SKinMN's Journal

My Mohs surgery went better than expected. They were able to get it all in one pass as the doc could easily see the edges of the tumor. The defect ending up being about the size of a dime (rather than the nickel size anticipated) and stayed within the confines of my ala (which was what I had been hoping for). The worst part of the surgery by far was the injection of the local anesthetic. It was very intense. Let me tell you those little rubber ambulances they gave me to squeeze really got a work out. As the tears streamed down my cheeks I asked if that was normal or just a sign of my self suspected wussiness. Thankfully they assured that it happens to everyone… it’s the nerves my doc said… and not to worry. Whew! I was relieved and continued to joke with them to ease my distress.

After the first… and luckily only pass… my cousin and I went for some much needed breakfast. (I just couldn’t eat beforehand was too nervous.) Wait time was about an hour. When they took me back I confessed to the nurse that I really had been hoping I wouldn’t need to return to the surgery room and she said “But you are going into the good room. We got it all!” I stared at her in disbelief and said “Really?” “Really!” she said. So with a huge grin I patiently waited for the doc to come and give me the results. I was so relieved.

Reconstructive surgery was very early the next day. As planned my facial plastic surgeon sat down with me before the surgery to take a look at the defect and make final decisions about reconstruction. He felt the best option for me would be to do a full thickness skin graft using skin from in front of my ear. As the defect had left enough structure to support the skin graft he did not think a cartilage graft would be necessary. (I was relieved about that... one less incision. Woohoo!)

I had iv sedation for this surgery. Though sometimes the patient is still awake with iv sedation just not aware I opted to be completely asleep. I figured why not seeing as they were giving me an option and that way I wouldn't have to feel the local anesthetic injections he would need to do. After surgery I came out of sedation quickly and didn't have any side effects. For those interested it's called Monitored Anesthesia Care or MAC for short… I highly recommend it.

The donor site where they took the skin for the graft is right in front of my ear and the scar is about 4 cm long. Though it feels pretty tight, itchy and achy at the moment... it should heal up very well and as I almost always where my hair down it won't be noticeable.

The defect on my nose was 1.6 by 1.3 cm and covered nearly the entire nasal ala or nare. It wasn't too deep so no need to repair the nasal lining or use a cartilage graft as I mentioned earlier. After the surgeon placed the graft he stitched a plastic stent dressing or splint over my ala to encourage the graft to take and to hold the normally convex shape of the ala. I will have the stent on until next Friday when they take the stitches out.

The pain meds have definitely helped… am taking darvocet as vicodin doesn’t agree with me. Actually needed to take one in the middle of the night the last two nights as sleeping has been kind of uncomfortable. Hopefully that will improve as the week progresses.

All in all I feel pretty lucky that it wasn’t any worse. I had prepared myself for a more extensive reconstruction than what was needed so now I just feel relieved and well… lucky.