Biopsy on tip of nose.. Dermatologist or plastic surgeon for minimal scarring?

Hi there! I had my BCC on the side and top of my nose and had it excised last week by a plastic surgeon. I had my reconstruction done yesterday, also a day surgery case. Like my surgeon said, there is not operation without scars, we can just minimise them by having a good surgeon I guess? I haven't got photos to show you yet as all bandaged up but am having my stitches out on Tuesday so will have something to show you then? Personally I would go for the plastic surgeon. My dermatologist was the one who suggested that as it was on my face he would refer me to her. I had Dr Barbara Jemec at the Royal Free Hospital in London, lovely lady with the most amazing bedside manners!! 

Not sure this is helping you answer your questions but just thought I would let you know my thoughts on it.

Love and luck,

Hi, Thanks for posting. Any information at all is helpful. Did you have a biopsy first, or did they diagnose off appearance and then go ahead and remove it? I'm torn about what to do.. I'm booked into theatre with dermatologist for biopsy next Fri, but then appointment for biopsy with plastic surgeon I've never met is Fri after that. I wish the appointments had come the other way around really as I'd rather talk to the plastic surgeon first and then decide whether to have biopsy with him/her or whether to have the dermatologist do it. The other thing is as well, the dermatologist is referring me for MOHS surgery if it does come back cancer, which I know is supposed to reduce the need to have as much removed, but if the plastic surgeon does the biopsy, I'm assuming they will have to do a wide excision removal as I was told I can't have MOHS at that hospital. I'm really hoping beyond hope it doesn't come to that, but in terms of biopsy I'm thinking possibly plastic surgeon may have more experience doing nose biopsy than dermatologist so may do it in a way more likely to minimise scarring? You sound really brave. I hope your reconstruction has gone well. Let me know how it goes and if you feel up to it, post some pictures. It's so inspiring to see how people are handling this. I'm not so brave!

Love and best wishes for Tue xx

Hi 

Try not to panic, it really is not as dreadful as it sounds. I've had several biopsies on my nose in different places and none of them showed any real scars. Unfortunately one was a BCC but one that was a rather ugly mole/spot was not and the added benefit is that it was removed and so that looks a lot better than before! 

I had mine removed by a plastic surgeon on the recommendation of my GP, but when the BCC was confirmed I chose to be referred to a dermatologist for MOHs as I wanted the benefit of smaller area removed + assurance I would not have to have repeat surgery. The dermatologist did the MOHs and then I went back to the plastic surgeon for 'reconstruction' after MOHs (skin flap to cover the wound). They prefer to work this way apparently as the dermatologist concentrates on removing the growth (their skill) and the plastic surgeon concentrates on doing the best repair possible (their skill).  

The biposy really is quite simple so I think you can be very confident in the outcome whichever route you follow. Its great that your dermatologist is already planning to refer you for MOHs. Take your time, ask lots of questions, you don't have to rush this.

I was really worried when I was first told I had a BCC, but it can be treated, so try not to worry. Six months surgery I have a small scar which is still improving, but I can honestly say no one else seems to notice! 

If you have any questions about biopsies or MOHs please ask, you are most definitely not alone. 

Hello! I know this is a few years old, but I'm wondering how the biopsy went for you? I'm pretty much in the exact same situation - needing a punch biopsy for a small lesion (3mm) on the tip of my nose and I can't decide if I should find a plastic surgeon to do this, or the dermatologist I've seen.  I feel I'm being so ridiculous worrying about what might be a tiny scar, but I also have no idea what to expect from a biopsy scar! I cant really find any pictures of examples.  I'm also aware it might get much worse if it is a BCC (haven't yet got to grips with this possibility yet...!). Any advice you have from your experience would be so helpful. Thank you!

Hi Ashier85,

Sorry to hear that you are facing biopsies and possible surgery for BCC.

I have had lots of biopsies including on my nose and I can honestly say that a few weeks afterwards there is hardly anything to see. It is very important to cover the site with a sun block in the first year and to massage it once it has healed. Even in Winter if you are outside for any length of time use sunblock in the first few weeks.

I would say that dermatologists would have a lot more experience of biopsies and plastic surgeons of surgery.

In my case I had two BBCs on my nose and another at the side and I have a lot of scarring. I wish they had been identified and treated earlier. I needed skin grafts on my nose and a big Y-shaped incision at the side that have all left white marks. You are lucky to have this lesion treated while it is still quite small.

Best of luck with your upcoming appointments

Miranda

Hi and welcome to the online community

I'm sorry to hear that you need a biopsy find out if an area on your nose is a BCC or not and it's natural to worry about the scar you might be left with.

I noticed that you haven't 'joined' the group yet. Don't worry, you haven't done anything wrong but joining means that you could start your own discussion and you can also get email notifications telling you when people have posted.

To join just go to the top of the page and click on 'join this group' and that's it. You might also like to pop something about your journey with skin cancer so far into your profile as it helps others when answering or looking for someone with a similar diagnosis. It also means that you don't have to keep repeating yourself. To do this click on your username and then select 'Edit Profile'. You can amend it at any time and if you're not sure what to write you can take a look at mine by clicking on my username.

x

Hi

I was wondering whether you'd decided on a dermatologist or a plastic surgeon to do your biopsy?

x

Hi Latchbrook, thank you so much for your replies. They were really helpful. I sort of buried my head in the sand a bit tbh... but I think I’m just going to get it done at the dermatologist. The advice I got was that they probably do more punch biopsies than plastic surgeons anyway. I’m thinking about asking him some questions ahead of the appointment to get some more info.

A dermatologist friend (in my home country of Aus) suggested I should try and ask for a shave biopsy, as that should give a result and leave less of a scar. I don’t know, it’s right in the middle of my face but I’m hoping it won’t be much bigger than 3.5mm and I can cover it with make up ...

I’m sorry to hear about your BCCs. I’m sure your scars will fade with time? I can see the scar revision technology these days is amazing.

Hi

That sounds like a good idea to have a chat with the dermatologist to way up your options.

I didn't have a BCC, mine was a melanoma, but the scars have faded and are now barely visible.

Keep in touch

x

Hi I'm in same position as you atm,just wondering how it went?was 3mm biopsy on nose ok?x