IMHO I think you should visit a plastic surgeon that does not work with the same hospital as your recent surgeon and see what's up.

I had bilobe flap reconstruction 2 years ago. My doc used the skin from the top side of my nose to cover the wound on the tip which was the size to a dime. It will feel tight for a while, especially if you are still swollen. It takes a long time to fully heal. The scar and skin will change as it heals. I had to go back after 6 months because my doc didn't pull my flap tight enough and I had what is called a pin cushion effect on the tip. It was corrected and looks a lot better. I'm going in for another scar revision in the next couple of months. Best wishes and keep in touch!

Thanks for replying, both of you!

I went to the doctor's this week, and that's what he told me--it'll be six months. (My skin on my nose is also quite mottled-looking. The flap almost "died" because it wasn't getting enough oxygen. So I'm in the middle of hyperbaric oxygen therapy. but he told me it will take, but it will be 6 months for the skin looks normal. )

It's just so hard to know what to know is right. I had a very large defect (much larger than a dime, covered my whole nose almost.) But I feel like he should have done a graft...like I shouldn't have any scars or look "disfigured."

Lisahh--do you feel what you are going thru is "normal" procedure and everything was done correctly?

I am wondering if you can ask to start a skin graph group? It is a pretty detailed and important subject. I thought they take a patch off your rear end and go from there...

My doc told me that it's a process and a lot depends on how you heal. I know how you feel. I felt the same way. I would trust that your surgeon chose a flap instead of a graft for good reason. You might want to ask so you can feel reassured. Whether you get a graft or a flap, you will have scars. There is no way around that part. Over time they will soften, but they will always be there.

I don't know for sure if everything was done correctly for me, but I have had second opinions and there are no magial answers. I know it's so hard to deal with this, especially on the face. It took me a very long time to accept my scar and I still have trouble with that sometimes.

I wish you the best. Let me know if you have any other ? or just need support.
Lisa

Just wondering how you are doing? I hope your healing process is going well, both physically and emotionally. To answer your question about "normal procedure", I really don't know what normal is. It's my understanding in talking to several plastic surgeons that every case is different and that my procedure was the best choice for me. There are options as far as grafts and flaps , but I guess since there doesn't seem to be one procedure to address the defects, we have to depend on the skill of the surgeon and what he/she thinks is the best. I went through second opinions about what was done and I wasted a lot of time doing that. What was done, was done. Nothing I could do. Now I try to focus on scar revision and laser treatments which I have been putting off. I know I need to move forward, but I am still nervous about the outcome and hate going around with a bandage on my nose. Maybe I should wait for summer, then I won't have to worry about putting sunscreen on my nose!!

Hi Lisahh,

Thnaks for asking, part of why I'm having such a hard time dealing with this, is because I don't know anyone or even seen anyone who has gone thru this or looks like me.

My face is getting better. there's no denying that.

For me the scar isn't even what I'm thinking of yet! As I said my cheek was pulled really tight to cover the defect. But the docotor said it takes 6-12 months for your face to relax and stretch. My nostril is also smaller on that side of my face.

My skin is totally red and mottled on my nose--but they said that would go away too--6 months.

I feel ok some days and other days, I feel so sad. I feel--I know--- that my doctors didn't prepare me for this--that I'd never look the same. Although I guess if someone says "we're going to pull your cheek over your nose to cover up the giant hole you have," maybe I should've had some idea it was serious.

I go back and forth and it's really hard. I can't believe I'm never going to look the same, but i also think I'm not going to be totally disfigured, which is what I afraid of just a few weeks ago.

Sorry for rambling! Cause what you said was true: "What was done, was done. Nothing I could do" Because I've considered goign to another plastic surgeon for a second opinion.

Where is your scar(s)?

Best,
India (real name!)

Is it on the tip of your nose?

India,
Please ramble! It helps me to know there are other people out there who I can relate to. I don't know anyone who has gone through this either, except on DS. Your thoughts are pretty much the same ones I had.

I don't think I was prepared by the docs for the possibility of disfigurement. I just remember being told that the basal cell tumor would probably be small and the scar would not be noticed at a "conversational distance". Boy, were they wrong!

My scar runs from the top left side of my nose down to the center tip in a shape kind of like a 3. It is white and indented. My left nostril is smaller because the cartilage on the inside of my nose collapsed due to the surgery. My nostril was raised during my 2nd surgery and the doc will raise it again during my next scar revision. Hopefully, this next surgery will be the last.

