how painful is it?
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.
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.
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.
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?
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.
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.
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.
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.
[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.
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.
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!
Sending good thoughts to all.
Recipient of a Gift of Life
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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