Infiltrative Basal cell on nose tip

Sorry to hear you have to wait but I've had a similar procedure in terms of MOHS & the forehead flap so happy to share if you'd like to know my experience. Mine has gone well but this procedure does cause some challenges with vision if you wear glasses like I do. Let me know if you have questions or would like to know more about the process.

Hello, thanks for your reply️. I also wear glasses. So I guess you can’t wear them. How did you manage.? I have to wait as you know, but I would like some info.  Firstly, I remember how extremely painful the injection to my nose was when I had the punch biopsies.  Pain is short lived, but with MOHS when they take a bit at a time, how long does it take to check whether they have got all the cancer. How many times did they come back for more, and if so do you have to keep having injections.

A lot of questions there for starters .

I had local anaesthetic for the MOHS treatment which was a few needles. The surgeon cut out tissue twice so I had to wait around an hour after each one for the results. This was in a specialised room in day surgery. Then I had the plastic surgeon booked in the same afternoon. That procedure was under a general anaesthetic.

As for seeing - I can wear contact lenses so I got those updated but they don't assist with all my vision needs. The bandage went from my forehead to my nose so I couldn't wear glasses. I tried using a magnifying glass to read some things & some things on your phone can be enlarged. I also have a google chromecast so that meant I could send things from my phone to my TV screen to see them e.g. emails.

Some other members on the forum suggested things using an old pair of glasses like taking the arms off and attaching a stick so as to use them like opera glasses. I ended up taking arms off an old pair & attaching an elastic ribbon so I could tie around my head. 

At first because of the bandage being in the middle of my nose, glasses weren't possible at all but after I could have the bandaging moved to one side, I found that I could fit something over my unpatched eye, even a pair of reading glasses. That was after a week or so post the first operation

Hi there

Sorry to hear you're having to have MOHS surgery. If it helps though, it really is the best procedure when it comes to facial skin cancers as it preserves as much healthy skin as possible and it is the most accurate way of making sure all the cancer is gone. I'm really glad I went ahead with it because when I was first told he would need to take the edge of my nostril off, I wasn't too keen!

I didn't have the flap procedure you describe in your treatment plan - mine was a V-Y advancement flap - but I can tell you that my 9mm BCC was initially removed with a 2mm margin. Some more cancer was found in the margin so another some more skin (either 1 or 2mm, I can't remember which) was removed from that area, which came back clear. So that's initial removal, another round, then the flap closure, and in total this took 7 hours.

My BCC was tucked in right next to my nostril sort of between the nose, upper lip and cheek and I had two injections for the local anaesthetic - one through my nose and one in the upper lip. I had both of these 3 times over, one for each part of the procedure. I've got to say these were the worst part in terms of pain and I was very anxious waiting between the rounds. During the actual procedure itself, I was told to just lie back, close my eyes and don't move, which I find very easy to do and I actually almost fell asleep at one point! It helps if you have a great team working with you.

I hope my experience goes some way to helping with your questions about the procedure.

Good luck!

Thanks for sharing.  How long did you have to wait for the MOHS, I worry that mine will grow deeper in 12 months. Was your cancer in the centre like mine. I just wonder why I can’t have plastic surgery straight after.

Thank you for your help.  I think I am more worried about the bcc growing even deeper into the tissue over 12 months. I know we have to have the procedure and we cope don’t we, because there is no other option.  I feel bad, but I’m more worried about how I will look after.  Being slap bang in the middle of the face, I am 64 so I should be grateful , but even at this age I want to look ok.

I had a flap procedure when I had a mastectomy for breast cancer when I was 50. Half of the graft died and went black. I had to be patched up with skin from my hip. My new boob is like a patchwork quilt.  I’ve grown to love it like my own.  But a disfigured face, I don’t think I would cope with.

Did you have to wait a time for your MOHS?

From when my bcc was detected to the actual surgery was 3 months as I had private health insurance. The cancer went from the centre across to near my cheek. But MOHS is the recommended treatment & mine is healing well but will take time. I am 62.

The skin flap was done that day & then I had a second op a month later to disconnect the extra vein (blood supply). Then they wait for swelling & fluid to reduce. I massage my new skin to help with that but other treatments are offered. 

Mine was diagnosed in December 2020 and my MOHS happened in March 2022. They were originally going to do a standard excision with a 4mm margin in June 2021, but when the surgeon saw the location of the BCC, he decided to do MOHS instead. They gave me an appointment in September 2021 that I couldn't make, then I had an appointment in, I think, December 2021, but the surgeon got covid so that was cancelled. Then eventually had it done in March the following year!

I can definitely empathise with being concerned about how you will look afterwards. I was absolutely terrified of being horribly disfigured, but you actually can barely tell. I'd actually had mine for around 10 years before I thought it might be cancer and had it looked at. So I'm estimating mine grew at just under 1mm per year, but mine was going more across the skin than down if that makes sense.

Thank you both for helping.  As you say MOHS is the right treatment for me.  Will try to put it to the back of my mind until I hear from hospital. Thanks again Lou Lou and MsC19754c.  You are both stars x

Hi, I'm in a similar situation to you with intrusive BCC on nose about 15mm deep. This is going to be removed by MOHS on Tuesday and then a skin flap from forehead done the following Monday. Like you, it's taken months to get to this point, and it's got bigger and worse over time. The only reason for the action now is that I consulted a private dermatologist who was appalled by how I'd been treated and the lack of urgency from the NHS. He contacted the NHS on my behalf sending them his assessment of my case and I got an NHS date a week later. I was repeatedly told by various people that it was slow growing and not to worry. I now realise I should have worried. I would really urge you to get back on the case. I am dreading the operations but at least something is happening which is far easier to live with than waiting and not knowing.