Saturday, October 25, 2014
Wednesday, December 10, 2008 anonoymous, Community Member, asks

Q: what can i expect after mohs surgery on my nose ?

how painful is it?

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Answers (20)
Cardinal, Community Member
3/21/10 4:50pm

http://www.topicalinfo.org/forum/topic.asp?TOPIC_ID=563

 

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shelly brennan, Community Member
7/22/12 7:14pm

Im due for my second mohs surgery tomorrow so ill write tomorrow but i know it was ok enuff and im not prtrified to have it done again im just so tireddd of these darn sureries i had like 14 now 3 tumers melenomas on breasts hip, buttock,belly, back 3 or 4 on  fac a melanoma on nose and a basal skin and this tommorrow quarmis cell which thye have anesthesiolalaist all on standby for noon as Iv been overhearingthing Idnth think they want me to knowand that is that they may be rebuilding the nose? wt? all i know it iss 7 m and im going to sleep soon and and wil wake felling like crap..as i just cant go through this any loner but what r my choices? a horrible death of skin cancer or 22 surgeries..send me out a prayer im a 52 yr old attractve stil, lol, female, but wont be much longer..hha shellycemt

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Karen R, Community Member
12/10/08 11:17pm

The pain is not anything a few over the counter pain killers can't treat.  I had mohs surgery on my nose 5 months ago.  Just be sure to insist on getting a Rx to prevent staff (sp?) infections when you leave.  I was not given one, and have had 3 staff infections ever since. 

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San, Community Member
1/ 5/09 8:57pm

Tongue out

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Sadie, Community Member
8/17/09 10:30am

I had Mohs Surgery on my nose a few months ago; what an unexpected and painfully awful process.  The healing time was much longer than anticipated (based on what I was told by the dermatologist) and the scarring much more severe as well.  The wound takes several weeks to heal to the point of not feeling self-conscious when you go out in public and the scarring requires dermabrasion, which as I understand will take another two to three weeks to heal.  I would investigate another procedure if at all possible.  A close friend of mine was recently diagonsed with Basil cell and underwent the PDT procedure - she seemed much happier with her outcome than did I.

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Forest Hills, Community Member
9/24/09 6:36pm

I had Mohs on the rim of my nose at the end of July/09.... it is end Sept. now...... I basically went ahead with it because, compared to the other option, it was a surer cure, even if it was more disfiguring.  I had plastic surgery the following evening.... am still healing from that.... they took cartillage from just inside the ear, and stuffed it into the hole from the Mohs.... but i think that they may have to adjust the cartillage, and remove some of it... because it is "mounded" a bit.  I am scheduled for dermabrasion in early October, to sand down the scar lines.... but was told that if the cartillage needs "tweaking", they will reschedule to do that, instead.

I must say that i had minimal discomfort from all of this.... it's just been pretty unsightly at the beginning.... just now i've begun to go out without bandage.  If I wear makeup, it still looks funny.  My 21 year old son has teased me!  (Nice guy!).  Good luck with your process... have patience.... you did what was really necessary!

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Doug, Community Member
6/16/12 7:53pm

I had basal cell Moh's surgery on my nose 2 1/2 weeks ago at which time I had skin taken from the top of my forehead and place on my nose. I look terrible and will have my 2nd surgery by my plastic surgeon in a few days. This has been very unpleasant and hope things turn out good. Anybody have any experience to what I am going to have done? I'm kind of scared and not sure what to expect?

 

I look like crap but I know it had to be done.

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Deborah, Community Member
9/28/09 3:32pm

what is PDT

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Deborah, Community Member
9/28/09 3:41pm

What is PDT

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Amylia2371@aol.com, Community Member
9/17/09 2:29am

after no pain after stiches where removed  no pain just odd numbness

 

 

 

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Amylia2371@aol.com, Community Member
9/17/09 2:43am

they give you novecain(sp) that hurts then it is like you are numb but not 

 

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JoeF4, Community Member
12/14/09 5:10pm

I just had Mohs surgery today on the rim of my nose.  While I can't answer any questions on scarring, healing, etc., I can certainly comment on the pain side.   For me, the only pain involved during the surgery was from the initial numbing.   It stung a bit and that was actually worse when numbing for closure.   I'm guessing that it's already tender from the initial surgery.  

 

It's now about 10 hours later and while I had some discomfort about 2-3 hours after the surgery (aches and the such), I took a couple Tylenol and I'm fine now ..... 90% of the discomfort is from some slight swelling that makes me feel like I have a cold (nostril is somewhat blocked from the bandage).

 

I'll be going back in a week to have the stitches removed.

 

The surgery itself was effectively painless.

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RG, Community Member
1/24/11 7:19pm

I had it on the bridge of my nose last week.  The day of the surgery there was some pain, however the Dr had me get some pain pills and after taking a couple of them I am fine.  I can still feel the pulling of the stiches, but not where it is really painful.  I am to have my stiches removed on Wednesday and from the looks of things I am going to want to keep my nose covered for a few weeks while it continues to heal.  I did not have graft since they were able to pull skin something like a facelift job.  I felt my surgeon was very thorough and explained the entire process prior to doing the surgery.  I went for the Moes since it was Melanoma and I wanted it all removed.

