Skin cancer

A place for people affected by any type of skin cancer, including basal cell carcinoma and squamous cell carcinoma, to support one another, ask questions, and share their experiences.

Skin graft is slightly raised

Ess
Posted by

I had Mohs on the side of the nose and a skin graft around the size of a 20p piece on Nov 29. The graft seems to be healing reasonably well. I'm doing the massage and using Scaraway silicone pads for around 22 hours per day. 

One thing that concerns me is that the graft is rather 'high - it looks a bit like a large blister, and proud of the surrounding area. I've seen people mention a dipped appearance, but not raised. 

I realise It's early days, but wondered if others had had the same and how it panned out? (I have to wait until mid-Jan for my histology appt to be able to ask the surgeon about this).

Dignity
Posted by

Hi Sue..Ive got a similar.concern..i had.BCC surgery done in early.November but had a skin flap rather.than a graft. Altho it' healing slowly the area of skin over the area is.raised and looks.and feels.like.a blister..I will be going back to Hospital for.a.follow.up consultation so will have a checked.then and hoping it.is a temporary condition..Good luck with your recovery..

Ess
Posted by

Hi Dignity

I wondered whether you've had your consultation and how it went?

I had my histology appt last Wednesday and was hoping the consultant would be able to give me some reassurance. But the clinic was running 45 mins late, and the consultant was abrupt and clearly in a rush to be elsewhere. I mist have sen him for all of 5 minutes. So very little reassurance or information.

Have you fared any better?

Dignity
Posted by

Hi Sue

Glad you got back in touch..sorry to hear you didn't get the proper care from your consultant.. mine was a much better experience!! He took time to explain the results of the surgery and was happy with the healing of the flap. Unfortunately there is a very small percentage of BCC left on the tip of my nose which may have to be removed if it develops further..but the good news is there may be alternative treatment to surgery as it is on the surface of my skin. Have to go back and see him in 3 months time but am feeling a lot more positive as nose is looking a lot better and healing all the time. Hope you can get the answers you're looking for and keep positive..

Andy

Ess
Posted by

I really am going to the wrong hospital! Are you in the UK? Your experience sounds so different to mine. I will ring the consultant's office tomorrow and ask for a copy of the histology report. 

Glad to hear your nose is looking better - maybe mine will turn a corner any day now. It continues to look like I've been stung by an enormous bee. Sorry to hear there is still a little BCC left on the tip of your nose - but it sounds like the treatment options  (if needed) are less radical than the last time around.

Dignity
Posted by

Hi Sue yes I live in the UK. Our NHS service is one of the best in the world for healthcare..unfortunately it's not getting the financial support it needs so there are long waiting lists for ops.  I was feeling the same as you regarding looking swollen around the area..but it does settle down and there are a lot of treatments out there to improve your look.  Sounds as tho you're going to push your hosp for answers so good for you...let me know how it turns out..Always good to share similar experiences with other nationalities...

Andy

Ess
Posted by

What I failed to say in my last response was that, despite it being a histology appt, the consultant told me absolutely nothing about the histology of my BCC. I had 2 ad hoc biopsies taken during the op and he told me they were clear. But as far as the BCC went, he told me nothing - so I have no idea of margins etc. I can only assume they were good, but I don't think that's good enough, on reflection.

Dignity
Posted by

Hi Sue

I would feel let down by the post op care you've been given..id go back and confirm all the BCC has been removed to clear any doubts. It's a worry enough to go thru the operation but then have to chase up for the results is terrible..Hope you get the all clear eventually.. keep me posted ok

Andy

Ess
Posted by

I rang the consultant's secretary and explained that I'd not been given any info 're the histology of the BCC, so know nothing of margins. She said they don't go into this at the histology appt. She read me the letter that's going to my GP over the phone which simply states the BCC has been removed satisfactorily. It seems to me they could save a lot of money by just sending out an email if that's as much info as you're going to get - why bother with the appt?

