Well, it’s done.
The dermatologist did the Mohs procedure on Thursday morning. It took 3 passes to get all the cancer out, and I was left with a defect about the size of a dime on the lower left part of my nose. Sort of like this –
Despite what was being done to me, I had a good time at my Moh’s surgeon’s office. We talked kids, and schools and family and money – and then I hung around his little back Mohs waiting room for a few hours till my plastics appointment, returning patient calls and checking labs on my laptop (one of the curses and advantages of an EMR). I left feeling relieved and upbeat.
Until I saw the plastic surgeon.
The Closure
Where my dermatologist is an upbeat, everything is going to be fine kind of guy, Dr Plastics is an empathetic, caring, almost rabbinical kind of guy who really understands how women feel about their faces. So when he entered the room and saw the size of my defect, he looked at me with those dog-eyes of his, looking so sorry for me that I started to cry. He told me the defect was larger than he had expected, and that he would not close it in the office, but under anesthesia at the surgi-center the next morning.
I walked home crushed, sure that I was going to be deformed for the rest of my life. And the fact that I had to spend the night with this hole in my face did not help. What if something happened and I couldn’t get to the surgery tomorrow? Suppose there was a fire, or I got hit by a car, or one of my kids got sick? I’d have to decide between them and closing the hole in my face.
Somehow I got through the night, and next morning went to the surgi-center. What a place – an Upper East Side townhouse that, when you enter, looks for all intents and purposes like a private mansion. Until you head into the back, where the place looks just like any recovery room and OR suite you’ve ever been to. Runs like a well-oiled machine, wonderfully friendly staff and anesthesia, high quality care. A real New York kind of place.
I waited for several hours in a gown on a gurney, listening mostly to my neighbors letting go of gas after colonoscopies while I finished almost all of the Friday NY Times crossword, a feat worth mentioning in any post. My nurse had had two surgeries similar to mine in the past, a fact I did not notice until she pointed out the faint scars. This made me feel hopeful.
Then my surgeon appeared, apologizing profusely for keeping me waiting due to his previous case that had gone longer than expected. I felt oddly reassured by this, figuring that he would take as long as he needed to give me the best cosmetic result he could.
So to sleep I went, the Fentanyl and Versed doing their job quite nicely, and awoke some 30 minutes later, finally done. Dr Plastics had performed a bi-lobed flap and used about 20 tiny stitches to close. So I have an incision running from near my inner eye down the side of my nose that looks like a half of a flower. Sort of like this –
Nice, Huh?
Post-Op
In addition to the incision, I have a black eye and my nose is swollen and red. The pain isn’t too bad during the day, but has kept me up a bit at night, and my stomach is a bit upset from the antibiotics.
Now I just have to wait. Wait for the sutures to come out next week. Wait for the swelling to go down and the scar to fade. It will be sometime before I know how I am going to look, but at least this thing is done.
I find myself embarrassed thinking about having to see patients over the next few weeks with a big bandage on my nose. I wish I had taken off a little more time from work, but everyone said I could go back pretty much right away, so I’m going back on Tuesday. But I feel like it’s all going to be about the nose for sometime. And I am anxious for the point when I can cover the incision with some makeup until the scar starts to fade.
Most people I talk to are remarkably supportive and no one seems particularly worried about how I’m going to look. But somehow their comments haven’t helped. They only make me feel as if I am over-reacting.
And in some respects, I am. I think about Patrick Swayze and know that I am so, so lucky that this is all I have to deal with. And truth be told, I haven’t thought about my nose too, too much today, as we are now on the 7th episode of the first season on The Wire.
But then, I look at myself in the mirror, and get upset all over again. It makes no sense, I know, but this thing has really hit me hard. I think it was the combo of the big hole, the unexpected wait and and then the Frankenstein sutures, and I expect I’ll feel much better about things in a week or so. But right now I’m feeling pretty darned sorry for myself.
After all, it is my Nose.
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If you want to see photos, go here. I’ll be posting updates periodically as I heal. I warn you, it’s not pretty……
Thank you so much for sharing your story and your pictures! Your writing style is very enjoyable to read! I am scheduled to have Mohs surgery in about a month on my upper lip with reconstruction after. I am only 41 and had Mohs when I was 36 on my forehead. I wear bangs, so that wasn't nearly as upsetting as getting the lip verdict. Anyway, I found your story comforting and I guess it just makes me feel less lonely. Thanks so much!
Thank you for sharing your story, Dr. P. I am 38 and had Moh’s and reconstruction done yesterday- mine was very close to where yours is, but closer to the tip. I appreciate you sharing your feelings- I am shocked at how quickly this went from “hmm… that seemed like a zit, but it’s not healing” to a scar on my nose. Scary. I had my moh’s in the morning and came back mid-afternoon for the closure and while the numbing was going on, I started to cry… I felt pretty embarassed! Even after the nurse was finished (no more pain- no one was touching me)- the tears still flowed for a few minutes. I think it just hit me all at once. Thankfully, I remind myself, the cancer is out. Healing has started. Ice is my new constant companion and I am so grateful that you and others have shared their experiences and results. Thank you again for sharing!
I also have had cancer on my nose, my back and my arm. I however have a question about my mom’s nose cancer. She is 89 years old and in a nursing home. Her nose is just about gone and wears a band-aid to cover her black and lumpy, cancerous nose. She tells me she hates to go out of the room much, with the band-aid and the make up doesn’t work. The band-aid also causes bleeding sometimes being changed etc. My question is … heard of any type of fake plastic nose that someone could wear ( maybe hook on to her glasses) that doesn’t cost too much. It’s not like she can get one fitted or anything, as she is not mobile. It’s something that would really help .. please email me if you have any ideas where I could look or ask. Thanks so much. Sandy
Thanks so much for sharing your stories.
I had the procedure done yesterday…was in denial for months thinking that aloe would get rid of the spot next to my nose. I finally went to see a Dermatologist. I also has 3 passes done. My face looks horrible and my ex let me know that I look like ” Frankenstein ” under the bandage. He actually watched me being stitched up. So hard to believe, as you pointed out, that the small ” zit ” let to having a dime sized hole taken out of my face! My lip is swollen beyond recognition from the 20 plus sutures. My eye is getting black & blue and yes, I do feel sorry for myself. It’s Thanksgiving today, but I KNOW I have much to be thankful for. Besides, it’s also Hanukkah 🙂 I feel so much better after reading about your experiences.
Thanks again!
Paula
i toi have had mohs 6 days ago on side of nose, worried as its concave and insightly! I know I need to give it time. is there anything i can do to speed healing? i hate the bandages and the hole.