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Jeff, Community Member
1/26/12 10:57am
I had MOHs for basil cell small on right nostril towards center. I was very anxious for 2 weeks before. Needed Xanax & Valium that morning. That said the Numbing was not a big deal and even ending up with THREE layer removed was minor. Each time took less than 10 minutes,and pathology was very fast, I between taking about 25 minutes, we had been advised typically it can be 45-90 minutes wait in between for results. Then the repair...idid not look at would, I had been advised not agood idea. Doctor offered skin graft patch quick option, but recommended v-shaped incision on nose, using nose's own skin for any graft, maybe down to in between tip, only if needed. The numbing for this was a good 15 minutes, I was poked about 30 times for this and about 60 altogether that day! I can't explain why, but I was OK with that. Then I has to wait in chair for about 25 minutes nurse said for Epiniphrin(sp?) to work, apparently this reduces bleeding. I was fully awake talking to them for the next...60-80 minutes, with a LOT going on (my eyes were covered at all times). Poor wife in waiting room now 3 hours, said this was another 2hours beginning to end. I did not feel any pain except a few times, doc shot me up again when I said anything. A few of the MANY elecocuterizations I felt a little,,lots of pulling and fingers and the weird sound of the suture device and interesting cutting sounds. In the end I asked to see. At this point I was a bit SHOCKED, incision center of nose from just below eyes to under the tip in between nostrils! Maybe 20+ sutures. Not so red at that time. Looked very bad! I had HUGE. 6 layer pressure bandage on, almost comical. I took Vicodin for THREE days, did not go to bathroom for 4 days(which resulted in another issue when I finally went that I will not go into), I was also taking stool softeners, should have taken much more! Bandage off after 2 days. Looked like horror movie, had to take Xanax to remain calm, felt regret, ,anger. Pain. 8 500mg Tylenol for the next 4 days, still 3 as of days 10. Stitches out day 8. You have to self care day 2-8, nasty. Nurse cleaned lots of stuff off and 2 scabs to get to stitches. Upper portion incision looked 50% better, but towards tip, nurse said "wound not closed there"' put 2 seri-strips and glue on upper portion, script for stronger antibiotic ointment to use, no bandage? Gross. Very red along entire incision and tip is almost to tender/sore to touch. Nurse advised all is A-OK. Some patients are more red than others. They were surprised I did not have raccoon eyes or very much swelling? Only the slightest improvement days 8-11 now. Soreness at tip worries me a lot! Every day it is the slightest biti less, which is good. sadly I joined the unemployed a few months ago after 22 years at same job, if I was working, l would NOT have been able to go to work week #1, and it would be hard to due my job week #2, for me. Looking at wound every day in center of face is traumatic to me. It is about 70% better than a week ago, but still very red, tip still sore. sleeping without strong meds is a miracle. 4 hours sleep per night the past 10 days has not helped. I wanted to get rid of the cancer 99.9% and I did. In hindsight , at this time, 11 days post surgery, I am not sure I made the best choices for my overall physical & mental health. I should have just done scrape & burn, or chrmo cream. At this point the "repair" was 20X worse than the Mohs itself. I do not doubt my very skilled and eccellent bedside manner doctor did what he felt bestd. I was just mot preparred for the recovery trauma. I leave it open that I might reconsider in just a few more weeks. The not closed wound on tip has mostly sealed in just a few days, they advised 1-2 weeks possible. I am still using antibiotic oniony,ent, I also used Betadine first few days and tried Silvadine last night, which seemed to work well. ointment burns a bit, seems to trigger pain to itch? Nurse was not impressed with the original CVS triple antibiotic cream I was using. As a worrier, I can't help but think there is an infection in tip, or...I am going to need add'l surgery or lose tip, or worse. (like isaid, worrier) My wife wants me to post everyday sequence so those going into this have wide open eyes. So that you can see, without my interpretation, how actually amazing the healing has been in a relatively short time, considering how bad it looked. If the tip was not so sore and the redness not so red, I might feel better. But it is not. Looking and worse feeling disfigured to do the right thing is very hard. I know many seem to cope better, I am only speaking for myself. Thank Yoou to those others who posted comments about their own experience and feelings. Reply
Jeff, Community Member
1/30/12 11:50am

Day #15 now, I have to admit that the healing is beyond amazing.  I am on my seconds fresh pineapple (maybe does some good?).  The redness is still present along the long incision and at the tip, though...each day it dminishes slightly.  I have also had mixed days with some yellow, purple, and redder too.  I tried to stay calm during these, as they only lasted 12-24 hours, so I only thought the bruise is changing.  MY right nostril is tigher (cancer removal wound was on right).  I can breath, but right is "narrower, tighter.  Maybe its still swelling?  I can't help think that the TENDERNESS of the tip is something wrong, though they keep reassuring me that "that is normal".  Each day it seems, though minimal, that the tender area shrinks a tiny bit towards the center.  After day #12, the incision line that was not so tender, now is, and I feel much more "pulling" than previously.  I assume both are related to nerve healing and feeling returning. 