I wondered whether your consultant had mentioned seroma in relation to your scar? It seems to me that is what's been happening with my graft - there seemed to be fluid sitting under it. One suggested management is to apply gentle heat for 10 mins and then massage. I've done this a few times and the site is definitely deflating and feeling less tender. It's looking more like a skin graft than a blister. I'm hoping things will start to improve now.

suelynne
Posted by

Hi Ess

After my forehead flap my nose healed well ,but I was left with quite a raised area where the the skin had been replaced. If it doesn’t settle and massage doesn’t help you might need a corticosteroid injection. I had to go to my dermatologist who suggested it. It was really successful but it was a private procedure. NHS won’t do it

Hope this might help if it doesn’t improve

Regards suelynne

Ess
Posted by

Hi Suelynne

Thanks for responding, and I'm interested to hear that you had a raised area too. My graft does seem to be 'deflating' a little, but I've made an appointment with a plastic surgeon to have it reviewed just in case. I fully realise that you can't expect miracles after 11 weeks, but I'd just like some reassurance that things are as they should be at this point in time. Sadly, I didn't get that reassurance from my consultant's team.

I have seen mention of steroid injections when casting around on the internet. Did your dermatologist ever suggest why you had a raised area?

suelynne
Posted by

Hi Ess

No reason as to why I ended up with this raised area, consultant at hospital just said keep massaging and it will improve. It didn’t!!

 I think I seemed to have quite a lot of scar tissue around the area. The steroid injection made a great difference really quickly. I had it done a couple of times as they don’t like to put too much in at once. It makes it look worse on day one but soon goes down.

After all one just wants to look normal again

Macmillan-54
Posted by

Hi, Sue, 

I'm curious where your doctor took your skin graft from? Mine was from my forehead (forehead flap nose reconstruction), and it covers the entire tip of my nose - about the size of one's thumb-tip. My last surgery was December 29th. My graft s definitely raised above the normal nose skin. And, it's quite white in comparison.  I am in the US (Austin, Texas), and they have mentioned things like microdemabrasion, or possibly a revision surgery to improve the appearance later after I've healed more. I am really hoping that they don't leave me the way I am. It may sound vain, but I miss my face. I know it could be worse. I'm grateful they got rid of all the Melanoma, but I feel sad when I see the way I look. It takes me about 20 minutes to fix my make up so the "seam" of the graft is a little better camoflauged, but I can't camoflauge the fairly significant height difference on the bridge of the nose. I feel as if everyone is looking at my nose when I'm at the store or doing errands. Oh, well. We will get through this! I do hope that your nose levels out as time goes on. 

Best, ~ CJ

Ess
Posted by

Hi CJ 

Sorry to hear your graft seems to be on the high side. To be honest, I can't figure out whether mine is 'normal' or not, as there's not too much info out there on what to expect. I'm in the UK and my surgery was done on the NHS. I am visiting an independent plastic surgeon on March 2 to have the graft reviewed for my own peace of mind. My last NHS appt was pretty terrible - very little time or info given. I will report back if I get any useful info.


My donor skin was taken from just above my collar bone. I understand that the skin will never look quite the same as the surrounding skin (my BCC was on the side of my nose) and will be a slightly different colour and texture. Will yours always be a different colour? I thought graft skin from the face would provide a better colour match?


I'm not using makeup on it. I've tried in the comfort of my own bathroom but, like you, I find the difference in level hard to disguise. I'm using 3M flesh-coloured tape cut to size and this is a workable solution for me at the moment. 


I know what you mean about the time it takes to get the graft 'day ready'. It's like having a small pet! Takes me about 20 mins to massage the graft/donor site/site of other biopsy, apply silicone gel then do my magic 3M cutting and pasting!


I don't think it's vain to be concerned about your appearance. I look at old photos of myself and marvel at my intact nose. The thing is, we're in the early stages of recovery and it will get better. I sometimes find myself wanting to fast-forward a few months when things will have settled down a bit more. 


Not sure if you've trawled around this site. If not, take a look at user Indie15's blog. She had a skin graft on the bridge of her nose and blogged the first 8 weeks or so. You might find it interesting.


Stay strong!


P.s. I have heard that Austin is really cool! (Are the kids using that word these days?)


Macmillan-54
Posted by

[Hi, Lee. I've put my comments after yours. My replies have 3 asterisks in front. 

