A woman speaks to a medical professional, while in the background, the shadow of her face looms over both of them.

Never Say Never (Mohs Under My Nose)

I’ve had skin cancer for 25 years. In those 25 years, my treatments have included cryosurgery, “scrape and burn” surgery, laser surgery, and numerous excisional surgeries, but never Mohs surgery. The plastic surgeon who treated my skin cancer for 20 years until he retired, wasn’t a fan of Mohs surgery. I wasn’t a fan of Mohs surgery. I didn’t want Mohs surgery. I spent a lot of years saying I don’t want Mohs surgery. I never intended to have Mohs surgery.

Mohs surgery is a patient decision too

I’ve had a couple of dermatologists over the years. One of them was adamant that she would send me for Mohs. She didn’t want to discuss why I wasn’t keen on having Mohs. I’m a big fan of the patient being included in the treatment plan, but she wasn’t. She wasn’t my dermatologist for long.

Plastic surgery consult prior to Mohs surgery

My current dermatologist listens to my input, considers it, and tells me what she thinks is best for my situation. When I got an area just under my nose that didn’t respond to cryosurgery, she said we needed to biopsy it. And when the biopsy showed that it was infiltrating basal cell carcinoma, she said she recommended Mohs surgery. She knew of my aversion to Mohs, so we again talked about it. I told her I’d rather first consult with a plastic surgeon, so she referred me to one.

The journey to find the right Mohs surgeon

That plastic surgeon said he’d do the surgery, but his words and body language and actions let me know that he didn’t really want to. I realized I wasn’t comfortable with someone doing surgery on me (especially on my face) who didn’t appear comfortable or completely willing to do it.

My dermatologist then referred me to another plastic surgeon. I met with her, and I was comfortable with her, but she told me she wouldn’t do the surgery. She said because of its location and because of scar tissue in the area, it wasn’t a good candidate for excisional surgery. She told me she recommended that I have Mohs surgery. Of course, I told her I didn’t want Mohs surgery. We talked about why I didn’t want it, and she told me she would refer me to an excellent surgeon in Indianapolis (not the normal doctor known for Mohs in our area) and that he does incredible work.

Mohs surgery on your face deserves expertise

I met with the Mohs surgeon. I told him I didn’t want Mohs. And you know what? He listened to my reasons why. He agreed with me that not everyone who does Mohs is excellent at Mohs. He said there are more than a few “Mohs factories” around.

This doctor is fellowship-trained in Mohs. He explained what I could expect, he explained his stitching method to minimize permanent defects down the road, and he even helped ease my fears about the shots for anesthesia in that area. When I had the biopsy, those shots hurt worse than any other shot I’ve ever had. Most importantly, this doctor didn’t downplay any concerns I had. He didn’t make me feel like my worries were needless.

So here we go...an upcoming Mohs under my nose.

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