 

There is no question that it appears Standard Operating Procedure is to send the patient home with a post op sheet (generally basic vague instructions), call if there is a concern.  This is only my 2nd major surgery in 50 years and I was not prepared to be my own would care specialist.  Maybe I need more medical directions and reassuring than most?  Based on the MULTIPLE unusual sights and sensations I have experience in just 14 days, I think that it would take 5 pages to just summarize post op care.  I am sure each patient is different, but that is no excuse for what seems to be "you are mostly on your own".  This is likely a common complaint for most surgical patients.

 

Thank heaven that the ITCHING has subsided 75% (still comes and goes).  On day #14, in the tip area, I had 4 short bursts of intense pain during the day (took 1000mg tylenol).  Again, I attribute this to healing, though during the pain I had other thoughts.  The scabbing is from just above the tip to the tip, it is minimal, but visually annoying.  I got mixed messages from post op care, one saying "let it dry out" the other two saying "keep it moist".  I have opted for the MOIST choice most the time, alternating from putting the antibiotic ointment on 2X/day to cleaning it with Qtip, or pad with 50% peroxide/water and letting it air out a few hours.  I have also used Betadine/Providone (OTC fro CVS) 3X the past 2 weeks, and some Silvadine cream I have 2X. (I mentioned both to doctor who seems unconcerned.  I also had to take OTC decongestants 3X/day the past 2 weeks and my BP shot up to 148 (not a shock).  I still use my nose spray sparingly.

 

The nostrils do not seem perfectly even, maybe this will equal out. (or maybe its not a valid expectation).  The incision between the nostrils (gross) has also healed to almost not visable.  I get scared any time I touch any part of the nose, adding to my medical insanity.  I have also sneezed about 8 times the past 2 weeks, without incident, never holding it in.  I also lost 8 pounds during the 2 weeks, though 3 came back the past 2 days.  My energy is bordering on cronic fatigue (now I know what others mean about this).  My sleep pattern is very disturbed and I continue to use the Ambien or OTC PM before bed to help (and it does!).  The only down side, is that while the actual Mohs 3 layers was easy, nothing to fret about, the repair and recovery has me now in a mindset, NEVER to do this again (wife says never is a long time).  Meaning when another skin cancer is found, its scrape & burn, freeze, or chemo cream for weeks or months.  I suppose it's fair to say the location of the skin cancer would effect my next decision (I.E. not on the face).

 

PS, my digestive system is still out of wack too.  The anxiety and Vacdin for a week cause constipation.  This has continued in week#2, still using PTC stool softenres 2-3X/day.  MY backside is still recovering from the extreme episode on Day #4. 

 

Another huge issue for those of you in Winter in cold weather...if possible this is NOT an optimum time for sugery.  Even short exposure to the cold on my nose, causes discomfort and concern, and warming up that area (or my damaged nerves) seems to take HOURS after just a few minutes cold exposure.  I now can cover my nose with a scarf (though still hurts when ANY pressure is applied, though I could not do this until about 2 days ago.  Maybe I should have waited for Spring? 

 

The entire recovery trauma has also set my general anxiety issues back about 5 years.  this is not good, not the surgeons fault, though many peers think that I was not prepared for the post procedure issues.  Without question I would have been out of work for 2 weeks, and still very fatigued and mentally not all there for week 3.  I do not know if it is a vanity, medical phobia or reasonable concerns looking in the mirror.  I see the surgeon in another week, though as I understand normally, you are just DONE until 6M dermatological check up.  I still leave it open to change my positions down the road. 

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nn1, Community Member
7/14/12 4:30pm

Please update us on how it looks, feels now & whether you would do this if you'd known the course of recovery.  I have an anxiety order also, and though I've had surgery before, my vanity is showing up because I don't want to look like a freak.

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Jeff, Community Member
6/18/13 7:09pm

See my 18 month post surgery post.

Would I do it again?  Sadly, I would say yes, though, I might choose the skin graft VS the reconstruction.   As far as the MOHS and the needles, I assure you that was really very minor, maybe it was the valium, or the overall fear numbing my mind.  I only felt a very minor pain the first 2 pokes, and then 1/2 way through when I requested more numbing.  I assure you to be awake, mostly alert and talking to the doctor during the 90 minute reconstruction amazes any I tell and me too.  I did look like a freak after, and for about 2-3 weeks, but....I assure you I went to work on the 3rd day and no one said anything (good co-workers I guess).  Anyone who knows you had cancer surgery, face or anywhere takes pity on you (ha, that it is not them).  I did FREAK OUT after, and for about 10 days.  I went back to the doctors 2X and called 2X, they were understanding and courtious, never made me feel funny.  I also took xanax and that helped.  Looking back, though I hope you can avoid it, I am much stronger for the experiece and what I now know that I can endure now to survive.

