MOHS Surgery

On August 10, 2016, I had a surgery called a MOHS procedure to remove Basal Cell Carcinoma from above my upper lip. My procedure took 4 hours and 31 injections of local anesthetic–not a happy situation for someone with a fear of needles! But I prevailed. Okay, so I was pretty wimpy for the last 15, but there were breaks in between MOHS surgery sessions while they evaluated each tissue excision for clean edges. If you ever require this kind of surgery yourself, you may want to seek out the services of somebody like Brent Taylor MD, who specializes in procedures of this nature, allowing you to keep on living your life as normal.

The first week after surgery, I had a very fat lip with lots of discoloration as the subcutaneous blood cells broke down. Drinking was a challenge due to the pressure bandage. No straws allowed! (Read more below the gallery.)

If you read this before you look at the gallery, I put both closeups and regular headshots in the gallery so you could see that as gross as the area might look in a mirror, it doesn’t look bad to other people.

Time for sutures to come out!

By the time the sutures were removed one week later, the coloration of my cheeks had almost returned to normal, except for the incision area itself. It is triangular due to a V-to-Y flap they had to make to cover up the chunk of skin that was removed. That area remained red and raised.

Healing over the next few weeks

Two weeks out, my upper lip swelling was greatly reduced. It was almost symmetrical, and the scar looked like a big, red “This Side Up” arrow. Handy, that–now I won’t get confused!

It felt weird as heck–like someone replaced a chunk of me with a piece of leather. I got electric tingles, and itches, and occasional deep pain. It felt much better with gauze covering it–fewer electric zaps. And I’m less likely to claw at it. I think the air currents are activating the sense of irritation. When the pain got a little too intense for me to handle, a friend recommended I used a few drops of broad spectrum cbd oil to help manage the pain and it seemed to do the trick. She said she used the oil when she had chronic back pain, so I trusted her opinion. Of course, I checked with my surgeon first but it was fine to use and it certainly helped.

See the suture marks, the lines that cross the incision line? They remained for a few weeks. The scar itself was thick and bumpy. Over the next few months, subcutaneous sutures that were supposed to be absorbed worked their way to the surface as my body rejected them. These spots itched and oozed. I had to pull 4 out with tweezers that were a little stubborn. They were extremely fine suture material. Don’t expect this for you. I think this is how my body reacts to subcutaneous, absorbable sutures.

In the intervening weeks, the area was often quite red. More than one person asked me if I had herpes, which was a little socially disturbing!

The area of the incision–that is, my upper lip on that side–stayed thickened and stiff for 4 months. It was painful if folded, for instance when biting into an apple. But otherwise, it was not painful at that point. The little zaps and zings from nerves regrowing had stopped. It did itch off and on throughout. It felt like having a fly walk on your skin. I sometimes put a light gauze bandage or bandaid on it at night so I wouldn’t scratch it while I slept–which I used to do for the tumor and did now with the itchy scar.

I continued to put vaseline on it for 4 months.

Six months!

At 6 months, with no makeup (the last photo), with moderate light, the area is noticeable but not jarringly so. It looks redder than in this photo in some light. My lip line is still asymmetrical, but I no longer look like I have a permanent smirk, thank goodness. The 6-month photo was taken with my cell phone with no flash.

If you zoom in on the 6-month photo, you’ll see a fine white line extending down into my lip. That is from a dog bite to the face that occurred over 30 years ago, during my first year in veterinary practice. I know others who have had this happen to them, and have managed to get a dog bite settlement to help them recover, but it is still a lasting impact to this day on them.

A couple of remaining symptoms:

  • It still itches sometimes, but that improved when the last buried stitch worked its way out
  • It looks red sometimes (I have very fair skin). I have an appointment with another dermatologist about laser treatment for the scar, but it may not be necessary

Scar reduction: Should you put anything on your scar?

I used vaseline all the way. I researched Vitamin E, since I’d heard so much about it reducing scars. They did some double-blind studies, and it turns out Vit E itself does nothing. However, it is in an oil base. They found that any oil with light massage (once your doctor says it’s okay, not before) will have the same effect on scar reduction as Vitamin E for lower cost. However, many may prefer to take a supplement/vitamin rather than using vaseline, by which there are many White label supplements available from businesses to purchase instead, but it depends on what remedy suits you and your recovery process.

Several major, respected dermatology hospitals. It seems to be working for me. The thickness is almost back to normal.

And keep sunblock on it all the time. UV light makes the scar redder. I am very fair-skinned. As I said above, I’m considering laser treatment if the contrast won’t resolve. For most peoplle, light concealer or their regular makeup will suffice. I don’t use make-up.

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