MOHs surgery on the lip | Lori's story - Part 2

This is part two of my conversation with Lori, she had wrote in the guestbook and had questions about her recent MOHS surgery to remove a Basal Cell from the lip area. Our email conversation was open and rather personal, as I asked Lori some tough questions, and shared some insight from my own experience.

Hi Kent,
I am 53 (yikkees i hate to say my age) and have been sunning myself for 53 years. The tanner I got the better I felt... I suffered with sun poisoning many many times and that still didn't stop me from going out again to the shore for tanning. I grew up in NJ and every summer my family left the day school was out and we would go to the shore until labor day. So the beach was a big part of my life. Sun block was never mentioned years ago.

About 5 years or more I got a little lump on my upper lip, I really didn't think anything of it but every time I went to have my lip waxed it would open and bleed a bit. I honestly thought that I got it from a wax burn which the doctors told me was not the case. It wasn't until about 6 months ago my kids kept telling me that they thought it was getting bigger, then my family started to notice it also, that was when I kept telling them I would have it checked out... I didn't do this until a few weeks ago as you know already. I do understand how this spread a lot since it has been there a very long time. I now know never ever to go in the sun again without any protection.

I was wondering why they put the gauze sewn over the graft? And if they know it is going to stick why would they do this? So, basically (tell me the truth) it is going to hurt to have them take the gauze off which is stitched to my face? Huh? The doctor said Monday 1/2 the stitches come out and then a few days later the rest will come out. So I am assuming it is the gauze that comes off on Monday. I was ready something on the Internet last night that was talking about looking so different after the skin graft and how to handle other people looking at you knowing that it looks terrible... I am really scared to see this. I know I must repeat myself and sound like a baby as this is probably nothing compared to what other people have gone through but I can't help how I feel... I am truly grateful that the cancer is gone.

As a mom I can relate to your mother about not looking like her anymore... We do all the work and then our kids come out looking like their fathers... so she was hanging on to the only part of you that looked like her and you went and changed the look of your nose... at least we can laugh a bit about it...
Well, I am going to email you Monday night to let you know how this looks and how the gauze came off....

By the way do you have any pictures of you when they blew up your head to grow the skin? I didn't see that on the web site, it all starts with the skin being there grown already.

Always great to chat with you, basal cell guy.......
Best regards,
Lori

Hey Lori,
Nothing wrong with 54, I'm 50 so don't fret about that. Ok, well maybe a little. Like everyday! I don't like it either but not much can be done about it eh? Reason I asked was to see if your age fit the general profile of someone who would get basal cell. It is, even the sun exposure, it's pretty much right in the middle of what I've read about all this. Although you are probably more to the extreme on the amount of sun you had. If fact I'd say that by now you should be fairly well done. lol.

Getting your bandages off will most likely hurt, but should just be for a few minutes while the doctor is actually working on you. Nothing you can't handle. After that mostly you'll just feel some discomfort which should lessen each day as it probably is already. As for what others will think when they see you, well you are in control of how you perceive that. My mantra about my nose was always this, 'Outa sight, outa mind'. I got to where I wouldn't even think about what others thought and you know, really the only ones that ever had anything to say about it was a couple times some kid would ask. That never bothered me at all. Did people talk about it when I wasn't around? Probably, but guess what, don't know and don't care. But here is where we may differ, I've never been one to put much thought in my appearance, hair sticking straight up, no problem, that's what hats are for! Nose look a bit funny, again, no problem. Who's it really bothering? Not me, maybe them but that's their problem not mine. Just roll with it and you'll do fine. Don't dwell on it.

One more thing I wanted to touch on and then I'll give it up for the night. About using our conversation on my site, when we get to some point, I'll go through everything and edit out what doesn't need to be shared and then send you a copy to approve/edit before anything is published. Ok? That way you'll have final say. I think that's just fair and allows us to be totally open through all this.

Be strong,
Kent

Oh, about when I had the flap done, I understand now what you're referring to when you say "blown up". It wasn't like that at all. I'll go into more detail later but the flap was just a strip of skin that was cut from the forehead and pulled down to form the nose. I'll explain more as this is important for you to know just what is involved here.