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victoria, Community Member
8/ 7/12 11:01am

Hey Jeff:

 

I have to have Moh's Surgery on August 27th on the right side of my nose for Sequamus skin cancer.  The dermo did a bioopsy and nothing has returned.  She just wants to be certain that all is gone.  I'm a nervous wreck, as I'm a whimp when it comes to needles but can be made to be brave when need be.  I've been doing a lot of reading on it and no one can tell me how long I'll need to be out of work...I don't have that much sick leave and really don't want to delve into my vacation time...

 

 

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Jeff, Community Member
6/18/13 7:21pm

See my new 18 month post surgery post.  I am sure you heard the one "90% are negative".  I laughed after I had heard that 3X, and fell in the 10% group each time.  the needles (I am needle phobic) were almost less trauma than a immunization or blood draw, maybe the Valium?   The MOHS was also a breeze.   Just read the info and be knowledgable about the post MOHS choices you could be presented with. (hopefully you did not have any surgery).  I was at work the 3rd day and you could be to, if needed.  Pain meds were only needed a few days.  I purposely had the procedure on a Friday AM (lasted till 3pm), so I could recover at home on the weekend.  I was at work Monday and was easily able to due my job, in fact the distraction was good medicine.  To this day my wife can't beleive that I was awake during the 90 minutes post MOHS reconstruction.  I did have them cover my eyes and I also (on a trusted recommendation) choose NOT TO SEE THE MOHS WOUND when the doctor offerred.  That was one of my good decisions.  Each case is so different it's hard to generalize.  My surgeon was a MOHS and Plastic combined.  Some have to have the 1st step, then go home, then to another doctor for step 2.  That would have been hard for me.  In closing, the would looked as bad as I could imagine, at times I thought that I had ruined my face, but...the body is amazing and except for the business about them rubbing OFF the scabs intentionally (I had to admit it looked 3Z better after they did) I would have never thought that I would look normal again, yet...I have even had 2 other surgeons in my face and not notice, amazing, really.  If any of us are alive to share these experiences, we are the lucky ones.  This did teach me that my vanity was much bigger than I thought.   It also taught me that I can do  so much more than I ever thought too.

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Alexandra, Community Member
1/28/12 8:10pm

I had Mohs surgery 13 days ago and the part that is not healing properly is closer to the tip of my nose. I keep an  ice pack in the freezer and have continued to apply it ever since I came home.  I had 3 internal stitches and 8 external stitches, which were removed after a week.  I was told by my Dr. that the skin on the tip of the nose is thicker and heals differently than the skin higher up, between the eyes on the septum.  I also was not prepared for the swelling and thick appearance of the area around the incision.  I have a follow up appt. in 5 weeks.  My Dr. mentioned something about steriods in case the swelling is not going down. I have also read info on dermabrasion to take down the thickness of the scar.  I asked

 my Dr. if I could massage the area and I was told NO. Not until 6 weeks post op. Same for topical ointments like Mederma and such. 

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Jeff, Community Member
7/16/12 12:44pm

IT's been 6 months now post surgery.  The recovery was tramatic for me.  I was NOT prepared for how bad it looked at all.  Everyone says, it looks amazing, whihc is true considering how bad it looked for 2 months.  I still see the entire vertical scar, though others do not.  I had numbness at the tip and nostrils until almost the 6th month, very maddening.  Now the numbness comes and goes, codl sensitivity, dryness, and the small red spider like veins are only now about 80% gone.  My nose does NOT feel the same, though breathing and air flow have returned to normal on both sides.  In hindsight, I would have chosen the "SKIN GRAFT" option absolutely.  Even more annoying, my nose after more than 24 internal and external stitches is slightly thinner, but just as long as before.  While the small skin cancer spot on right is gone, it was not worth it.  I also might have mad emore effort to try laser or chemo options first.  Maybe had I had the skin graft, VS reconstrructive major surgery, I might feel different?    HAd I been preped much more about the recovery, I might have either rejected the surgery altogether or done better post surgery.  I have been told by others that 18-24 months is more typical to get full feeling back, if ever.   I would advise any that MOHS itself was not the issue, but the post MOHS repair.  I am considering posting ALL the post surgical pictures and timeline so that others can have a MUCH BETTER idea of what is possible.   I think that my MOHS/Plastic surgeon was very skilled, but...I would think carefully if giving the choice after MOHS of skin graft or reconstruction.  I currently regret my choice while heavily drugged and not prepared for the outcome.   While it did set my anxiety back years, it also set the bar higher too for my own expectations, as NO KIDDING, 3 months after the MOHS thyroid cancer was found and I had to end of having total tyhroid removal and radiation scans and treatment protocol.   My 2 inch would on neck was a breeze compared to the nose...so maybe, it was all meant to be put things in perspective for me?  Some say the 2nd cancer might be trigggered from the extreme stress of the MOHS reconstruction?  I think that might be contributory, BUT, not the cause.  Just ask more questions about the post MOHS process, and they should show you actual pictures like mine.  MY wife says if they did then you would not go through with it?  Good Health. 

