Mohs Surgery and Forehead Flap Nose Reconstruction





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Published on Jan 21, 2011

This video is intended to help others who may be going through this process of Moh's skin cancer removal and the forehead flap nose reconstruction. I was unable to find much information about it before I underwent this procedure so here is my experience.
I had been to 3 doctors who told me the sore on my nose was not cancer so the area of my nose that was affected was significantly larger than it would have been if treated sooner.
The first step was removing the cancer. I went to Dr. Ammonette in Memphis, TN. This was done in his office with a local anesthetic. I have to tell you that the most painful part of this whole ordeal was the novicain injections. They about put me on the roof, but after that, no pain at all. What they do is take the area that is the doctor's best estimate of the area with cancer. They biopsy that tissue and see where they need to take additional tissue. That process is repeated until the biopsy is clear. This helps them take the minimal amount of tissue.
I was sent home that day with just a bandage over my nose. It did not hurt. It looked awful but I took a shower and cleaned it out very well and headed to my surgeon for the reconstruction the next morning.
The reconstruction was done by Dr. William Young of the Otolaryngology and Facial Surgery Center located in Jonesboro, AR. They have a wonderful staff by the way.
The surgery was done under general anesthesia so I can't tell you anything about that part but I really don't remember anything until very late that afternoon. What they did was to take a section of my forehead, (leaving it attached at an artery by my eyebrow for blood supply) and bent it down over the area where the cancer was removed and stitched it down. There was a hard and nasty smelling bandage on it for only a couple of days. I was very glad to be rid of that. The incisions were easy to clean by taking q-tips and soaking them in peroxide and gently scrubbing. Don't worry. It doesn't hurt.
One the bandage was off and I saw the "trunk" it was a bit shocking. I found that the best way to keep it clean was to either go to the kitchen sink hose sprayer and really hose it down or a removable shower head works well too when you're in the shower. This trunk seeps and oozes a lot so it's important to keep it clean. The sprayer allows you to get the back of it real well. Keep it moist with the Toposporin (not neosporin).
The next step was to have the stitches removed from my nose and forehead. It was a relief because they were becoming itchy and irritated.
This period between the removing the stitches and removing the "trunk" seemed to take forever. Over time, the trunk began to shrink and ache a bit. It obstructed the vision over my left eye and was overall annoying.
The next step is removing the "trunk". This was done under a twilight anesthesia so I do recall some of it. During this process, Dr. Young also did what he called "de-bulking" on my nose. He opened up one side of the new nose area and cut away some of the underlying flesh underneath the skin. Everything was stitched back up and sent me on my way. I was very concerned that the new flesh was so blue, but it turned out to be normal. From there on it was just a matter of keeping it clean, having the stitches removed and waiting for the healing. I have just gone in for my 6-week followup and all is going according to plan.
I just want you to know that there is light at the end of the tunnel and so keep a positive attitude, all will turn out fine.
A special thank-you to Dr. Young and his staff for taking the time to develop these skills. When you look at what they started out with, the fact that I have a nose at all is truly amazing.

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