Nose BCC

Hey Hazel

Glad you have your surgery date. My BCC was diagnosed in December 2020 and I had MOHS surgery in March 2022 so my wait was pretty much the same as yours.

You're right in what you said in that the answer to your questions is mostly it depends, but here's what happened in my case.

My 0.9cm BCC was nestled in right next to my right nostril, sort of between my nose, cheek and upper lip. Very awkward position. It was excised with an initial margin of 2mm, in which some cancer still remained when checked under the microscope, so a second round was taken, which cleared it. It was then repaired with a V-Y advancement flap and the whole process from arriving at the hospital to being told I could leave took 7 hours.

I had the dressing on for 48 hours and the stitches, of which I had 20, were removed after a week. I didn't have any bruising but did have some swelling, which got worse one morning when I woke up and was actually laying on my face (try not to do this!) but this went down quite quickly. I was amazed when I saw the finished result as you could barely even tell anything had happened. Nearly 4 years on and I can feel the area all the time (kind of like I have a sticker stuck to my face!) but this doesn't bother me, and the scar isn't noticeable to others.

It's definitely understandable to be nervous. I was a ball of anxiety between the rounds, but felt surprisingly ok whilst the surgery was happening. In fact, I almost nodded off at one point!

I hope this helps somewhat and I wish you all the best for a great outcome x

Thank you so much for this.  It sounds as though my BCC is in a similar position to yours.  I am so pleased to hear that all went well for you and that 4 years on the scar is hardly noticeable.  I have previously had knee, back and shoulder surgery, so as you can imagine I do have scars, which do not bother me at all, it is just with this one being on my face!!  Thanks again for your very reassuring response.

Best wishes. 

Hi Hazel S ,

I had surgery for a SCC that grew quite large on my nose and had a skin graft from below my ear in September last year. I also had a biopsy towards the top of my nose at the same time. Unfortunately this turned out to be a BCC and I had further surgery in Dec plus another biopsy which I am still waiting for the results for. The swelling and bruising disappeared pretty quickly and smoothed out very well, I started massage with moisturiser shortly after I had my stitches out and the scabs had fell off.I was advised not to play netball as you just don't know if you're going to get a ball in your face as accidents do happen don't they.

 I used dry shampoo until I had my stitches out but I did manage to wash it over the kitchen sink wearing a face mask to protect the pressure dressing / steri strips the second time. I also went to the hairdresser's which is a lovely treat.

I would advise just take a list of questions when you go to the hospital. But they do usually give you an info sheet after your surgery /stitches are removed.After my surgeries I did go out, but I was pretty self conscious , I think this was the only negative thing for me and waiting for the results. 

Wishing you all the best for your surgery. 

Thank you so much for your positive response, this is very reassuring.  You have certainly been through the mill!  It took 8 weeks to get my biopsy result!  I hope you do not have to go through this again, fingers crossed.  As you say, I will go with a list of questions.  I have purchased my dry shampoo and moisturiser and like you say will enjoy a trip to the hairdressers after stitches out!  The sooner I get this over with the better, only 4 weeks to wait now!  Thank you so much and wishing you all the best. 

Thank you Hazel S Keep in touch x️

Good luck Hazel and so glad you’ve got a date.  I’ve got MOHs tomorrow.  Have been feeling quite anxious- it’s about, like you the waiting and the inconvenience and having to pause the active things I love for a few weeks.   I’ve decided to have  a few counselling sessions (by zoom) to spare my loved ones - they don’t need a blow by blow account of my fears and anxiety since they’ll be doing quite a lot of household stuff that I usually do!! x

Wishing you all the best Ruth.  Let us know how it goes.  My MOHS is in the 24th!  Take care.