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KC, Community Member
3/24/12 3:43pm
Hi. I had MOHs surgery on my nose yesterday. The doctor was excellent. I had a melanoma in situ removed. Two times cut then extensive area removed for margin, then stitched deep inside and then an outer layer of stitches the length of my nose into my eyelid. The doctor did a great thing making me look at the stitched up face before she bandaged it. This has kept me from peeking when I know it needs to stay clean. I am allergic to most pain meds so I did not fill the pain prescription for fear of vomiting. It was a wise decision. I did not need it as there is no sharp pain, just a stretched, dull ache. (However, I probably would pass out if I was slugged in the nose.) I have a lot of pulling on my face from stretching the skin to cover the hole. No skin graft. My nose looks very weird as the left nostril is nearly swollen shut and hangs down, while the right one is pulled up like a pig. The doctor says it will even up in 3-4 months, so I'm going to have to get used to it. I also have a black eye where the incision went into the eyelid. I am not sorry I did this. I am disappointed that it is going to take so long to heal and will feel a little embarrassed at work Monday waiting on customers, but melanoma in any stage is not something to mess with and MOHs has the highest success rate of any method. I'm paying now for the vanity of my youth, but I choose life and temporary discomfort and disfiguring any day over the alternative. All in all, I definitely recommend this technique. Reply
acfilmz, Community Member
4/11/12 3:58pm

The surgery itself is not painful just the initial sting of the numbing shot.  My basal cell carcenoma (bcc) was on the edge of my nose on the left side near my tear duct (yikes).  The first week wasn't bad except the red, bumpy swelling around sutures.  A week later the sutures were removed.  A few days after that is when the area that they removed the bcc from opened up and there was a tiny bit of puss/blood.  I called my doctor immediately and got in the same day.  He looked at it and said that it should close back up and to come back in a month.  It's a week later and it separated along the line where the stitches were and has form a very thin scab.   I hate going out in public with it uncovered but if I cover it then the scab gets mushy. It doesn't look like it's growing back together or healing at a rate that I had expected.  Has this happened to anyone else?  Did it finally heal? 

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Agatha Maud, Community Member
5/26/12 4:06pm

I'm glad I didn't read any of this before having a squamus cell carcinoma removed from the left sideof my nose. Numbing is painful but that pain doesn't last long. No external stitches, internal dissolving kind. Pressure bandage and imitation skin. Hurt enough to take oxycodone that night and the next day. Swelling, black eyes went away soon. A week after the nurse was amazed at how well it had healed. Two weeks after that I have kind f an odd sensation on that side, like my nose is a little stuffed up, but that's it. And I can hardly see the scar.

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Mr. Bill, Community Member
7/ 7/12 8:40pm

I had Mohs surgery three days ago on the right side of my nose. It has been interesting reading the varied responses. My own experiences:

- my initial numbing shot(s) did not give me any pain. I barely felt these at all. I probably had 15 different shots during my entire procedure but could not feel anything at all after the first one. I am convinced that injection pain or lack of it (also based on dentist experiences) has everything to do with the skill of the person adiminstering the shot.

- the actual removal of the cancer takes very little time. I was the "winner" of the day at our office with three different sessions to get complete removal. These were really not an issue.

- I was not quite ready for the 80 minute suturing session to finish the process. There is a good bit of pushing/pulling and it is tough to stay completely calm with someone all over your face for that amount of time. I will say, however, that this part was not painful but jus uncomfortable.

- I did have a good bit of pressure or pain after the procedure. It was hard to tell whether it was from the pressure bandage, swelling or whatever. I am usually pretty good with pain (no novacaine for fillings) but did take my Vicadin for the first day. Now I seem to be OK with no meds for pain. My nostrils do seem a little constricted but I think that may be from swelling.

- your first "viewing" of your surgery site may be a little unnerving. My nose is red right now. I hope this is normal and we'll see how things progress.

- overall, right now I feel pretty good about everything but based on reading the comments of others know that I have a ways to go.

- thanks to many of you who have supplied comments so others can see where things might be headed.

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LYNDA, Community Member
1/14/13 2:40pm

I'M SO SORRY FOR BAD EXPERIENCE, BUT THANK YOU FOR LETTING US KNOW.

MY MOM HAS GONE THROUGH PROCEDURE AND HER NOSE LOOKS HORRIBLE VERY DISFIGURING.

THE DOC ACTED LIKE THE SURGERY WAS NO BIG DEAL....BUT IT WAS!

I WISH THE DOCS WOULD READ THESE BLOGS

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nn1, Community Member
7/14/12 4:26pm

I was told last week that the basal cell cancer on the left side of my nose, the lower right eyelid and the part line of my scalp require Mohs.  I watched videos on youtube, however, was unprepared for the long term reconstruction & healing photos.  I'm a nurse, love surgery views, but am COMPLETELY freaked out about this.  I've had surgery in the past but think it is scary because it will be so obvious after.  There is no way I can take even two weeks off work, and I am so anxious about how my patients will view it.  I work in close proximity on patients, so I'm worried they'll be freaked out when I lean over them.

 

PLEASE, please share with me any knowledge about the alternatives to Mohs.

