Forehead flap repair of nose after MOHs of bcc - what do I need for recovery?

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In 5 days time I have MOHs surgery and 2 days later I have reconstruction surgery. The plastic surgeon said my bcc, which is in the crease of my nostril, is substantial and will almost certainly require a forehead flap. He was very casual and offhand about it. It was only because I had googled MOHs after the dermatologist told me I should have it, and naturally browsed all the gruesome images, that I knew what a forehead flap was, but I never expected that I was going to need it for a little sore spot. I was too stunned to ask questions and he was only interested in getting me out of his office quickly.

I have done more googling and they say forehead flap has best result, which is of course what matters, but also that the aftercare is onerous and patients should be counselled beforehand. Help help help me please!

What do I need? Can I go outside? I usually wear a hat in the sun, but it sits on my forehead. Can I wear my spectacles? How do I cope with my 6 month old puppy who is devoted to me and loves to lick my face? I thought about boarding her but discovered that kennels only take dogs over a year old.

I have a supportive husband, thank god, but no family and no friends. That sounds awful but when the chips are down you realise how it is.

I am 68 and on the plus side, I don’t care much about my appearance. But are people going to feel sick when they see me?

Carole F - Macmillan over 2 years ago

Hello LuckyLass,

Thanks for getting in touch and welcome to our online community.

We’re sorry to read that you were not able to ask questions at your clinic appointment.

Sometimes consultations can be quite overwhelming, especially when an unfamiliar treatment is recommended. And even when questions are asked at the time, it’s not unusual for more to spring to mind later.

We can’t tell from your post, whereabouts in the UK you live, so appreciate this leaflet may not have been produced by your local hospital. However, it provides general information about forehead flap reconstruction and may be helpful to look at before speaking to your hospital team.

They are best placed to give you specific advice about your surgery and recovery as they have access to your medical notes.

It’s important to know about precautions you may need to take, how and who will look after your wounds and how you will be followed up.

It’s only natural to wonder how other people will react to you after you have had surgery. People may react differently to changes in your appearance initially, whilst you recover from surgery. There are ways to respond to this.

The NHS website suggests that a psychological assessment may be given before surgery, but your hospital team will be able to say if this is something they can offer. If you think it would help to talk to a trained counsellor, we may be able to arrange for this through our partnership with BUPA. If you’d like us to refer you to them, please don’t hesitate to give us a call, or if you’d rather arrange this yourself, we have more information here.

I hope this is helpful.

Sending best wishes,

Carole

Cancer Information Nurse Specialist

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or email us.

Ref/ KM

LuckyLass over 2 years ago in reply to Carole F - Macmillan

Thanks very much for your reply Carole. I am in the West Midlands. The leaflet is very helpful. I guess the hospital didn’t give it to me because it’s an NHS leaflet. I chose to go private, after waiting on the NHS for some months I began to panic. I am regretting that now because it does feel like I am getting a lower standard of care, and paying £15000 for that privilege. But there we are. It will be ok. Just wish I wouldn’t keep waking at 4 am and worrying.

Carole F - Macmillan over 2 years ago in reply to LuckyLass

Hello LuckyLass,

Thanks for getting back in touch. I’m glad you found the leaflet helpful.

I’m sorry to read that you keep waking at 4am and are worrying. It can be normal to feel anxious about surgery, but it’s important to make sure these feelings don’t become too overwhelming.

Whether you’re having treatment on the NHS or privately, it’s important to have enough information about treatment, and how you will be supported as you recover.

This article, published in the National Library of Medicine, was written many years ago, but it has some good tips about managing pre-surgery anxiety. It explains how some people might cope with anxiety by getting information and talking with others about their concerns. Other people might try to distract themselves by reading, listening to music or using relaxation techniques.

It might be worth letting your GP know that you’re having surgery soon, if you haven’t already.

I’m not sure if you have heard of our partnership with the digital therapeutics company Big Health. They have developed a tool called ‘Sleepio’ which can help improve sleep. You can access it here.