Punch biopsy on nose

Hi, SisterM,  Had my Mohs last Thursday - wasn't as bad as I thought, the surgeon was really nice with a great sense of humour which helped. I had to have 3 rounds of Mohs which took just under 6 hours and he closed up the gap with a skin flap from my nose next to the hole so that the skin colour will match. While I was in the waiting room a fellow patient showed me his nose that the same surgeon had done a skin flap right down the centre of his nose and you couldn't see anything so I am quite hopeful although it looks a mess at the moment. Stitches out tomorrow. Thanks for all the support  it's made a big difference knowing someone else has been there and understands the daft things you worry about.

Hope you and your nose are well make sure you let me know how you get on in March. Lee.

Hi David, I was wondering what happened to your scar (indentation)? I had a punch biopsy on the side of my nose, where my reading glasses sit, just last week. I can't tell how it will look yet but the doctor said I'd be left with a scar. I guess that doesn't matter if it turns out to be bcc!

David123 said:

Hello all

i have a BCC on my nose, tried a six week course of cream which has no effect now dermatologist wants to do a punch biopsy.

i know I'm being superficial but how bad will it look after?  He says it will be two stitches and leave a scar, will this scar be really bad?  Anyone had a punch biopsy and can advise?  I don't really know what to do, I wouldn't stress but the nose is such an obvious place to have a scar.  Is leaving a BCC alone an option? 

Manda59 said:

David123

Hello all

i have a BCC on my nose, tried a six week course of cream which has no effect now dermatologist wants to do a punch biopsy.

i know I'm being superficial but how bad will it look after?  He says it will be two stitches and leave a scar, will this scar be really bad?  Anyone had a punch biopsy and can advise?  I don't really know what to do, I wouldn't stress but the nose is such an obvious place to have a scar.  Is leaving a BCC alone an option? 

had bcc removed from side nose 23rd may skin graft  needed from shoulder injections were hell to numb nose didnt get it all so 23rd aug another op to remove it again something to do with a margin second skingraft was put to sleep this time also had biopsy end of the nose left doesnt look the same as it was before went back to hosp told me they had got it all from sidenose after to attempts but now the biopsyshows bcc cried 

Just to join in with my total empathy for everyone.  I'm currently approaching treatment for my third facial BCC.  The first was on the bridge of my nose, and the plastic surgeon went straight in and removed it, and did a skin flap to cover the excision.  I felt a bit stupid, because it started with a tiny white nodule like a whitehead, but wouldn't go away and literally about 4 years later started bleeding, which I knew was bad news.  The biopsy was done afterwards, and confirmed it was all out but 0.9mm margin instead of 1mm - tiny difference, but margin is important to minimise chance of recurrence.  The skin flap is a great success because otherwise I'd have those deep lines between my eyebrows - as good as a facelift!

The second one was on my nostril - aaarrrgh!  It started as the tiniest pinprick - I thought I'd pricked my nose when pruning a rose - but it didn't heal.  GP said go off on holiday (imminent), nothing's gong to happen ... but it did!  Within a week it had developed into a nasty little abcess.  Spanish Dr diagnosed impetigo: I don't think so!  On return, no dermatologist was available (one had died!) even to do a biopsy, so I went back privately to the plastic surgeon who'd done the first one.  Despite his assurances there would just be a slightly deeper indentation behind the rim of the nostril (in hindsight, this would probably have been a punch biopsy) he went and did a 5mm x 7mm x 3mm excision biopsy, and for good measure took a segment out of my nostril.  This I didn't realise until after Mohs surgery - which I had on the NHS and was absolutely brilliant as a procedure.  I did get my GP to prescribe Valium to calm me down, and also EMLA anaesthetic cream which is absolutely fantastic before the local anaesthetic injection - it has to be applied about 40mins in advance.

This was followed by a tiny skin graft (from behind my ear, so no problem) but it didn't take so I'm left with a small scar and a slightly collapsed nostril.  I used Biooil to begin with, but currently I'm trying hyaluronic acid cream that a chemist in Austria gave meto heal another (self-inflicted) wound on my face, called Bionect, and I think that's helping - HA plumps up the skin.

My third is right on the 'cupid's bow' of my upper lip.  Again, a tiny white nodule, but I'm taking no risks.  I'm threatened with a 3mm punch biopsy which, as it goes down to sub-cutaneous fat layer, I'm a tad sceptical as to a Dematologist's assurance that 'it will leave very little in the form of a scar ... usually fades to  being hardly visible at all'  especially as Wikipaedia says it's 'cone' shaped.

Partly of course the terminology they use - a punch on my upper lip doesn't sound much fun.

But like others of you, there's no way I'm not going ahead with this asap, to pre-empt anything like the escalation of my previous experience.

My friends and family are really great, so supportive, and a cousin is having an infinitely worse time with a lentigo maligna, so I'm grateful for the mercy I've been shown so far, and for this conversation.

Hi,

I have recently had a punch biopsy on my lower lip and had two dissolving sutures. It has come back a BBC and I am having it removed on 5th December. It will not really show on your nose afterwards. My husband had a biopsy from his nose and you cannot tell.

Unknown said:

Hi,

I have recently had a punch biopsy on my lower lip and had two dissolving sutures. It has come back a BBC and I am having it removed on 5th December. It will not really show on your nose afterwards. My husband had a biopsy from his nose and you cannot tell.

I only had a nasal bridge  punch biopsy done 9 days ago and after having the stitches removed this week am left with a deep indentation which is very visibly noticeable   I have requested to see my Consultant Dermatologist as I was only told that I would have a scar not a great chunk out of the middle of my nose.  Very worried and upset   Don't feel that pre procedure information was full and comprehensive. 

I had a 3mm punch biopsy done on the tip of my nose with 2 stiches, 3 weeks ago. The dermatologist said it would leave a scar and I thought it would be small. My nose reacted to the stiches and the whole area scabbed over with a 15m wide scab forming over the area. I went back 7 days later and they removed the stiches (and the scab) and gave me a silicon resin gel for the first 2 days to fill the gap and then a silicone gel to put on the scar once the area had scabbed over again. It looked atrocious when I walked out of their offices. 3 weeks in and the area has settled down and the redness is slowly decreasing. Turns out it wasn't a BBC and was just a sun spot. I'm 36 and I had a melanoma removed from my back when I was 18 so my dermatologist will always err on the side of caution. I’ve had 7 other moles removed and a BCC removed from my hairline on my face. I can handle scars on all the other parts of my body but scars on the face are pretty tough. I find I’m pretty self-conscious in the first month and then gradually get used to it. Doesn’t stop me doing what I love, playing with my kids, hanging out with mates. Good to hear everyone’s stories, at least I know I’m not alone.

I have had s punch biopsy for bcc that has infiltrated so am having mohs in s  couple of months on my nose 

Im told a skin graft is not as good as a forehead flap has any one had this done I don't want to look disfigured