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grlnxtdore, Community Member
7/19/12 3:22pm
I had MOHs surgery on my nose just about 24 hrs ago. As everyone has said the pain from the numbing was painful but tolerable. My Basal cell carcinoma was located right around my right nostril near the tip of my nose. My fear was that I would have to have my nostril reconstructed. This was not the case. They brought me to the back, numbed me up, and they removed tissue.All of that took about 6-7 minutes. I was then bandaged up and sent to wait in the waiting room. About 35 minutes later they called me back to remove more tissue. They numbed me again, removed tissue and bandaged me up and sent me to wait again. About 45 minutes later I was called back to close it up. I was told that a graft was needed. They took skin from the side of the bridge of my nose and just pinched that area and stitched it together. They then stitched the graft in place. I was told I have 12 stitches. I cannot take my bandage off until 48 hours have lapsed. I was then told to clean it with soap and water or 1/2 peroxide and 1/2 water then cover the sutures with something like neopsporin and a band aid. Easier said than done...I'm not sure how I am going to place a band aid on my nostril. I was also to keep and sleep with my head elevated. By the time i arrived home I started feeling throbbing and a few sharp twinges. I took 2 extra strength Tylenol and applied ice. This was more than enough to take the edge off the pain. 6 hours later it was time for bed so I took to extra strength Tylenol pm and slept surprisingly well. A few toss and turns here and there but I felt rested. I took nothing for pain today(day 1 post-op). I did not realize when your body moves you can feel it in your nose(go figure). I am extremely afraid to see what my site will look like. I am only 40 and have always had a great complexion and am freaking out about what my face is going to look like! I will keep an open mind and remember that healing takes time. Reply
Denise, Community Member
9/13/12 1:31pm

I had MOHS surgery 2 days ago for basal cell from the bridge of my nose almost to the tip.  The surgery was not painful at all, even after the anesthetic wore off.  I went yesterday to the plastic surgeon and was overjoyed that I didn't need a forehead or cheek flap.  The stitching seemed to take forever and the pulling and tugging was very uncomfortable but not painful.  However, about 2 hrs. later after the local anesthetic wore off, my whole face was throbbing.  My nose started running and it hurt a lot just to touch it with a tissue.  I took advil and the pain lessened.  I woke up about 5am and had to take more advil.  My doctor said to watch for redness but it looked red as soon as the stitching was over.  I'm so worried about infection since the Mohs surgeon said there was an infection under the cancer which he cleaned out.  After reading some posts it seems that the most pain was after the repairs.  If I don't get some relief by tonight, I'm going to call the plastic surgeon tomorrow.

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cjohns, Community Member
11/ 3/12 10:10am

I had MOHS surgery for basil cell on left tip if my nose 5 days ago.  The next day I had plascic surgery repair with nose flaps.  As I understand it, one flap was used to cover the MOHS wound down to the tip. Another one, above it, was then used to cover the flap wound. That second cut was then sutured closed as it was higher on the side and thus stretchier skin.  I woke with no pain.  My nose was packed both sides with gauze but I could breathe through it . I had a stiff plastic like "nose cast" over some dressings. The tip of my nose was still exposed and sutures showing. 

Ive had swelling and under eye bruising which is now starting to fade. Ive had little actual pain. Itching and dull ache are the best descriptiion for me.  I apply antibiotic ointment to the expose sutures to keep it moist . There is some crusty blood the first couple days but thats all gone now.  Its a bit ugly, my nostrils are kind of turned up Miss Piggy like.  I assume when the cast comes off in 2 more days that will go away. Its probably pulling on them.  

Fortunatly I can use PTO and disability time for work.  Theres no way I could face the public looking like this.  I was surprised by the amount of bruising and swelling and the rigid cast thing.

Im curious to see what the sutures look like and how long they will be in.  I have great faith in my doctor's skills.....hope Im not disappinted. I am vain enough to care about that.

In any case, it needed to be done.  It's cureable, it's not life threatening. 

 

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Candis, Community Member
1/27/13 2:17am
How has it healed? I had Mohs on my left nostril and it is pulled up and doesn't match the other side. Plus, it's "Miss Piggy like" too. I'm hoping yours improved? How long did it take? It's only been 4 days for me, but I don't want to leave the house. Reply
Jeff, Community Member
6/18/13 6:59pm

[UPDATE] at almost 18 months, from MOHS Nose Basil spot (3 layers) and extensive nose reconstruction (top to under the tip & across the tip) back in Jan 2012.  Doctor and staff said 3-6 months full recovery.   Relaible sources said, 18 months is the magic number, not 3, not 6, not 12.  Sure enough my nose is feeling about 90% normal again approaching the 18th month post surgery.  I still have some numbness, hypersensativity and tenderness along the ridge of the nose if I squeeze it and at the tip.   No infections, no trauma, just a long healing.  I clearly see the encision site (a light line), but most do not.  I have also had a touch up sesison of electro cautery on the many blood vessels that appeared on the nose surface after the basic healing.  That has helped the skin look more normal. (gets rid of the fine red lines)   I will get one more touch up next time I am at the docs for another reason.  Again, the MOHS part was a breeze, it was the recovery from the reconstruction that was tough.  I can't comment on alternative choices (like a skin graft) since that choice was not taken.  I still think, in hindsight, I would now choose the skin graft (with slight discoloration possible) over the resconstruction, but that thought will be for some of you heading into MOHS or for me another time in the future.  All of us seem to agree that having the cancer gone is primary, the rest we will live with.   My nose was "healed" in a few weeks and looked OK (to others) in a few months, but... just be aware with serious reconstruction or a good size incision that my experience is 18-24 months for the area to feel mostly normal again.  I am not complaining, but sharing, so that those of you getting surgery can ADJUST your expectations VS what you might be casually told.  I think that some minor feeling loss, and nose tip feeling colder is going to be permanent and is the price of fighting cancer today.  OF course your experience, cancer, doctor, treatment and procedure make direct comparisons difficult.  