Hi Hazel thank you.  Well here I am post MOHS!  I was a bit shell shocked after the surgery and then the stitching but it was all done with local anaesthetic.  The surgeon prescribed antibiotics to prevent infection and some lovely codeine and my partner popped down and got it from the pharmacy.  I sort of knew that I’d need to eat soft food until the stitches come out (next week) so we’d made soup etc.  I was at the clinic for 4 hours altogether and although I had my kindle etc after the first layer was removed I just sat.  I also had a biopsy for another patch which I found out when we chatted during the stitching that the surgeon thought might be sun damage and not a BCC as I’d thought (but admittedly I’m not qualified!). That apparently can be treated with cream but we’ll see when the results are back.  

One of the things the surgeon warned me about was a little blood seepage- happens when the anaesthetic wears off but nothing to worry about.   He kindly phoned me today to check in which was reassuring.  So a quiet and gentle few days ahead but frankly that’s most welcome as it was a tiring day.    Have to sleep on my back with extra pillows and not do any bending for a while.  and can’t get the dressing wet.  Although I’d love to go to the hairdresser to have my hair washed without getting the dressing wet as I can’t guarantee to myself that I won’t have a mishap am going to leave it until after my stitches are removed.  

And of course the best thing is that the BCC is all gone!

let us know how you get on Hazel and all good wishes for your treatment 

Ahh thanks so much for getting in touch Ruth, I have been thinking about you.  I am so pleased you have it over with, such a relief.  I hadn’t really thought about soft food afterwards, but that makes sense.  I have been advised to take a book but like you, I don’t think I will be able to concentrate.  I will miss washing my hair but have bought some dry shampoo.  However my hairdresser has said I can give her a call and she will fit me in for a shampoo, if I feel up to it  I would still be afraid of getting it wet though. How many times did you go back to theatre and how many stitches do you have?  Do these come out after 2weeks?  I was aware that you have to sleep propped up for a few days.  Have you had any swelling or bruising?  So sorry for all the questions??  I hope the second patch they took a biopsy from isn’t a BCC and can just be treated with cream.  You can now sit back and relax, enjoy being waited on for a few days and let the healing process begin.  Thank you so much for coming back to me Ruth, you have really helped me.  Take care.  Hazel

Hi Hazel so I had three layers taken (he said the average is 2 or 3) and a little flap. They gave me a cotton gown to put over my top half and I kept my jeans on.  

So the actual removal of each layer takes just a few mins and then you wait - I chose to wait in the waiting room but I was offered a side cubicle.  meanwhile they  look under the microscope nearby.  They put on a temporary dressing while you wait around 30 to 60 mins.   Then if it’s not clear it’s back in for another layer and so on until it’s clear.     

The final stage once it’s clear is the stitching that  takes about 40 mins as it’s then that he also did the flap   I think that I had 3 stitches on the actual site of the MOHs and about 7 to stitch over the whole lot including the flap   The stitches are all coming out on Wednesday  (6 days after surgery). I’ve got no swelling or bruising yet   

He drew it for me afterwards but quite honestly I was exhausted and didn’t really take it in.  Rightly or wrongly I don’t mind so much about having a scar - for me it’s more about getting back as soon as possible (without damaging the healing of course) to lots of exercise etc.  I do totally get though that for a lot of people scarring is a big issue but everything I’ve heard suggests that the scars fade over time.  He said 2 weeks until I can exercise and ring light church bells but I’ll see how it goes.  

One more tip if I may.  The internet is full of dos and don’ts in terms of foods to eat/foods to avoid which can be misleading. Eg it says avoid ginger.  The surgeon said a person would have to be eating huge amounts of ginger to make a difference to the outcome of MOHS.  The surgeon said no alcohol a few days before and then two weeks post surgery which makes sense as it increases blood pressure.  I decided as a light weight drinker to do Dry January and February which is interesting in itself (in terms of how I feel physically- better) aside from having the MOHs.  

I’m not sure whether everyone gets prescribed antibiotics and codeine but as soon as the surgeon mentioned it I jumped on the idea, trying not to sound too eager!!  The course of antibiotics completes when I have the stitches out on Wednesday and in fact I’ve only needed to take 3 codeine tablets   

And of course the best thing for me is that the anxiety has gone. 
I will be thinking of you Hazel on 24 th x