Probable forehead flap in a week’s time, how to prepare?

Hi! I had flap surgery in the area just above the lip for BCC in September 2022. They removed the part of my face with the BCC and replaced it with skin from my cheek. It was done with a local anaesthetic only. No pain during or after, just took paracetamol for two days. It looked pretty awful at the beginning but today, four moths later, the scar is barely visible (I can share photos if you think this would be helpful). And I can now feel the skin, which is great as it was numb at the beginning. For the first month or so I had a bandage on it then it was really thin strips of bandages for a while but only where the stitches were. I did not do anything particular to protect it from the sun, just tried to stay in the shade as much as possible. I am also 67 and my partner says I look great and that it is barely noticeable. I am sure it will be the same for you! All the best!

Thanks Pisanaf, that’s good to hear.  

Hi lucky lass

I had a basal cell removed from my nose without reconstruction.

If you look back at the posts on here there are people who have had forehead flap and have posted their experiences which I'm sure you'll find helpful and reassuring.

Hi Luckylass whereabouts on your nose is the cancer.  Mine was right at the side of my nostril the bulbous bit and on my face at the side.  My skin flap was taken from my facial line by the side of my mouth.  When the dressing came off it looked a mess but we were wearing masks then so I could hide.  The one attop of my nose near my eye was worse and skin graft on this.  Wearing my glasses was impossible as dressing was big, when this came off still hard to wear them as it was sore. I did go out but not far as I looked a mess.  A year on and the scars are fine.  Mine were nasty little beasts but I had locals and surgery took about one and a half hours and I went straight home.  I wear factor 50 sun cream from March until end of November and always wear a wide brimmed hat in the summer.  Good luck and keep in touch. I did wonder if I would have forehead flap on the one at top of nose but surgeon said no skin graft would be fine xx

Sounds like my BCc is in the same place as yours, it is along the join of my nostril to cheek.  I may get a cheek flap instead of forehead, depending on the size of the wound after MOHs, but the surgeon thought forehead was most likely.  But I am sure it will be fine in the end.  Thanks for the reassurance.

Hi Luckylass.  

I had an invasive BCC near the end of my nose 2 years ago.  I had MOHS then a forehead flap with a 5 week gap between the initial surgery and separation.  The flap was done under GA but the separation under local.  

The anticipation is the worst stage so I think it’s good you don’t have too long to think about it.  Once done - well you are then on the road to recovery and every day is better.  

It will be hard to wear glasses when your flap is is place.  You have a tube of skin going from the corner of your eyebrow to the top of your nose.  You can roughly balance your glasses there but it’s not easy.  Once the separation is done, the bridge of your nose is back to normal.

You just need to be careful with applying suncream going forward.    I wear a sun hat when walking / gardening.  

It’s definitely not a great look for the period when the flap is in place but you will be wearing bandages so you can get out and about. Once it has been separated there are a few weeks when that lovely husband of yours will have to help you adjust but remember that no one will notice it as much as you do and the scars will get better each day.  3-6 months on people were saying that it was barely noticeable and it continues improving.  

One thing I did not anticipate was that my scalp and forehead would go numb.  My scalp is back to normal but the left hand side of my forehead is still numb.  I don’t know if that is inevitable.  

Wishing you all the best. It will be OK! 

x 

Thanks Lizch, that’s helpful and encouraging.

Well I am through the MOHs.  The dermatologist was very nice, talked me through the process all the time, and there were two sympathetic nurses tending to me and distracting me with chat.  The injections of local anaesthetic were painful, which I knew to expect after the biopsy procedure, but otherwise the surgery was not uncomfortable. After the first session I sat and waited a bit over an hour, during which the anaesthetic wore off and the nose began to ache.  Then the doctor came in to say he hadn’t got all of it so back for another session.  Fortunately I only needed that one more.  It seems that I have a pretty big hole now with some loss of rim of nostril.

 The surgery started at 5pm as the private hospital doesn’t have MOHs equipment so it was using the NHS hospital facilities after hours, and they were NHS nurses doing a second job..  My fee as a private patient was £2500.  I was finished at 9.30 pm, so a long day for us all.  Including my poor husband who had been looking after our puppy in the car outside while I was in the hospital.

During the hours drive home my nose began to get very sore as the anaesthetic wore off, despite my taking painkillers.  Paracetamol was suggested but I had codeine left from my hip replacement so I treated myself to that and got a reasonable night’s sleep.  I won’t take any more codeine as I want to be in best condition for the graft surgery tomorrow.  Today I am just hanging around in a sort of limbo.  I have a huge sticky dressing over my nose which is itchy and it is hard to breathe through my nose, but surprisingly little soreness.  Less soreness than I had the day after the biopsy.  I have felt a bit sick at times which may be from the shock to my system but may also be from the painkillers.  Or maybe the oral antibiotics I have to take for 5 days.   Or pure hypochondria.  I took paracetamol at 8 am but will try not to take any more.  I don’t have much appetite but have had a small breakfast and lunch, soft food because it is hard to open my mouth much or chew.  Teeth brushing is difficult.

The puppy has been kept at a distance to avoid her licking my face, but she is getting lots of extra fuss from my husband.  So I don’t think she is missing me as much as I am missing her!

It’s good to know that the cancer is out.  

Thinking of you.  Best wishes for the graft surgery x

Hi Luckylass  Glad that part is over for you and good luck for the next stage.  What hospital did you have it done at.  Let us know how the next stage goes xx