I know how hard it is to accept the scars and disfigurement. I don't think I will ever totally get over that. As time passes, the only time I really get upset is when I have a special occasion that I'm getting ready for. My husband and son have given me a lot of support and that has helped.
Lisa

Hi Lisa,

My one nostril is samller than the other. i don't know why! But I think iit's because my cheek was pulled so tight over, it flattened it--even though the doctook some cartilage from my ear to raise the nostril. Plus the scar now runs straight down the middle of my nose and along the side. (As it looks now)

anyway, I've been informed they did not get all the basal cell.

The plastic surgeon wants me to come back, cut my scar open again and "hopefully" get it all. If not, back to Moh's. I'm totally freaking out about this.

I'm goign to go to a dermatolgist for another opinion, because as it stands now, i can't go thru this again. My nose is starting to look somewhat acceptable (I still go other with bandages over it, and it's 2 months later.) I can't stand the idea of them then cutting away the other side of my nose. It's so crazy.

I totally understand. It's hard to go through it all. I'm going back in for the third time and I too hate the thought of being cut open again. I have put my third revision off for a year and I shouldn't have waited so long. I wish I had just kept going forward, but I chickened out. I finally made my appointment Friday and I'm going through with this, band-aids and all!

How did they find out that not all the cancer was removed the first time?

Good for you! I really hopeit turns out well, so much!!!!!. I can totally understand what emotional strength it takes to go thru the surgery again. At least you know what to expect this third time around (Ha!) I don't believe you chickend out. Doctors keep forging ahead...you know, and only you know, when you're ready.

Well, the Moh's surgeon said she got it all. But, this was after having it done 8 (eight) times over two days. The last procedure, I said to her you have to get it all, because I can't do this anymore. I was in tears, and just emotinally exhausted. i wouldn't look at the damage, but I knew it was huge. She told me that the plastic surgeon wouldn't operate on me unless they got it all out (she called him).

So the last go-around, she took out a bigger slice and--after a short time because I was the only one left in the office-- she came back and yelled "WE got it!' and she hugged me and the nurse hugged me.

(It turned out the skin on one entire side of my nose and over the bridge and just to the tip had been taken off, People talk about a dime or a quarter, this was more like ..well the entire left side of my nose and then some)

So , I don't know what happened.

But now I feel the plastic surgeon is really pressuring me..he said he'd be slicing away a 3/4 inch long (!) biopsy right down the middle of my nose. (Where, my scar is barely healed yet. ) and says "he's hopeful" he'll get it all. but if , not, back to Moh's.

Anyway, I don't trust him and there's no reason to think that the basal cell hasn't grown past what he plans to take out, considering it's 3/4 inches long. I don't think basal grows uniformly. I think he just wants the money to do the surgery, quite honestly.

So I've made another appt to see the Moh's surgeon to see if there's other options. My nose is not ready for another surgery.

Thanks for listening.

Will the surgeon address the nostril also? Or just the scar? Are you knocked out or is it local?

Thanks for you kind thoughts. I had my appointment today to discuss my revision. It will be a local and my surgeon will raise my fallen nostril and do a scar revision on the lower part of my nose. The scar on the upper part is flat and white, but the lower scar is indented and has parts the puff up. He said he can fix that. Yea! I know I have to live with this scar, but it will look better.

How are you doing? I hope you are doing well and that things are better for you. Take care!

Wel, that sounds like what I have to look forward to in the future! How can they fix your nostril? (My one nostril is smaller than the other also.) Plus, I'm probably going to get some laser work in the future to get rid of all the broken vessels on my nose. (another thing no one mentioned.)

Anway, I went back to the Mohs surgeon and they cut another l itte piece of nose (near my eye).and they got it all! yeah.

I told her before we started though, that I did not want to get as far as having pastic surgery..she said, well if it's spread to your tear duct, you're eye will water. I was like...I think I can deal with that versus having my tear duct and lower eyelid cut off. But anyway, it's gone, and I have a follow up with my plastic surgeon this week. Blech.

Anyway, do you sometimes wonder if it was worth it? Because I do.

Please post, if you're up to it, how it goes. I sincerely hope everything goes better than expected. Best of luck.

Yes, I do sometimes wonder whether or not it was worth it. I also wonder why the nurses told me it was just a small tumor because I was younger than most of their patients (50). Then I wonder maybe they made a mistake in the lab and it goes on and on!! I just have to accept what is and move forward.

I also had laser done, but I stopped after my surgeon suggested another revision. FYI, I had to fight for coverage for the laser. At first, they said it was cosmetic and not covered, but I didn't buy that answer. I went to the head of the dept. and he got me covered since it was a result of the surgery. I had 3 treatments and although there was a difference, I needed more treatments to get rid of the stubborn ones. After this last revision, I will start again.

To answer your question about my droopy nostril, my surgeon will raise it by cutting away some of the excess flap skin right above the old stitch line that is above my nostril. Then he will do a scar revision on the lower and mid part of my nose.

My best to you and keep in touch!