Hi Lou,

How are things with you?

I had my private-pay appointment with the Mohs specialist today. He took one look and confirmed the ‘main’ lesion, the one I went to my GP about, is bcc. That’s the one at the top of my eyelid, under my eyebrow. 

He’s booked me to have it treated via Mohs surgery on the NHS, at the hospital where he does his NHS work.

During that surgery they’ll also take biopsies of the two other spots I had concerns about, though he doesn’t think those are cancer. (yay!) PLUS a small one on my nose which he thinks is also bcc. (Gulp!) But if it needs taking off they’ll do it via Mohs too.

The waiting list will supposedly be about six months but he says that’s safe. (That’s what it would be if I got it done at my local hospital too - and I don’t even know if they’d agree to do it there.)

I really hope you get your appointment soon. 

Hi Dawn, thank you for the update. I’m pleased to hear there was a sprinkling of good news in there about the other two areas of concern unlikely to be cancerous. What a relief! It sounds like speaking to the surgeon was a positive experience and you now have a plan of what’s to come. 

My next appointment is with the Mohs surgeon to talk about the operation but unfortunately it’s not for another 5  weeks. I’m trying to stay positive for the sake of my family but to be honest I’m not dealing with it very well. 

Would be great if you could stay in touch and let me know how you’re getting on.

I’m glad they’ve given you a date to see the surgeon, but if you’re struggling with the anxiety, I’ve heard of people on waiting lists politely ringing up to ask if there have been any cancellations they could get slotted into. Might be worth trying?

I realised as I walked away from the appointment yesterday, that I don’t know if the expert I saw will actually be doing my surgery - he never actually said HE would be the one doing it. Maybe I should email him and ask but I don’t want to seem pushy

I also realised I failed to ask about a very small ‘lump’ on my hand I’m wondering about. I will bring it up next time I see someone. 

Hi Dawn, I’ve managed to get an appointment to talk to the surgeon tomorrow thanks to a last minute cancellation like you suggested. (I’ve gone privately this time but have had a mole removed 2 years ago on my side thanks to the NHS, thankfully that mole was benign) I’ll spend some time this evening tying to think of all the questions I need to ask. 
I think emailing the surgeon would be a good idea, perhaps you could attach a photo of the lump on your hand? I hope you get a reply soon. 

Lou, given the sensitive location of your bcc it’s good that you’re able to go private and avoid the dire waiting list. Good luck formulating the questions. Based on what I failed to ask on Monday, you might want to ask if the surgeon himself/herself will do the surgery, and who would do it if he/she is not available. And how many stitches it’s likely to be. Good luck xx

Lou, given the sensitive location of your bcc it’s good that you’re able to go private and avoid the dire waiting list. Good luck formulating the questions. Based on what I failed to ask on Monday, you might want to ask if the surgeon himself/herself will do the surgery, and who would do it if he/she is not available. And how many stitches it’s likely to be. Good luck xx

 Dawntreader Hi Dawn, I now have a date for surgery which will be at the beginning of November. Feeling anxious as not sure of the outcome. It all depends on how much skin they have to take away. I’ve been advised that it could be anything from being left with a slight dent in my nose or a skin graft taken from behind my ear or a skin flap from the top of my nose. All the scenarios keep going round in my head. 
Hope you’re doing ok xx 

Hi Lou, that’s great that you’ve got a date, and only a few weeks from now. I know the scenarios are anxiety provoking - it’s understandable you keep ruminating on the possibilities. But you’ve got the best type of surgery for your particular situation, and not too long a waiting list - you’re doing great so far. Well done! I’m still waiting for the next shoe to drop. After I saw the consultant 10 days ago, he said I’d hear from the hospital he was referring me to … but I should have asked when. 

Hi Dawn, have you heard any more news about your appointment? How are you? X 

Hi Lou, thanks for thinking of me. I was starting to wonder whether the surgeon I saw had actually managed to refer me to the hospital. Then I got a missed call yesterday afternoon, called them back today and am now booked in for a ‘routine’ screening appointment on 31 October. I asked if that was the soonest available and the secretary said the only other available screening date was January!
I guess I’m not an ‘urgent’ case as bcc is slow growing. I hope I made the right decision going for Mohs rather than accepting the basic excision surgery my local team offered - it would have been done in a few weeks.

How are you feeling, are you still quite anxious or have you been able to put it out of your mind to some extent?

Hi Dawn, no unfortunately it’s still taking up major head space. Bad week last week, hardly slept which then made me feel unwell. The thought of having a skin graft on the top/end of my nose is giving me major anxiety. It’s not just being awake whilst the operation is happening but getting my head around living with scars and marks right in the centre of my face with no option to hide it. The thought of just returning to work a week or so later fills me with dread. 

