Squamous Cell Cancer Upper Lip and Philtrum

@moorjan3: There are various types of sutures, for instance vicryl, monocryl or fast-absorbing - although the latter are generally not used in the lip area due to a weaker hold. The type of suture is based on provider preference generally based upon past experience. However, it is true that most of the actual holding power in the former two lose their strength after the first month although the actual thread can take longer to completely disappear - hence, the longer "recovery" time for complete absorption. For some people, it may be a shorter duration and for others longer - though one may not even be aware of this process. My background is in nursing so I tend to look at it from that perspective and it's not meant to be confusing, apologies if it added to your distress!

Kenalog could certainly be a good option as it sounds like you're doing everything you can to ease the discomfort. What this corticosteroid could do if you don't relieve the discomfort is essentially target the collegen to break down scar formation that may be contributing to the problems you're reporting.

Can you report back next week as to your progress?

@grammato3
This week I saw both my MOHS surgeon and an ENT plastic surgeon. My discomfort level remains very high. My nostril is pulled on constantly and is irritated and swollen. My left philtrum is also irritated and rope-like as that is next to the straight line stitch that was done from my left nostril to the bottom of the upper left lip. I have asymmetry. My mouth pulls the left more so in movement. The left side of my lip will not move up and down with the right when I speak. Both Drs. really cannot offer any additional solutions other than giving more time. It has been 8 weeks today since my surgery date and I am really frustrated with the level of discomfort and my appearance. They say it can take 6 months to a year. I cannot think about tolerating my nostril being pulled on for a year and this level of discomfort. It is very hard emotionally and physically. I am not sure what else to do or where to turn to for some comfort and a solution to my issues. Is it common at 8 weeks to have all this tightness and pulling still. There are some concerns in using the Kenalog that it may cause atrophy and depression especially in this area philtrum and lip, so they held on that for now. What else can I do or seek out to try to get comfort.

@grammato3
This week I saw both my MOHS surgeon and an ENT plastic surgeon. My discomfort level remains very high. My nostril is pulled on constantly and is irritated and swollen. My left philtrum is also irritated and rope-like as that is next to the straight line stitch that was done from my left nostril to the bottom of the upper left lip. I have asymmetry. My mouth pulls the left more so in movement. The left side of my lip will not move up and down with the right when I speak. Both Drs. really cannot offer any additional solutions other than giving more time. It has been 8 weeks today since my surgery date and I am really frustrated with the level of discomfort and my appearance. They say it can take 6 months to a year. I cannot think about tolerating my nostril being pulled on for a year and this level of discomfort. It is very hard emotionally and physically. I am not sure what else to do or where to turn to for some comfort and a solution to my issues. Is it common at 8 weeks to have all this tightness and pulling still. There are some concerns in using the Kenalog that it may cause atrophy and depression especially in this area philtrum and lip, so they held on that for now. What else can I do or seek out to try to get comfort.

@moorjan3 You caught me right before I'm leaving on vacation but I wanted to second @gingerw's suggestion. I understand this is difficult for you as you're uncomfortable and your providers haven't been able to provide other concrete options at this time aside from waiting it out to allow for more healing to take place. The reason I suspect they're reluctant to do Kenalog in this area is the skin is already somewhat thin around the lip and Kenalog could cause existing fat cells to shrink, which could potentially make the situation worse before it has time to get better on it's own.

8 weeks seems like a long time when waiting for a post-op recovery, however, this is very much still in what is considered the early stages for many Mohs procedures. This may help to understand the evolving the process: https://www.mohscollege.org/for-patients/about-mohs-surgery/post-operative-care

When I was healing from my WLE on my face, I honestly thought I'd be scarred for life; I had lost sensation on that part of my cheek and I was terribly embarrassed. Within a year, I regained full sensation and people were telling me they couldn't tell I'd had any type of surgery. The day to day waiting is hard, I know. Can you circle the date on your calendar, say 8 months from now, as a target date to assess your improvement then?

@moorjan3 You caught me right before I'm leaving on vacation but I wanted to second @gingerw's suggestion. I understand this is difficult for you as you're uncomfortable and your providers haven't been able to provide other concrete options at this time aside from waiting it out to allow for more healing to take place. The reason I suspect they're reluctant to do Kenalog in this area is the skin is already somewhat thin around the lip and Kenalog could cause existing fat cells to shrink, which could potentially make the situation worse before it has time to get better on it's own.

8 weeks seems like a long time when waiting for a post-op recovery, however, this is very much still in what is considered the early stages for many Mohs procedures. This may help to understand the evolving the process: https://www.mohscollege.org/for-patients/about-mohs-surgery/post-operative-care

When I was healing from my WLE on my face, I honestly thought I'd be scarred for life; I had lost sensation on that part of my cheek and I was terribly embarrassed. Within a year, I regained full sensation and people were telling me they couldn't tell I'd had any type of surgery. The day to day waiting is hard, I know. Can you circle the date on your calendar, say 8 months from now, as a target date to assess your improvement then?

@moorjan3 My heart cringes just thinking about the discomfort you are facing. Often I have cuts or somewhat. One thing I have done over the years when there is an abrasion or scar in an awkward spot, that has keloids forming in scar material, is to do gentle massage often. It seems to break up the formation of the tightness. Using a vitamin E cream to help lubricate that area while doing the massage is helpful. My lower arms are a mess of scars in some very awkward spots. This has helped me. Do you think you could try this?
Ginger

@gingerw Yes thank you. I am doing the massaging now 3 times per day and hopefully that will help to break up the scar tissue. I can feel just the slightest improvement which is starting to give me some hope it will gradually soften but everyone has told me this takes a very long time. It does affect my ability to move my mouth which compounds the difficulty. Thank you again for your story and information.

@moorjan3 You caught me right before I'm leaving on vacation but I wanted to second @gingerw's suggestion. I understand this is difficult for you as you're uncomfortable and your providers haven't been able to provide other concrete options at this time aside from waiting it out to allow for more healing to take place. The reason I suspect they're reluctant to do Kenalog in this area is the skin is already somewhat thin around the lip and Kenalog could cause existing fat cells to shrink, which could potentially make the situation worse before it has time to get better on it's own.

8 weeks seems like a long time when waiting for a post-op recovery, however, this is very much still in what is considered the early stages for many Mohs procedures. This may help to understand the evolving the process: https://www.mohscollege.org/for-patients/about-mohs-surgery/post-operative-care

When I was healing from my WLE on my face, I honestly thought I'd be scarred for life; I had lost sensation on that part of my cheek and I was terribly embarrassed. Within a year, I regained full sensation and people were telling me they couldn't tell I'd had any type of surgery. The day to day waiting is hard, I know. Can you circle the date on your calendar, say 8 months from now, as a target date to assess your improvement then?

@grammato3 Hello. I saw in another post that you had the laser treatment on this scar on your cheek. Can you tell me what the laser therapy was exactly and how that was done. What reactions you had and what you experienced from that after the fact. My surgeon does plan to do the C02 laser in August. I am still having tightness and the burning sensation. It has slightly scaled down in intensity but still pulls everytime I move my mouth unfortanetly like a tightrope. Thank you.