Basal Cell anyone? Very worried!

[njshep]

A month ago I had a basal cell nodule removed from the space between my eye and nose. It had been there for several years and was misdiagnosed.
I had an occuloplastic surgeon do the surgery. It was a tricky spot because of not much skin to work with and so the stitches were very tiight and stayed in two weeks.
My biopsy came back indicating it appeared the lesion was completely removed and the margins were negative.
I’m a bit worried because as the scar continues to heal there feel like a hard lump under an area of the insision line and the skin around the scar is lumpy looking if I look at it with a magnifying glass.
I have been very worried about this diagnosis and even more so thinking that maybe it’s growing back?
If anyone has had any similar surgery I’d truly appreciate any thoughts.

I had a bcc removed years ago and the surgeon had to go very deep to remove everything. The way he explained it to me was "imagine a 5 point star, what you have on the skin is the tip of one of the points. It appears small on surface but to get everything out, I need to go deep."

There are many nerves on your face, and when scar tissue builds up after a surgery it is quite normal to feel a lump. I was given pure rose hip oil to massage on the incision spot to prevent scar tissue and a neat scar. I reckon it wouldn't be easy to massage your incision and you need to be careful to avoid oil going into your eye but I would give it a go.

Chloramphenicol eye ointment (not drops) is magic for helping fade scars.

I’d get it checked again. I’m about to have mine operated on for the fourth time because it keeps coming back .

Hi op, I had a bcc in corner of eye close to tear duct diagnosed a few months ago, had a biopsy that removed the lump, and was given the option of further surgery or wait and see.
I went to a plastic surgeon to discuss options and one was quite a large skin graft, the other was a cut between the eyebrows to pull skin over to cover the piece that they remove. Both options sounded pretty drastic to me, I was told the chance of the chance returning was 20%.
Does this sound similar to your experience of diagnosis? I’ve been searching the site for this topic for some time as I’ve been desperate for someone who’s been through this to discuss it with.

@curlyfries, what did you opt to go with? Mine sounds in a similar place. I’m having Mohs surgery next month as mine appears to be a persistent little bugger. The first two surgeries were very neat and not at all noticeable but I’m a little worried now that the surgeon is going to run out of skin to use .

@stitchingmoss, (not sure how to make user name bold!) I haven’t decided what to do yet, the consultation with the plastic surgeon frightened me to death to be honest, it sounded like I would be left with either a skin graft (which might be a different colour 😮) the size of a 5p, or a scar between eyebrows, and I would imagine some distortion as the surgeon would be pulling skin over toward my eye. When she then said under local anaesthetic I really panicked as I can’t imagine being awake while someone is operating close to my eye - At the moment I’ve just got a tiny indentation where the biopsy was taken.
Can I ask how long the bcc took to return? I had the lump removed around four months ago.

Did you not have a local anaesthetic first time? I had it removed in 2015, then done again in 2016 and now again in 2019! It’s a stubborn one!

I have my consultation next month in London so I’ll find out more then.

It is a horrible procedure but doing nothing isn’t an option apparently .

I've had three over the last 18 months, my forehead, my cheek and my nose. The first two were cut it out and stitch it up but the one on my nose was more complicated. It was a mohs procedure. I went in for the first round at 9am, they tested it and I went back in at 11am for the second round, they tested it and I went back in for the third round at 1pm and when they tested it was clear so that was good. By then though there wasn't much left of the side of my nose and I had to have a skin graft taken from another part of my nose and a piece of cartilege cut out from my ear and stitched on to make up the shape of the side of my nose. Just waiting for the scars to be less noticeable now and hopng it doesn't come back.

I’m the OP.
Yes, mine was very close to tear duct. I had an eye surgeon do the job. They usually do flaps and folds but he said he wasn’t going to. Straight incision line from corner of eye to bridge of nose which is barely noticeable. It was tight for a few weeks but has stretched out. My nodule was about 3mm and they took out a 10mm chunk.
I’m just concerned I have a little ball underneath the skin and terrified it already grew back??

@doeswhatitsaysonthetin, that sounds awful . Is that fairly standard for Mohs or were you really unlucky?

I also had a long and rather gruelling Mohs day (forehead/temple in my case) - three rounds and I was the last person still there when all the other patients had gone home. I now, 3.5 years on, have quite a sizeable new bump right next to the scar but GP says it’s “nothing sinister” and won’t refer me.

Go and get it checked - it's the only way you'll get an answer that will be accurate.
FWIW, my DBRO had a very complex cancer (basal cell plus two others) removed from the side of his nose last year and it's fine now.
I hope its the same for you.

I’m shocked of the descriptions of the Mohs procedure - I’ve had two consultations now and neither mentioned taking away layers until they get a clear sample, I thought it was just cut away a piece, and stitch up - that sounded bad enough to me! @stitchingmoss, yes local anaesthetic for my biopsy when they first diagnosed, they just scooped a little piece away and cauterised the wound, it was hard to try and keep my eye shut and that probably didn’t take that long.

I think the Mohs procedure is only required for persistent ones? I just had it excised first time, so simple cut and stitch, but then it came back .

The whole point of Mohs is that each sample gets checked in the path lab while you wait and you don't leave the building until they are satisfied that margins are clear. In my hospital that meant spending most of the day in a waiting room watching daytime TV with fellow patients going through the same thing; every so often a name would be called and the person would either be told they could go home or they needed another round of Mohs. By the time the cleaners arrived in the early evening I was the only one still there!

StitchingMoss yes Mohs is indicated for recurrent BCC or BCC which is of elevated risk for other reasons (due to e.g. subtype or location). It consumes a lot of resources (given the need for histopathologists to be on hand to deal with each sample immediately) so as I understand it the system is struggling to meet demand/need. It may well be that there are patients who ought really to have Mohs rather than simple excision but for whom it is not available, but I don't know for sure.

The diagnosis has made me really worry about being out in the sun, I’ve worn high factor protection for many years but as a teenager in the late 70s early 80s we didn’t use sun cream, and used sun beds regularly. When I went for my initial consultation the first thing the doctor said was “are you a sun worshiper”. This surprised me as I haven’t had a sun tan for many years.
I thought it was an unusual place to have the cancer, as right in the corner of my eye where sun would find it difficult to reach, especially with sunglasses on.
I’m even thinking should I avoid going abroad now, does anyone else worry about this 🙁

StitchingMoss The mohs procedure I had was a standard one and it was successful because after the three attempts all the BCC had been removed and it's good to be told that on the day and not have to wait days or weeks for results. I was unlucky because my nose had to be reconstructed, that was due to where it was and how deep it had gone. I really hope it doesn't come back, I wouldn't want to go through it again.

Actually, the nose/eye area is the most common place for these things to occur. I didn’t sun tan either but it’s from damage decades ago. I’m 45 and didn’t expect this but it is non invasive. Actually, many people have this and have no idea that it is what it is.