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Forum Category: Ask the Doctors, and Other Medical Related Topics
 Originator Date Posted 
   basil cell carcinoma  

11/3/2009 23:35
Posted By:  - VALLEJO, CA  
Date Posted: 11/3/2009 23:35
   16 months ago i felt a small nodule left of the tip of my nose.

shave biopsy came back negative, but my plastic surgeon told me at the time he was alarmed at how fast it was growing.

a second lump appeared on the right side of my nose, this time it was positive for BSC.

in total i have had three shave biopsies on each side. the right side was clear to the margin on the third biopsy.

the left side started coming back about 4 months or more ago filling in the divot from the first shave. my reg doc thought it was scar tissue. i didn't and got the second biopsy and then the third which had a small island of BSC.

reg doc sent me to the dermatologist who recommends mohs procedure with reconstruction. the doc referred to is a mohs factory- a beautiful building in the worst part of town imaginable. he doesn't normally even meet with patients prior to surgery and they have no photos of his work. he says surgery with dermabrasion followed by dog ear correction in two months followed by retin a or 5 FU.

today i went back to my plastic surgeon who has photo albums of his work on the tables to peruse when you walk in. i used to work with him and his work was stellar.

he did miss a basal cell while i was there, and it was extensive. so i know he is fallible.

my plastic surgeon says in no way do i need mohs. he says in 22 years he has never sent anyone for mohs and his partner didn't in 40 years.

three shaves on each side. plastic guy says he undertreats because 30% will die off on their own and he wants to minimize damage and scaring. he wants me to go to another dermatolgist for 5 FU if that is what they think and then reevaluate.

mohs guy says three strikes he is out, and 5 FU doesn't work on basal.

i am a nurse and am so completely confused. i feel like i am in a war of egos to a certain degree. i also don't want unnecessary surgery even by a self proclaimed expert.

if it was your daughter what would you have her do?

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