed again.

Had the “first’ plastic procedure done on my ear yesterday.

When my dermatologist did the MOHS on my right ear, he showed me the extent of the cutting in a handheld mirror. I commend him for taking the minimum of skin and cartilage that removed cancer from my head.

He recommended I see a plastic surgeon then and there… and also offered to close it up himself.

I am glad I opted for the plastics consult.

The plastics doc showed me, graphically, how misshapen my ear would be with a simple closure. I would have lost at least 1/4 of my ear with simple stitching. With the help of my fantastic wife (she is also a physician) I opted for reconstruction that will take two surgeries. Had the first yesterday, about 3 hours under general anesthesia. Seems like a lot of effort for just one ear, I know!

Moral of the story, get a consult first as you don’t want to make decisions with permanent ramifications while you’re looking in a mirror at the fresh results of 7 MOHS cuts. It’s a bloody mess, I can assure you. I almost said, “screw it, let’s just stitch it together and get out of here.”

I would have come to regret that choice, deeply.