Sorry to hear your graft seems to be on the high side. To be honest, I can't figure out whether mine is 'normal' or not, as there's not too much info out there on what to expect. I'm in the UK and my surgery was done on the NHS. I am visiting an independent plastic surgeon on March 2 to have the graft reviewed for my own peace of mind. My last NHS appt was pretty terrible - very little time or info given. I will report back if I get any useful info.

*** I know exactly what you mean. I’ve looked online at quite a few before and after pictures, and usually the after pictures are taken some 6-months to 1-year after the procedure. So, it’s hard to determine if our graft is where it should be at this point in our recovery. My plastic-surgeon scheduled a 2-month follow up, though, so I’ll at least get a chance to ask him. I can tell you at my last appointment, he said it can take a long time before everything settles down.

My donor skin was taken from just above my collar bone. I understand that the skin will never look quite the same as the surrounding skin (my BCC was on the side of my nose) and will be a slightly different colour and texture. Will yours always be a different colour? I thought graft skin from the face would provide a better colour match?

 

***I’m unsure if it will always be a different color, although I’ve also read that skin taken from the forehead is one of the best options for a color-match. However, I read some literature intended for the surgeons which indicated that the graft would have a slightly shinier appearance.

 

I'm not using makeup on it. I've tried in the comfort of my own bathroom but, like you, I find the difference in level hard to disguise. I'm using 3M flesh-coloured tape cut to size and this is a workable solution for me at the moment. 

 

*** I rarely wear makeup. I just don’t go out. Laugh! When, I’ve practiced makeup, I’ve been using a stick-foundation makeup from Anastasia of Beverly Hills which does a GREAT job of evening out the skin tone – so the color is virtually undetectable once I apply it. Then, I take an Anastasia product which is like an eye pencil, but it’s concealer. I go over the seam, and then use a Loreal mineral-powder concealer. You can still see the seam, but it’s far better than without. The bump still shows, though. I was quite attached to my Scar-Away Silicone Sheets, and preferred wearing those out. I would wear two with one covering my long forehead scar (right in the middle) in a vertical fashion, and the lower portion of my nose in a horizontal direction. I’ve only made two trips out without the silicone sheets! I felt naked.  

 

 

I know what you mean about the time it takes to get the graft 'day ready'. It's like having a small pet! Takes me about 20 mins to massage the graft/donor site/site of other biopsy, apply silicone gel then do my magic 3M cutting and pasting!

 

*** Hah! Exactly. Actually, my poor little nose has had such an adventure, we’ve named her Nosita. In the Spanish language, whenever you add “ita” to the end of the word, it connotes little and dear. We called the donor site, Mama forehead, and my pedacle was called Nanny Pedacle.

 

I don't think it's vain to be concerned about your appearance. I look at old photos of myself and marvel at my intact nose. The thing is, we're in the early stages of recovery and it will get better. I sometimes find myself wanting to fast-forward a few months when things will have settled down a bit more. 

*** Thank you for saying so. Yes, I agree, I want to fast-forward. I think you’re right that it will get better. If not, we’ll get stronger, right? I think about people who have had horrific disfigurements their entire lives and still live happily. It’s quite humbling, and puts things into perspective. The other issue is I feel so incredibly fortunate that my Melanoma was found. It was quite miraculous, because it did not look like Melanoma at all. A friend of mine talked about a young man she tried to convince to have a skin growth checked out. The man lacked funds and was reticent to go in. He waited too late. And, now he’s dead. I think to myself, “that could have been me.”

Not sure if you've trawled around this site. If not, take a look at user Indie15's blog. She had a skin graft on the bridge of her nose and blogged the first 8 weeks or so. You might find it interesting.

 

** Thank you for the tip on Indie15’s blog.

 

Stay strong!

 

*** You, too.

P.s. I have heard that Austin is really cool! (Are the kids using that word these days?)

 

*** Ha-ha. I’m too old to know what the kids say. Just kidding. I’m 54, and I know a lot of 20-somethings that say, “cool.”  Austin is a GREAT place to visit, but like all great places it’s really grown, and living here is expensive and the traffic is a nightmare. It is a very fun place to have a nice hotel room downtown and wander. If ever in the States, you must come.