Is it necessary to remove basal cell via Mohs? What are alternatives?

I had basal cell on my lower eyelid and had Moh's followed by plastic surgeon's reconstruction.

I am not sure what choice you have and the longer you wait, it becomes more disfiguring. If you get a good plastic surgeon they should be able to restore your nose the way it has always looked.

How big is the basal cell? Did they tell you your appearance would be altered? Were they making a bigger deal of this when it is just a disclaimer they need to make?

Might be a disclaimer but said my nose would look different...which is bothersome. Basal is at very tip of nose which is most difficult repair. Not sure what to do.

If you are healthy at your age Mohs is considered the best treatment.
There is less chance of incomplete removal and recurrence.
Radiation therapy is another option with good cure rate and healing.
Skilled experienced Mohs surgeons often work on this area more frequently
than plastic surgeons. Discuss with your doctor their Mohs training and
methods of repair they have used. Head and neck skin cancers are the most
often approached with Mohs. At 75 I had what looked like a small “easy”
basal and needed 3 layers. Fortunately can’t see the scar after a year.

I had BCC on my right temple and it was removed by Mohs and a very experienced Moh’s surgeon. I healed fine, but suspect I had some nerve involvement. Not positive yet. Problem could have come from dental surgery too. My lesion was small, but the hole left looked huge before he closed it! Fortunately, it healed well and there is no visible scar.

My great aunt got radiation for cancer on her cheek. I’m not sure which kind and it was ok. She lived well into her 80s even with T1 diabetes for over 60 years.

@cdeldeo Welcome to Mayo Clinic Connect!

I just had basal cell skin cancer removed from my nose crease right next to my left nostril. Truly an awkward spot! I had them take pictures with my cell phone while it was still open and before they sutured everything. Glutton for punishment, right!? They used a MOHS procedure, and the idea was to retain as much of the cartilage as possible.

It is my opinion I would rather have a somewhat misshapen appearing nose than skin cancer. Last year they removed part of my left eyebrow for a MOHS procedure on a squamous cell carcinoma, and back in 2012 there was a big divot taken out of my forehead for an aggressive squamous cell carcinoma; there were nerves cut and only one side can be raised in the classic "mommy look". I've earned every scar and gray hair! At age 70, it's not a big deal to me.

What are your reservations to having MOHS surgery?
Ginger

@cdeldeo , Is it a bummer that all of us will tell you having and getting skin cancer treatments.

I have had MOHS surgery a dozen times now and one of those was on nose. Dermatologist will (or should) tell you that MOHS is done to keep as much tissue as possible but ensuring all the cancer is removed. It is very precise and after removal of cancer tissue the tissue goes to pathology where they determine if all cancer cells have been removed. If not then more is taken but it is even more precise now on what needs to be done.

The surgery on my nose was on the side. It did take a long time to heal. But you cannot tell I had surgery there. I had this done at Mayo Jacksonville. They have limited MOHS surgeons as it is such a precise surgery and training needed for it.

You will see, and the monitor can advise, there are many many treatments you can have other than MOHS. But you will see that MOHS is recommended a lot because it is done in one setting and you stay until the cancer is gone. My dermatologist always asked what I want to do and gives me the list. I always pick MOHS and she concurs saying treatment can be done in one setting and you do not leave until the cancer is gone.

I have probably had a dozen basal cell and squamous cell surgically removed. Grew up in Florida where getting a sun burn over the weekends was a sign of how much fun you got. Then later in life playing tennis in the sun without a shirt on. Paying for these mistakes now. Good luck on your decision and hope this was helpful.

I had a skilled Moh's surgeon and a very skilled plastic surgeon all in one day. My cancer was removed in one layer. Moh's intends to take the least amount of tissue that is effective in removing cancer cells. I wasn't aware of any other choice given that my lesion was on my lower eyelid. They cut a large square of skin out, which looked disfiguring, but the plastic surgeon restored normalcy (though eyelashes are backwards on the bottom!).

I had MOHS surgery 3 places on my face 4 years ago and none has returned. The worst was my nose all over it. It took 3 or 4 layers to get it all but my surgeon after a few weeks took a piece of skin from my face near my ear and did a skin graft to close the wound. No my nose does does not look like it did before but I would likely look worse if the cancer had continued to spread. Another spot on my upper lip and one on my forehead look fine. As my daughter says there are worse things than a few scars at age 77. I am thankful for MOHS surgery. Best wishes on your treatment whatever you choose.

I have had MOHS surgery twice near the tip of the nose. It all worked out well.

I had MOHS surgery on hand and got Staphylococcus.