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Ellen, Community Member
5/ 2/14 10:14am
Hi Jeff, First, thank you so much for your posts on your cancer, they have helped me get through my situation. I had a very small basal cell on the center of my nose removed 2/27/13 by a plastic surgeon using a cheek flap (island pedicle flap). I wish I would've chosen the skin graft option but the surgeon insisted that the graft would look abnormal with discoloration. I think the cheek flap was excessive because of the size of the basal cell and this option has left the nasal crease area blunted on the right side and nose holes are two different sizes. The scar lines are very visible although I know I'm still healing. I wanted to ask you how you are doing now that it has been 2 years since your surgery. Would you still have preferred the graft? Are your nasal holes the same size now and how about the swelling and scar lines? Thank you again for your posts throughout your process, Ellen Reply
nn1, Community Member
6/19/13 12:33pm

10 months past MOHS then separate reconstruction surgery to remove basal cell cancers on scalp and side of nose.  MOHs was a breeze other than my anxiety around having facial work.  I worked with a therapist before & after surgery and HIGHLY recommend it if you're feeling anxious.

The cancer on my scalp left a bald spot that the plastic surgeon didn't think the hair would return, but it did!  My hair is almost as long as my bangs & most of the time I don't even think about it.

I'm going to share my experience not to scare, but to inform.  I received excellent care and have wonderful doctors that I would recommend to others. My wish was that they had been brutally honest about how painful facial surgery is.  I'm the sort of person who would rather expect the worst & be pleasantly surprised when it's better. I was led to believe this would be a piece of cake.

Hardest initial part was pain, and swelling, bruising, and the look of the repair.

The puffiness has persisted. The doctor wants to do a reconstruction of the original repair to the side of the nose, mostly for cosmetic reasons. I've been reluctant because most of the time, I can ignore the itching and pins & needles I still feel, and my friends tell me they can't even tell it's swollen.  I'm considering it now because for some odd reason, it will randomly swell & make breathing difficult. Hate waking up in the night feeling short of breath.

I really hated having to sit up for 6 weeks in order not to disrupt the grafts. It's so hard to sleep that way.  The nose had the deepest cancer, and a hole was left in the side of my nose (what, a new nostril?!?) after the MOHs and to reconstruct it, the plastics dr filled it in with cartilage from my ear and a skin flap cover from my cheek.  The ear hurt like the dickens and actually caused a lot more pain than I would have expected.

I'm pretty good with pain, had babies with no meds and major abdominal surgery with minimal narcotics. In the first week post surgery, I went through 2 prescriptions of oxycodone (60 tabs) and that was spacing them out to not experience the side effects of sleepiness & nausea.

Would I do this again? Absolutely! In retrospect, life is far more valuable than the change in my appearance.

I'm told that since I've had multiple basal cells removed, I'll have more, and that the surgeries were to stop the cancer in those specific areas. A little disappointing. At least now I know what to expect.

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Scousebird, Community Member
8/ 2/14 6:47pm
This site has been really helpful reading through the different experiences, sharing very similar experiences to myself. However, I am just wondering if anyone had a bcc on their tip of their nose and after MOHs did the surgeons decide to leave it to heal by itself. The wound is approx the size of a thumb nail. I am on day 4, wearing same bandages, feeling definitely some pain, throbbing at times and extremely itchiness which is very annoying. I am due to get bandages changed in two days time and really upset by the whole ordeal. I suppose my question is what can I expect recovery time to be? Is the itchiness normal? Is it normal to be feeling very self conscious and dreading the thought of returning to work? Also how long did you take off work up fully recover? Sorry about all the questions. I just feel so isolated. Thank you. Reply
Cardinal, Community Member
8/11/14 2:48pm

Scousebird:

 

I had SCC on my nasal tip and did not opt for Mohs surgery.  I used a product called Perrins Blend.  Btw, I understand you feeling "isolated."

 

Please update ASAP.  I would like to know how you are doing.

 

God bless,

 

Cardinal

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merrybe, Community Member
9/ 6/14 3:35pm

September 6, 2014

 

Dear Fellow Mohs commenters,

 

My name is Shar, and I just had Mohs surgery 2 days ago at UCSF.  I am writing to get your feedback, just as I read your comments prior to surgery, especially Jeff's story.

