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That's great to hear that your biopsy has shown it's not a BCC Flash0112!
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Thank you latchbrook. I was so shocked as GP, Dermatologist and plastic surgeon all thought it was. Just shows how important a biopsy is.
Hello. I can understand you worrying I myself was terrified. I had a bcc under my nose that went through my lip and needed a full thickness skin graft. I didn't ask any questions at the appointment but just kept thinking I can't do this and be wide awake. I saw a nurse later who explained everything to me including the fact that I could be sedated. I cannot tell you the relief. I spoke to my consultant who confirmed I could have light sedation. My surgery went ahead and I felt nothing and was talking and laughing and thinking why am I laughing when he's cutting through my lip. I had the skin graft done and a that was stitched then the padding was also stitched on top to keep pressure. Being where mine was I couldn't smile or eat very much as every movement of my mouth was agony. Ten days later it was removed and was told that it had taken. It looks pretty raw at first and I used to put a pad and tap over it. Once dried out i started to apply moisturiser. Just over a year now since having the surgery. Yes you can see I've had something done as part of my lip is missing but people hardly notice now. I am more than pleased with the result. I hope this can put your mind at rest.
Hi Sue that’s really good to read that you are feeling good about it a year on. I had a sedative when I arrived at the hospital but went straight in for mohs and it hadn’t kicked in so I found it really distressing. Had the graft done the following day by a plastic surgeon and was happy to be asleep for that. It’s 5 weeks on now and it’s healing well and skin coloured with red around the edge, but able to be covered with make up. However the graft is still lumpy and bumpy, pimples on the edge, and is in the exact same place that you describe. How long did it take to flatten out? Did you do anything to help the scar heal? And how long did it take to not feel tight when you smile, chew etc. (my graft was taken from cheek near my ear.) Many thanks for your information.
I was told when the dressing came off to let it dry out. I did that and ended up with a very large scab right across the middle. When I phoned them about it, I was then told to start putting Vaseline it. It was about 8 weeks when I could smile properly and about 4 to 5 months that most of the bumps went. I can still feel a couple, one on my lip and one just above but if I look in a mirror I can't see them. I now just use my normal moisturiser. I don't use anything to cover it as to be honest it really isn't that noticeable, just a bit of an uneven lip. Obviously i use high factor sun cream. My graft was taken from my collar bone.
I'm sorry your sedative hadn't kicked in and don't know how you coped with that, I know I couldn't have. I loved the sedative, even though i was awake, it felt like I was in there for just a minute.
I hope this helps and feel free to ask anymore questions.
Thanks so much for the reassurance Sue. I have faith it’ll be fine in a year and hopefully starting to be less confronting in a few months. It’s one thing to hear from a doctor but much better to hear it from someone who has gone through it themselves.
I was told not to let it dry out as scabbing causes scarring but to lather it with Vaseline 4 x daily. Now that the rawness has healed, I’m trying silicone patches at night. I’m kind of getting used to it now, even though I feel like I have a sticky lump on my face. I look forward to the day I can go make up free again and not feel self conscious. As I’m 51, I have a lot of wrinkles above my lip, but the graft is smooth and shiny, slightly grey ish. The surgeon said laser might be worthwhile in the future to smooth out the whole areas above my top lip. It’s amazing that you haven’t needed any follow up treatment.
Really appreciate you sharing your story.
I was wondering if you'd come to a decision on how you wanted to proceed with having your BCC removed? Did you manage to speak to your consultant to discuss the alternatives?
As a bit of an update...
I have gone from not really worrying too much to feeling quite anxious and back over this several times. And having talked about it with close friends and family I've had several offers of loans to cover the cost of going private - this prompted me to go back and see my GP (or rather, whichever of their doctors could see me first), voice some concerns and demand a referral elsewhere. I had noted that Nottingham have a number of MOHS specialists based at the (private) Circle clinic, who undertake NHS work.
I've since had a teledermatology appointment in Nottingham, which came around quite quickly and was undertaken by a very friendly and professional male nurse (?), who told me the digital images would be sent straight to the consultant for review.
Having come back off holiday yesterday I found a letter (finally!) from the plastic surgeon in Leicester (Rajshree Jayaraja) offering me an appointment next week. So I chased up Nottingham this morning; supposedly I should've already heard from them but as Circle is handing back the facility to the NHS things are getting delayed. Anyway, they read the consultant's response which was basically that he needed to see me to take a look as the images were inconclusive ... first available appointment 4 September :-(
So I have a choice to make quickly as to whether to just go and have the excision and hope for the best, or wait yet another 6 weeks to see someone with no idea what he's going to say.
Hi cuckoo22 and thanks for the update
I'm sorry to hear though that you still have a difficult decision to make.
If I understand correctly, your choice is either to have surgery with the NHS at Leicester next week or to wait another 6 weeks for an appointment with a private dermatologist in Nottingham to see if your BCC is suitable for Mohs surgery. I wasn't sure from what you've put whether you're paying for the consultations and subsequent surgery at Nottingham or whether this is NHS as well.
Looking back at your original post I think that one of your concerns was that you might need a skin graft if the BCC is excised and that was why you were keen to have Mohs. However, if you look at this information about Mohs surgery and scroll down to the heading 'What happens when the entire tumour is removed" you'll see that option two and three both mention that a skin graft may be needed, so having Mohs doesn't mean you definitely won't have a skin graft.
Hi latchbrook, and thanks for your message x
Actually both choices are based on the NHS. My original concern was that - having read up on BCCs from a number of sources online, it seemed that the recommendation for the best cosmetic outcome was Mohs - and this is particularly recommended for areas like the nose. Mine is just to one side above the tip of my nose - and although only about 6mm, very visible! And when you add a 5mm margin ... if it were anywhere else I'd probably be less concerned.
Now, when I went back to the GP, and asked whether a biopsy was recommended, he reckoned they may as well just remove it given the size. I asked to be referred to Nottingham as - rather than 1 Mohs specialist (as I understand they have in Leicester) - they have several. I didn't expect the Leicester appointment to still come through.
I've re-read various articles this morning and there does appear to be a significant difference in re-occurrence rates between excision and Mohs (it says as much in your link), as well as better cosmetic outcomes regardless of the need for a skin graft (which I realise is likely)
There's also the fact that this guy couldn't draw any conclusions from the "teledermatology" images he received. Someone on here mentioned the possibility of a false positive, and I'm thinking that maybe another 6 weeks to get another (expert?) opinion may be worthwhile. For all I know it might be something else (which is what I was told in the first place!).
I'm glad the link I provided has proved useful. Let us know what you decide to do.
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