Do you know what the routine screening appointment will consist of? I’m pleased to hear you have a date for this next phase. 

Hi lou 

It is a lot to get your head around. The procedure while you are awake will be OK the team will put you at ease and there will be no pain. You can ask beforehand  for a mild sedative. A post earlier by Hippyginger says she has a scar the size of 50p and is not worried and will wear her facial scar with pride. Im not so brave and very self consious of  having 5 such large scars on my face forehead and scalp two of them 50mm and try to hide them. There is a charity called changing faces 

https://www.changingfaces.org.uk/

Who may have info you find useful on concealing scars.  

I also have a scar on the side of my nose from a skin graft but this is hardly visible the plastic surgeon was exremely skilled. The scars do fade with time and your family and work colleagues will not notice after a very short while even if both you and I do. Main thing is to prevent any more lesions by protecting your skin. Wishing you the best for your procedure.

Ed

 Farmer_Ed thank you for your reply. If ok with you are you able to tell me how the healing process went after your skin graft. Did you have to leave the area exposed or did you cover it over with gel pads to help the healing? Did the new skin look raised or is it flattened to be in line with the surrounding skin? I’ve had the most awful thoughts going round in my head with visions of my nose looking like a patch work quilt. 
Thank you for the link to Changing faces I will definitely take a look at this. 
Hope you are keeping well, sounds like you have been through many challenging times. 

Hi Lou

Like you I had a BCC lesion. Id had it for 30 years I thought it was a wart but  it had started to grow so got it checked out. The skin graft to the side my nose was a full thickness graft which was taken from the skin on my face just in front of my ear. So the scar is level with the surrounding skin and the skin shade is a very close match. It is barely noticable now but was for 9 months or so. The scar on the donor site whick was stitched back together it is nearly invisible now. The dressing was kept on for 7 days during which time it had to be kept dry, tricky with not washing hair and not putting head under shower. Safer to take a bath if you have one. Take great care of the graft in the coming weeks. Including not doing vigourous excercise or bending down which can increase the blood pressure in the newly forming blood vessels and damage them. The nurses at the plastic surgery unit took dressing off to check if graft had taken and to look for infection then replaced a temporary dressing to be kept on for a further 5 days which I then removed myself.  The donor site was treated the same.  For the large SCC lesions I had removed on my forehead and scalp where a split thickness graft was used, there is a slight depression where the lesion was removed and the paper thin graft was stiched on. The dressing was stapled in place to keep it from moving, it has a spongy feel to it. The same instructions apply in keeping it dry etc. The donor site for these was the top of my thigh and this was very tender for around six weeks with the dressing being kept on for 14 days. It takes around a year for the redness to fade away. The donor site for your nose may be your neck and I have no experience of this. Once healed gently massage  moisturiser to the scar daily it will stop the graft drying out keep it supple and improve the visual appearance and avoid the sun.

The plastic surgeons do their very best to do a neat job and a successful outcome. I'm sure makeup can do a good job of covering the scar but as an old fellow I would be uneasy wearing makeup. Changing faces can help out but the wait for an appointment can be a very long time and you can probably do skin colour matching yourself.

The screening appointment is just a health check, blood pressure, weight,  they ask questions like do you smoke are you on blood thinners etc. If you do smoke try quitting now as it severely reduces the chance of the skin graft taking.

I hope this is of some help and I wish you a successful outcome for the surgery ahead.

Ed

Hi Lou, totally understand your being worried about your nose. Everyone that’s posted on here seems to be pretty satisfied with their outcome in terms of appearance / ability to disguise it with makeup. Surgeons can work wonders these days, and people also mention methods of massaging the scars afterwards. But still hard not to worry.
Good to see the link Farmer_Ed has posted to the Changing Faces charity, I’m going to  check into that.

Re: my hospital screening, I don’t actually know what it will involve, whether they’ll do a biopsy then or just look at the lesions and schedule the biopsy for later - and you know, I ought to find out. It’s stupid to just be walking into it blind - so thanks for that little nudge, I’ll try contacting them to ask.

Hi Ed, another facial bcc patient here. I initially was seen by my local dermatology / plastic surgery team but they didn’t offer me Mohs surgery… I saw another dermatologist privately, a Mohs expert, and he referred me to the hospital where he does his NHS work, but it’s a long waiting list.
Thanks so much for detailing your experiences, it’s so helpful to hear ‘true life’ stories rather than generalities.