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Hi Kent
53 not 54 don't push it.. ha ha... well I got all the stitches out today and it wasn't too bad. The gauze didn't stick to my wound and the doctor said the graft took.
It looks horrible!!!

At first when I looked at it I thought wow this isn't too bad as I was comparing it to the open hole I had there. Well now that I am home I am looking and now its a big hole with a piece of skin covering it and very red with stitch marks all around it. I am trying to stay optimistic about this and the doctor said I have to wait a few months and then we will go for the flap surgery if I want to. I am curious if another skin graft could be done to possibly fill in the hole after this heals. He told me on Monday when I go back that he will start me on how to massage the area, then what creams to put on it and so on and so on. It is very swollen now so I will give it a bit of time. I have to keep it covered for the week so at least no one will see it. I am going back to work on Wednesday. I will keep you posted step by step on what's happening if you don't mind. it feels good to talk about with someone who has gone through all of this.

Thank you my friend for being there for me.
Best,
Lori

Hi Lori,
Sorry 'bout the age there, dang ole eyesight anyhow! Well, I think you have the worse behind you now as far as things that might hurt at least. Now you are just going to have to accept and adjust to what the outcome is, as it is. From what you have described I'd say it all sounds pretty normal. I don't think that they can put a patch over a patch, kinda think it'd have to be reopened and another patch put there. Not sure about that though. I'll ask the Doc today when I see him, sure hope he has some extra time for me, have lots of questions for him.

You know, I feel really bad for you when you say it 'looks horrible', but understand that now 'time' is on your side. Before it wasn't. The healing process isn't overnight of course but you are still young and the body will take care of itself. Just give it time. You can see in my pictures how time worked for me, it may have been a year but what else was I going to do. I know you want to be as pretty as you think you should be and I didn't have to really deal with that emotion, but I'm sure that a year from now you'll be close to what you want. I hope this part makes sense, I'm probably getting outside of my understanding some what. But this is to a great extent why I'm wanting to share your experience on my site, it'll give a good balance for other ladies who visit and find themselves going down this same path. I don't know for sure but I suspect that the viewers to my site are probably more female than male. That's one thing the site analytics don't tell me.

I've always been thankful that I'm a patient person. Never felt like I had to have something just right here right now. Whether material things or in this case my 'good looks'! ha. What comes, comes and what doesn't, doesn't. I'm just determined to enjoy life as I get it, make the most of all that I like, dealing with the setbacks as needed. Thankful for today, hopeful for tomorrow. Even when things have knowingly gone downhill, I refused to spend a minute of MY life stressing on it. Sometimes what's at the 'bottom' is just as interesting and meaningful as what's at the top. I'll take it any ole way life throws it at me. If I can do it, well you can too. Right? Ok, enough of my philosophy, don't mean to bore you!

Most definitely keep me updated, I'm very appreciative of this whole conversation. I'll let you know what my doc says after my visit later today.

Kent


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Hi Kent,
I am looking forward to hear what the doc has to say. I personally have gotten more honest information from you then my doctor... I am going to try to take a picture and get it on my computer to email to you of what this looks like now. I have to wait for my daughter to get home from vacation to do this and then download it from her camera. I attached a recent picture which was taken in June. You can see where the cancer was above my lip... It is amazing that it is so small and yet it was so deep and large area that had to be cut away. Please understand one thing. I am so very grateful to be cancer free no matter what the outcome is. I just need to come to terms with it and be patient as I know that the flap surgery will work as it did for you. I am the one with the darker hair, the other person in the picture is my sister. The other picture is my auntie, daughter, nephew and me. so i will start with that is the before picture... chat later, my son (who is my baby of the family) is leaving for college on Thursday so we are having a dinner tonight to say our goodbyes. Although he is only going to be about 2 hours away it is very emotional for me to have him leaving...

