Mohs surgery and reconstruction: What timeline to expect?

@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
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!

You know what they say people with high foreheads are more intelligent. LOL. Good luck glad you r doing well.

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..

Thanks for the info.

Hello @keithl56 . I just had my elderly aunt to the surgeon for her Mohs procedure on her scalp on top of her head. It was quite superficial in the biopsy and we waited 3 months for an appointment for the surgery. It was removed in the first pass and instruction is to allow for granulation to heal this over the next 6-8 weeks. It is kept covered with antibiotic ointment and gauze and has been quite painless for her. With a 3 cm round area now open, there was no way to bring scalp edges together. At age 97, reconstructive surgery was not mentioned.
The scalp is a very vascular area so significant cautery was used to control bleeding. Granulation tissue is very vascular also so I am not concerned about blood supply for healing. Good luck to you.

You are very lucky. My lip and nose surgery done in Feb, is still looks quite obvious and feels "tight" and very hard. I can't exactly describe the sensation. Half of my lip is pulled down into my mouth. My nose runs all the time.
Now I think there is another cancer on the other side of my mouth, and for obvious reasons I am dreading yet another trip to the dermatologist. It never ends, as I have had numerous Moh's surgeries.

I just put in a long post about my scc's. the one on my hairline was a huge opening with long cuts so that it could be closed to heal smoothly. It always suprises me how relatively painless the recovery is compared to how it looks. My dermo MOHS surgeon at Mayo did an excellent job even though it required 6 passes to get it all. Took 3 months to close up enough for 20 radiation treatments. It was red for a few weeks and now almost a year later, not noticeable. My hairline is actually straighter than it was although my forehead a big higher. I'm pleased and thrilled at what was done.

Thanks! Besides scarring my other concern is that I'm concerned that it may affect my hairline based on the location of the cancer.

I had Mohs surgery on my cheek about two years ago.
I applied Scar Away daily for three months. My face really looks quite smooth now from the application.