If you're about to have a Mohs procedure, let me help you get prepared. I'm sharing my Mohs surgery pictures so you'll have a better idea of how it will go. I cried. And you might, too. And that's perfectly ok.
When I had to have a basal cell carcinoma removed in 2013, I was stunned.
Growing up in Southern California, I spent a lot of time in the sun. But I never expected that I would have to worry about skin cancer.
"So...I had skin cancer. I had surgery. I'm totally fine. I just wanted you to know because we are having dinner in a few days and I didn't want you to freak out when you see a huge wound on my neck." That is how my phone conversation went with a really good friend after my Mohs surgery.
Because although the doctor told me what would happen, you truly don't understand what the recovery will look like. But I want to help you plan ahead.
Basal Cell Carcinoma on my Neck
This post is about my experience with basal cell carcinoma skin cancer and how I had it removed with Mohs surgery.
And it's also about how I became depressed. I want to share my story in case you know anyone who has one of the "better" skin cancers, like basal cell, or you have it yourself.
It is ok to be scared. Even though a lot of people will not give it a second thought, it is ok to feel uneasy about it.
WARNING: I share photos with my stitches. If you are squeamish, you may want to skip it. I mean, it's not all that grotesque but I want to give a fair warning.
Discovering the Basal Cell
My dad had been dealing with his own skin cancer issues for the last few years. I take after his light complexion so I thought it couldn't hurt to get a doctor's opinion.
I had a little red mark, that had been on my neck for about two months (effing eczema, I thought). I was referred to a dermatologist and I'm so grateful I was. My primary care doctor wasn't worried about the red mark, but it turned out to be basal cell cancer.
If you think something is wrong but your doctor isn't listening, for sure get a second opinion!
Dealing with Skin Cancer
Most often you will have a biopsy done of the trouble spot. Typically they quickly numb up the area surrounding what they want to biopsy and they will slice off the whole mole or spot or a portion of it.
They send it off to the lab and in about a week, you'll get a phone call following up. Often they will also send a letter in the mail letting you know about the mole and what the findings were.
Most of mine are irregular but not cancerous. I've had Mohs done once because of basal cell. But I've had excision biopsies 4 times (I'll explain that in a moment).
On this particular visit, my dermatologist said "If I call you, don't freak out. It doesn't necessarily mean something is wrong." But then when the call came, he said, "You know if I'm calling, something isn't right..." Geez.
That was my neck. And it was basal cell.
It was decided that Mohs was the best way to deal with the basal cell and the appointment was scheduled.
He explained that because of where it was (in a very visible spot on my neck), he would refer me to another dermatologist who specializes in plastic surgery who would do a procedure to remove all the skin cancer cells.
I didn't know until right before the surgery that it would be Mohs Surgery, the same that my dad had a few months before.
So leading up to it, I just thought it would be pretty similar to the mole removals I had done so far, which required a small bandage for about a week.
To be fair, I do remember my dermatologist telling me that I may end up with a few stitches but I've never had stitches, aside from child-birth (hey if I'm sharing, I'm sharing everything) so even a few stitches seemed insignificant.
I didn't really know how to feel about the news. I was kind of scared but most people I talked to were not that worried. I went out to dinner the night that I found out about my basal cell diagnosis.
One close friend said, "yeah I had that, they just take it off, right?" And we moved on.
Several of the moms from my son's elementary school have had basal cell carcinomas and they seemed totally low key about the whole situation. And knowing that my dad had the surgery, that it was "no big deal" and was pretty common left me feeling, well, it left me not feeling.
I never really thought about it. So I didn't make any special phone calls to friends with news of my skin cancer. I didn't need any extra support.
What is Mohs Surgery?
Here is my, probably very wrong, description of what Mohs Surgery is. First they remove the area that they believe to contain the cancer cells.
There is a pathologist right on site who evaluates the cells and determines if they need to go back and take more tissue. They do this as many times as they need to in order to remove all cancer cells and get a clear margin around the area.
So the Tuesday before Thanksgiving, my husband took the day off of work and went with me to the most gorgeous dermatologists office ever in Newport Beach, CA.
I have not seen any bills from this procedure yet and I will probably have to sell everything I own to pay it but at that moment, I needed all the amenities they provided (update: the bills were reasonable and I don't believe I paid anything over what insurance would normally cover! A DREAM COME TRUE!).
The most amazing front desk gal had called a few days before and explained that I should plan on being there the whole day. Up to this point, I really thought I would be in and out.
