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Scheduled for a Vermilionectomy for premalignant lip tissue

Posted by mizlynnie @mizlynnie, Dec 17, 2022

Scheduled for a Vermillionectomy in mid Jan 2023 to remove premalignant lower lip tissue.
Maybe someone with experience can share tips for healing / recovery?

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new1 | @new1 | Apr 19, 2023
In reply to @mizlynnie "Hi there, Sorry that you're having lip problems. It's disconcerting and worrying when you don't know..." + (show)
@mizlynnie

Hi there,
Sorry that you're having lip problems. It's disconcerting and worrying when you don't know the cause.
My dermatologist said I had severe actinic cheilitis. (I would hope yours could recognize that condition).
I don't know what type of laser the dermatologist used on me. It wasn't too bad and only a 45 minute procedure. Healing took about three weeks.
Prior to that, the biopsy was performed by an oral surgeon under local anesthesia. Using a scalpel, he cut out a chunk of flesh. He put in a few stitches which were painless. It also took about three weeks to heal. The biopsy scar is jagged but hardly noticeable.
Unfortunately for me, at the site of the lip lesion, the skin inside the mouth is now ulcerated. Oh well. This will be my new challenge.
Sending best wishes your way for some good treatment options and a healthy outcome.
Best Wishes

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Thank u for taking the time to respond to my questions.
Did the biopsy cause any nerve damage and/or a lip
that droops on one side?
Approximately how big and how deep was
the area that was biopsies?
If u have time please let me know.

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2 replies
di341 | @di341 | Apr 19, 2023
In reply to @colleenyoung "@di341, apologies for the late reply. I'm tagging @marshaj and @mizlynnie join me in welcoming you...." + (show)
@colleenyoung

@di341, apologies for the late reply. I'm tagging @marshaj and @mizlynnie join me in welcoming you.

Di, what treatment, if any, is being recommended for you at this point?

Marsha and Lynn, any updates?

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Nothing but the Flurouracil at the moment.

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mizlynnie | @mizlynnie | Apr 19, 2023
In reply to @new1 "Thank u for taking the time to respond to my questions. Did the biopsy cause any..." + (show)
@new1

Thank u for taking the time to respond to my questions.
Did the biopsy cause any nerve damage and/or a lip
that droops on one side?
Approximately how big and how deep was
the area that was biopsies?
If u have time please let me know.

Jump to this post

Just a gentle reminder -- everyone is different, but below you will see a picture of the biospy site. I would guesstimate the incision was about 1-2 cm long, and as mentioned, a little ragged. Depth?? No nerve damage, no droopy lip. You can barely notice it now.
If asked, I would recommend a visit to a second dermatologist to see if you have actinic cheilitis, then go from there.
Hoping you find a speedy solution.
Blessings.
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new1 | @new1 | Apr 19, 2023
In reply to @mabfp3 "I am scheduled to have a biopsy of my lip on May 1st. Over the years,..." + (show)
@mabfp3

I am scheduled to have a biopsy of my lip on May 1st. Over the years, I have had many basal cell and squamous cells removed from other areas of my body. They think this also may be a squamous cell on my lower lip. From all that I have read about this online, it doesn’t sound good. I am hoping that they don’t have to remove a lot of my bottom lip if it comes back positive. It is very sore and looks like there are several of these small “cysts” but the main cyst is in the middle of my lip . If anyone has had something like this, I would so appreciate any information that you could give me! I’m very worried about it. Thank you in advance. MaryAnn from MA

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What kind of doctor will
be preforming the biopsy ?

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1 reply
di341 | @di341 | Apr 19, 2023
In reply to @new1 "Did the biosy leave a scar and how long to heal? Was the biopsy done with..." + (show)
@new1

Did the biosy leave a scar
and how long to heal?
Was the biopsy done with a needle or a scalpel.
If it was a scalpel how much did they cut off?
I am dealing with small sores on my lip that don't seem to heal.
Anything u can tell me would be appreciated.
Thanks

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I can see the slightest “divot” in the lip but no one else sees it unless I point it out. It was a shave type biopsy with a scalpel. No big deal. My lower lip hasn’t been “right” for years. I have tried every lip product and mask on the market without success. Dermatologist froze it 4 times but it never healed properly, hence the chemo cream.

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mabfp3 | @mabfp3 | Apr 19, 2023
In reply to @new1 "What kind of doctor will be preforming the biopsy ?" + (show)
@new1

What kind of doctor will
be preforming the biopsy ?

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A dermatologist.

