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Mohs surgery and reconstruction: What timeline to expect?

Cancer | Last Active: 14 hours ago | Replies (23)

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@tamaras

Hello I had squamous cancer on my bottom lip, which was cut out back in 2007. I lost pretty much my whole lower lip and a portion below my lip too. They did a graf and flap to help with movement and actually they put too much tissue in the place where they removed my lip and it's real puffy. Almost looks like I'm chewing tobacco. Embarrassing and deformed since then. I was always told there wasn't anything they could do because they now refer to it as being cosmetic. I guess that means I would have to pay out of pocket to try to look more normal.. such a terrible thing to be told. I live my life indoors or looking down all the time. Not how anyone should be. Recently someone asked how come insurance will pay for a woman to have breast implants after she had hers removed due to cancer. I was shocked. I feel our faces is the first thing that everyone sees so I would think our faces would be covered..

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Replies to "Hello I had squamous cancer on my bottom lip, which was cut out back in 2007...."

@tamaras
I am horrified after reading your post and am so sorry you had to go thru such an experience.
The surgery was I'm sure, painful enough, but then to be denied cosmetic surgery to fix your lip cosmetically. is an insult. It seems that your surgeon would be more than willing to try and repair your lip and chin. Could you see another surgeon, or have you already tried?
My lip is not as severe as yours, it is my upper lip. The scar runs from right beneath my nostril to inside my lip. This was done in Feb. and it still hurts & looks bad, it is very tight & "pulls". I am very aware of it all the time. I have other scars on my face from 2 other Moh's surgeries, but they aren't as prominent.
Keep in touch & be strong!

@tamaras

Welcome to Mayo Connect.

It is a shame that the surgeon was not willing to work with you on reconstruction. Cosmetic enhancements to improve appearance typically are not covered, whereas reconstructive surgeries to restore function and normal appearance may be covered. Establishing medical necessity plays a key role in obtaining coverage after Mohs surgery.

Your comment on breast reconstruction is correct. There was a law past in 1998, the Women's Health and Cancer Rights Act (WHCRA) that requires insurance companies that cover mastectomy to also pay for breast reconstruction surgery after mastectomy.

If you find a surgeon who considers it medically necessary to restore it may be covered.

Have you contacted your insurance company to ask about coverage?

@tamaras, it is incredible how much a significant change to the face can affect one's sense of self and limit social interactions. I'm sure this is affecting your mental health too.

You may wish to join this discusion:
- Scheduled for a Vermilionectomy for premalignant lip tissue https://connect.mayoclinic.org/discussion/scheduled-for-a-vermillionectomy/

I might recommend finding out more about reconstructive options. Some reconstructive, "cosmetic" surgery is considered a part of treatment and not elective. Keep asking questions. This is your health. Your life.