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.

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.

Thank you Farmer_Ed I’m so nervous, hearing someone else’s experience is a great help. I can’t wait for life to be about other things again and not just skin cancer. 

Many thanks 

 Dawntreader How’s it going? Have you had your hospital appointment yet? 
I can’t work out if I’m more frightened or relieved to get closer to the surgery date. I’m eager to get the cancer removed but in no rush to have scars over my face. 

Hi Lou, no my first appointment at the hospital is scheduled for 31 October. I looked on the hospital website to see what the screening typically involves, as nobody’s given me any info - it sounds like it will duplicate the initial appointment I had with the Dermatologist at my local hospital - but potentially with biopsies, either on the day or sometime soon afterwards. I know your date is relatively soon - refresh my memory please, when is it?

Hi Lou, no my first appointment at the hospital is scheduled for 31 October. I looked on the hospital website to see what the screening typically involves, as nobody’s given me any info - it sounds like it will duplicate the initial appointment I had with the Dermatologist at my local hospital - but potentially with biopsies, either on the day or sometime soon afterwards. I know your date is relatively soon - refresh my memory please, when is it?

Hi Dawntreader my op is on Monday 3rd November. I’ve also noticed a small area on the side of my nose that doesn’t heal properly. It’s tiny, not much bigger than a large pore. The surgeon said he will take a look when I see him on the operation day. Don’t think I can face another area of concern on my nose. Just when you think it can’t get any more worrisome, something else seems to pop up.

I hope your appointment on the 31st goes well. Not too long to wait now. 

Hi Lou, sorry you’ve got this additional area of concern - but it sounds so tiny that I hope it would be easy to manage, even if it’s bcc. Sounds like some people are able to use non surgical treatments for ultra-mini areas - fingers crossed. I’ve got 4 places on eyebrow, eyelid, side of nose and cheek that were identified by at least one of the three doctors I’ve seen as possible bcc - well the eyelid was IDd by ALL of them as a definite, the others will need to be biopsied - or maybe excised and sent to path lab.
I appreciate you staying in touch with me on this, it’s good to feel like someone understands the situation. 

Hi Dawntreader sorry to hear you also have multiple areas of concern. I hope treatment and answers come your way soon. It’s exhausting having this hanging over you every day. I can’t wait for life to be about other things and not wake up everyday and go to sleep every night worrying about this. 
Keep in touch, let me know how your appointment on the 31st goes. 

Hi Lou, thanks, and the same to you. Not long now for you - I'm going to be keeping my fingers crossed all day on 3/11 that the surgery goes really well and you're left with a tiny, discreet scar that only you will notice. 

Yes I will let you know after my appointment how things go. I'm not that worried and I'm not sure why ...  a bit orf denial? It's strange because I'm usually a terrible worrier!! Please keep posting here if you find it helps, your companionship definitely makes me feel more grounded.

 Dawntreader same here, thank you for staying in touch x 

Hi Lou, just wanted to check in and see how you’re doing.
I’m starting to feel a bit of fear in the pit of my stomach now that I’m getting closer to my appointment on Friday. I always go in with a written list of questions but I find the consult often goes in some unexpected direction so you get side tracked. You look at the list but you’re so aware you’re taking up their time so you kind of rush through and realise later that important things haven’t been addressed. That’s my fear at this point - that I won’t get all the information. Some people aren’t worried that way, they’re happy to just put themselves in the NHS’ care and go with the flow. Better for mental health probably!

Hi Dawntreader totally understandable to be feeling fearful the closer the day gets, I feel exactly the same. I think it’s a great idea to go in with a list of questions and have them in your hand when you enter the room. You already know how easy it is to get sidetracked when the consult is talking to you so I think you’ll be fine as you’ll be prepared for that scenario. Let us know how you get on. 
One week to go before my op and my emotions are all over the place. It’s hard to prepare yourself for something when you don’t know what the outcome will be. It’s not a case of well, at least it will be over this time next week. I’m struggling to come to terms with looking different. I know this is going to have a huge impact on my mental health and I’m scared where that will take me.

I hope your appointment goes well on the 31st. I’ll be thinking of you. 

Thank you for the encouragement and support Lou. I’ll do the best I can Friday. I’ll let you know what they say and what my next step is.

I’m not surprised you’re feeling wobbly, with surgery a week away. But people posting here about bcc seem to be ok with their surgical outcome - which is encouraging. Have you come across a less successful story that’s preying on your mind?

Hi Dawntreader I think it’s the thought of having a skin graft at the end of my nose and how it’s going to look afterwards. Also the new area of concern on the side of my nose/nostril is getting worse. I haven’t had a diagnosis on that yet but I’m pretty sure it’s bcc, again there is no excess skin to cover the area should it need to be cut out. So many scenarios going round my head right now.

Best of luck on Friday. 

Thanks Lou, the same to you. When you say you’ve not had a diagnosis for the place on the side, have they ‘looked’ at it yet?