 

Two weeks ago I had a biopsy for a spot on my nose (right side middle) that I had shown to both my primary care physician and the High Risk Skin Care Clinic at UCSF earlier this year.  It wasn't until two weeks ago that they took a second look after I described a non-descript flesh coloured bump that turned into a little scratch that healed, then didn't, then healed again, then opened up.  It was Basal Cell Carcinoma ("bcc" as I have now learned the lingo.)

 

Like some of you below, especially Jeff, I was very anxious.  Strange because I have already gone through a kidney transplant!  I knew there was a 100x increased risk of cancer, but have had not problems (that I was aware of) in the last 9 years post-transplant.  I could not take a Valium because I have what is called a paradoxical reaction to it, which means it makes me more nervous!

 

UCSF has an excellent surgical team, however for me, the informational prep was wholly inadequate.  I read the info. packet from UCSF cover to cover, but it did not answer all of my questions, especially regarding reconstruction.   The actual procedure began at 8 in the morning, and it was two stages.  The hardest parts (aside from the diagnosis) were

1) Fear and Anxiety -- will this return?  Will they get it all?

2)  the waiting after the first stage and

3) the stitching.  It took much longer than the actual tissue sampling.  I had 25 external stitches and a bunch of deep layer stitches.  I did have my sister-in-law with me, who is a scientist and shared my interest in the procedure.  I did look at the open wound with a mirror before being stitched up.   Having watched a bunch of youtube videos I knew about the potential for a skin graft and had hoped I didn't have to have the forehead vertical line, or any for that matter.  But I did...

 

My surgeon, who I think is very skilled, took a triangle from above the wound out, and cut a crescent moon shape next to my right nostril, and placed that on the wound and the triangle above my nose.  It is a very tribal looking L, for Love, Laughter and Life.   Yup, vanity is alive and well in me, but the overarching concern is did they get the cancer.

 

I am still experiencing what I hope is a psychological reaction or neurosis fearing that they didn't get all the cancer.  I had asked to take a peek at the patholigist's slide sections, before and after clearing the bcc.   Ot wasn't clear to me from the purple-stained die "designs."  They showed me a cluster of BCC cells on the slides, which looked like purple outlined bubbles.  The after still looked weird, and I am hoping to get more info. on it when I go back to get the stitches out next Thurs.  

 

Swelling and black eyes:  I don't have a black eye, but I am swollen with purplish reddish orange bruising, like a swatch of color wash on my bony cheek.  My nose is all swollen like the characters in Avatar, and it is stuffy, like having a bad cold on one side.  It hurts to bend over, such as to pick up something from the floor.  I feel vulnerable.  I took the pressure bandage off yesterday after 24 hours, revealing many steri-strips along the side, and in the crescent by the nostril.

 

I also feel whoozy but I am no longer on any pain meds.  I may take a Tylenol soon, because it just generally aches in a stuffy sort of way.

 

I have a few pictures, before, during and after surgery.  Anyone have any ideas where should I post them?  I don't have a Facebook page, and am fairly sure I'd scare away all of my Linkedin contacts!

 

Still healing.

 

Sending good thoughts to all.

 

 

Recipient of a Gift of Life

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sgeiger1975, Community Member
10/ 4/14 2:22pm

I just had the Mohs procedure done 4 days ago. I had Basal Cell Carcinoma on the top lower part of the nose. I was diagnosed and in the surgery office in less than 2 weeks. My Husband insisted I get a second opinion and I said no. I felt the office I was seen is was competent and I just wanted to get the cancer taken out.

 

So, the procedure wasnt bad at all. I barely felt the needle for the numbing. I did feel tugging and scraping, but no pain at all. I had to go through the cutting/scraping twice. I waited both times in the waiting room for an hour each time. They had to go pretty deep into the wound which was cut into basically a circle. When they stitched me up I think the Dr. had to cut more so that he could stitch up in more of a straight line. The process all in all took 5 hours. They bandaged me up and I went home. No drugs no perscritptions. nothing. I had swelling that first day but OH MY GOSH day two my nose was huge! I worked from home that day. I got worn out pretty quickly...just tied mainly. The pain was minimal. I decided to take off the bandage 24 hours after the surgery. WOW, I was in shocked at how awful I looked. my nose was double in size, very red and the stitches were covering half of the length of my nose. At this point Im just really worried about the scar. Day 2 after surgery, I decided to go in to the office. I bandaged up and off I went. I got work out pretty quickly again and my employees and boss suggested I just go home. I did. I feel the need to rest quite a bit. I dont have alot of energy and since I workout very regularly that is very hard for me. I have only been taking ibuprophen to help me with discomfort. Day 3 after surgery: I have had some bleeding a puss from my wound. I called the on call dr who took about 3 hours to call me back. She didnt seem to be real concerned. Just said keep it clean with warm water and mild soap and use vaseline. I said ok and if by Monday its not better Ill call again. The swelling has gone down. The area is still red. I hate the way the stitches look and Im feeling a bit depressed. I know this is temporary and also if I need additional scar procedures I can opt for that. This is only day 3 post opp. Ill be back with updates along the way.

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By anonoymous, Community Member— Last Modified: 10/04/14, First Published: 12/10/08