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mabfp3 | @mabfp3 | Apr 20, 2023
In reply to @colleenyoung "Welcome, @mizlynnie. From what I have read, vermilionectomy is effective for treatment of actinic cheilitis (AC)..." + (show)
@colleenyoung

Welcome, @mizlynnie. From what I have read, vermilionectomy is effective for treatment of actinic cheilitis (AC) and squamous cell carcinoma (SCC) of the lower lip. Wounds produced by cryosurgery and laser therapy heal within a period of 7–14 days, while it takes two to four months for those caused by vermilionectomy. After the healing process, many patients experience good cosmetic results." Read more here: https://www.news-medical.net/health/Actinic-Cheilitis-Prognosis-and-Mouth-Cancer.aspx

I added your question to the Head & Neck Cancer group as well in the hopes that other members may have personal experiences to share. Lynn, do you know is the premalignant tissue is a pre-cursor to squamous cell carcinoma? I'm glad this was found in the pre-cancerous stage.

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Hi Colleen, Thank you so much for this article! Very informative! MaryAnn from MA

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mabfp3 | @mabfp3 | Apr 23, 2023
In reply to @marshaj "I’m sorry that you’re having to go through all of this & that your procedure was..." + (show)
@marshaj

I’m sorry that you’re having to go through all of this & that your procedure was halted. Maybe it truly was a blessing in disguise. I am like you, in that I know this problem has to be dealt with and with the best treatment.
I hope you can get the lesion on your tongue evaluated.
My lip has diffuse areas of sun damage. I was a lifeguard for many years & we have lived in Florida for 31 years. I have fair skin.
My nephew is a plastic surgeon in NC & told me that Actinic Cheilitis, which is Actinic Keratosis on the lip is challenging to treat. They start with a chemotherapeutic (Fluorocil lip balm in my case), then if that doesn’t work, go to other options. Being a surgeon, he said the “complete shave” of the lower lip has high success rates. He also said that the lips respond well & cosmetic results are good.
I know I’m getting ahead, but he said a biopsy is important to know what I’m dealing with. The main area is right in the middle of my lip where it looks like I bit my lip, but some of my other lip is still inflamed after the chemotherapeutic treatment.
The dermatologist told me to go on a trip that I’ve had planned for quite some time, so I’m going to try to enjoy it & worry about the biopsy when I return.
My lower lip feels dry & chapped all the time & I use Aquaphor & Vaseline to soothe.
I think I have 3 of the 6 usual signs/symptoms for lip cancer:
1. A sore that doesn’t heal
2. Pain in the lip
3. Red patches on the lip
I’m glad there is an oral cancer support group. Being around other people who are going through the same thing can be beneficial to our mental, emotional & spiritual health.

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Hello Marshaj,
I just came across your post and it sounds so similar to my situation. I was a lifeguard here in Massachusetts for eight summers and I have fair skin. I am now in my early 70’s and have had so many basal cells and squamous cells removed from my body, usually using the MOHS technique. Like you,, I started noticing these patchy scales on my bottom lip about a month ago. (For years, my lips always feel chapped, so I didn’t think much of it.). About three weeks ago, I noticed these two or three lesions on my lip. I couldn’t get my dr so I was seen by an NP. She told me that she thought that they were squamous cells and to come back in a week and she would do a biopsy. In the meantime, I was very fortunate to get an appointment with the dermatology dept at Mass General Hospital for May 1st. My lip is so, so sore……a burning feeling…….and like you, I have been using. Vaseline and Aquaphor just to soothe the soreness. I would rather be seen by a doctor for this case in a Boston Hospital, where they have “seen it all”. I have read about that lower lip removal, followed up with cosmetic surgery, and I can’t even believe that this is happening to me. My biggest fear is that this lip cancer has not spread into any lymph nodes in my neck! Glad that you went on a trip and hoping that by now, things have resolved for you. Your case sounds exactly like mine. I hope that you made out well. MaryAnn in MA

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dtidmore | @dtidmore | Apr 24, 2023
In reply to @new1 "Thank u for taking the time to respond to my questions. Did the biopsy cause any..." + (show)
@new1

Thank u for taking the time to respond to my questions.
Did the biopsy cause any nerve damage and/or a lip
that droops on one side?
Approximately how big and how deep was
the area that was biopsies?
If u have time please let me know.

Jump to this post

I have been dealing with a place on my lower lip that was like chapped lips but would never clear up no matter what I tried. It never looked bad but at the same time it remained chapped constantly. I had an appt with my dermatologist who looked at it and couple of other spots that he said were just typical keratosis, but he was concerned about the lip, so he recommended they do a shave biopsy of the entire area and send it off. The injections before the biopsy were the worst! Much worse than any dental numbing I have ever experienced, but by the fourth injection my lip was starting to numb and I did not feel the last 4 injections thankfully. The actual biopsy was a cake wake as the area was totally numb. He told me to keep Vasoline (I used Minerin) on the wound. It healed over and was totally normal looking within about 10 days. I had NO discomfort other than the injections to numb the area.
The biopsy results unfortunately indicate a bowenoid actinic keratosis (early stage squamous cell carcinoma). This will result in a referral to UTSW here in Dallas as they are the experts on dealing with this as well as the reconstruction surgery. Not looking forward to this.

david

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