Chat later...
Lori

Hi Lori,
Meant to write back last night but had one those rare nights when I turned in early. Round trip to KC is a little over 300 miles and those are some crazy drivers up there. Then my parents came over, dads computer was acting up. That's part of my job description, building and repairing PCs. Anyhow, enough about me, hey thanks for sending those pictures. That spot on your lip sure looked like mine did the first time I had basal cell. And like you I ignored it way to long, told my self it was all kind of things but what it really was. It'd break open and bleed some then scab over, of course I'd tell myself then that it was healing. Not. Another thing about your picture I noticed, that twinkle in your eyes, 'ornery' is what came to mind!

My doctor visit went very well, he said everything looks fine. I had a chance to talk with him some, let him know about my website and how you'd contacted me through it. He's very interested in the fact that I took this situation and have turned it into a way to share with others. He says that you'll probably never be totally happy with the graf. It almost always has some shrinkage involved which will make it look pinched there. Of course he wouldn't commit to a firm answer, not having seen you, but he said that it was highly unlikely that a flap could be realistically done coming from the forehead. Too far and wouldn't get a good blood flow due to the length of a flap like that. Off the cheek would be his choice and he said that a flap from the cheek could be done with very little scaring. In fact he indicated that it probably would leave much less of a scar than one from the forehead. Basically he would, and again not having seen you, take it from an area going up beside your nose, pull the skin over to your nose to close that area. Since there's already a natural 'line or crease' beside a nose, the scar should hardly be noticeable. That's pretty much what I'd think makes sense, so consider carefully before committing to whatever you decide.

His nurse told me of a recent case he'd done where a ladies cheek had to be mostly removed and he did a flap from the neck area. She said that the results were wonderful with very little scar to show that anything had ever been done there. I may be a bit biased but I really think this doctor has to be one of the better reconstruction doctors anywhere. His website is www.drkriet.com if you'd like to take a look. As I've said before, a nicer man you'll never meet and his nurse, Becky White, she is what the definition of a nurse should be. Ok, I'm totally biased and when he asked if I'd like to come back for a checkup in a year, well you can guess what my answer was to that. Appointment is already made!

Well if you get the camera/picture thing figured out I'd sure like to see what your results look like so far. And of course, any questions, just fire away. I'll help until you say uncle...

Kent


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Two weeks after Mohs surgery

Hi Kent,
I am so glad your check up went well. Thank you for talking to the doctor for me. My doctor told me if the flap was done from my cheek it would leave a very big scar and that was why he said the head would be better because i could cover the scar with my bangs... One thing for sure is that I am going to get a 2nd opinion when this starts to heal a bit.

I am going to take pictures of this once a week to see the progress if any. i am taking these pictures with my phone camera and then sending them to my computer so they are not that great but it works. I attached some of them now for you to see. Going back to work was ok because I had it covered, but tomorrow I go back to the doctor and I know he is going to now tell me to keep it uncovered... so tomorrow is the day that I will get the looks from everyone. I am going to do a lot of praying and meditating tonight...

You can see the difference between week 1 and week 2, it is not as red as the first week.

I have to run but I will email you tomorrow and let you know what happen at the doctors.... Let me know what you think of the pictures please.
thank you always,
Lori

Hi Lori,
I don't think you're lip looks so bad, especially at this stage. Really it's better than I was expecting to see considering the location of it. Plus from looking at it and through my untrained eyes, I'd think a flap surgery won't require too big of a flap. Meaning less scaring if you do decide to do that. Keep me posted with pictures as this heals and I'll keep you informed of my opinion, and I'll try hard to keep in mind that what may be acceptable to me wouldn't necessarily be for you. I feel like I kinda know you by now so I want my judgment to reflect that.

How has work been? I think about you having to get out and around other people outside of your comfort zone, I know that's not easy. Most people are polite enough to not stare or ask questions. I would always act like there wasn't anything to be looking at when I'd be around people, the few that would stare really weren't people that mattered to me so it was fairly easy to shrug it off. And as I said before, it was only a few kids that would ask what had happened. I always rewarded their directness with a very kind and straightforward explanation. Mainly letting them know it was the result of being in the sun for so long without protection.

Have a GREAT WEEKEND,
Kent


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Mohs Surgery healing on the lip - Click here for page 3
Basal Cell on the lip - Click here for page 1