I asked my mom, who would watch the kids during the procedure, if she would just keep them overnight since I had no idea when I would get home.
The office smelled like a spa. The music was relaxing and everyone was beyond friendly. But I was starting to get pretty darn nervous.
My father's Mohs Surgery experience was much different from mine. I was given my own private room with space for my husband to work and a TV to watch. The entire procedure would be done in this room and the doctor would come to me.
I was free to get comfy and enjoy the time there as much as possible. And I totally did at first!
My dad's surgery, on the other hand, was done similar to how a lab is set up. The patient is called back in to a room, cuts are made, and then they are sent back out to the waiting room with everyone else.
That part alone would have probably done me in. But I do hear that is how most people experience it. I think I was super lucky to have found such an amazing doctor.
Basal Cell Carcinoma Before and After Pictures
To start, they marked and measured me. The red area in the circle is the basal cell carcinoma. Not that big of an area, or so I thought. Remember the front office gal I mentioned?
Well, she was like the best hostess ever. She brought me coffee. And teased me with treats she would be bringing around later. It was nice to spend some time with my husband. It was all very relaxed and enjoyable.
My husband and I, still in good spirits, took joke pictures to send to his mom. He doesn't do well in medical situations so we thought this photo, of him pretending to have passed out, seemed appropriate.
The dermatologist did round one. They laid me back, numbed me up and made an incision. It took just a few minutes. It wasn't awesome, but it was manageable. They removed some cells and took them to their onsite lab to evaluate.
Just a little bit of cotton and tape were put over the incision while we waited to see what would happen next. We were told results would take about an hour so we just had to relax and wait.
Sweet, sweet lady. First my husband and I were brought warm cinnamon swirl bread from the front office gal. Then an hour later she came by with these abelskivers from Trader Joes! I loved this place! They really did their best to make you comfortable.
The doctor came in and said they needed to take more cells. For the second round they needed to do some cauterizing. I'm not going to explain it. It's necissary but gross. But it made everything a little more real. Like, hold up, this isn't just a little cut anymore.
They ended up going in to take more cells a third time before I was finally told they got all the area they needed. As it was now lunchtime, we were brought delicious sandwiches! I made a joke about when the masseuse would show up and was very seriously told 4:30pm!
But I wouldn't be there that long. At this point, I just needed to be stitched up. So while the original red mark appeared to be very small, the cancer was actually much larger below the surface.
I was pretty ready to go home at this point. I had been sitting all day in the same chair.
The nurse laid me back and began prepping me for stitches. I got REAL nervous. The doctor explained that I would be getting two rows of stitches, one inside that would dissolve on its own, and one outside that I would have to get removed a week later.
When the doctor started stitching, I totally lost it. I started crying and they were so confused.
I was not in any pain but I think the magnitude of the procedure finally hit me and I was choosing to deal with all the emotion that I had repressed during the stitches.
I just couldn't stop. I was a hot and sweaty mess. And then I saw how many stitches I had. Wait, what? From that small red mark?
I was given care instructions - keep that first dressing on for 48 hours without getting it wet, then change the dressing twice a day for a week. Wait, what? I couldn't take a shower for 2 days? That would mean I'd be a few days unshowered for Thanksgiving...
That wasn't in the plan! I had to come back in a week for stitches to be removed? I couldn't exercise for a month? Well, that one I was totally on board with but everything else, a total shock.
They didn't give me any pain medicine and said I should only need a Tylenol. That first dressing was so big that I had trouble turning my head. The tape pulled like crazy and I was really uncomfortable. We got out of the doctor's office around 2:30pm.
And headed straight to Toys R Us. Wait, what? Yup. Since I had no idea how invasive the procedure was, my plan was to head straight to the toy store to pick up a Christmas gift for my son that was starting to sell out.
My husband drove me. I think at that point he would have done anything to make sure I didn't start crying again. In hindsight, I don't think going to Toys R Us was the best decision I've ever made.
I got the toy and some other shopping done, but I was uncomfortable, exhausted, cranky and needed to be cozy in bed.
Because of the stitches from Mohs surgery, I couldn't pick up my boys or lift anything heavy. I had not prepared for that. I hadn't stocked up on food at the grocery store in preparation.
I hadn't planned ahead for anything because in my head it wasn't going to be a big deal (which is also how all the doctors treated it). This was the picture we sent the boys that first night. I didn't want them to freak out or worry so I put on a happy face.
But I really felt more like this. I couldn't sleep on my side because the tape pulled so much. It was hard to get out of bed without my neck muscles pulling.
I rolled into Thanksgiving dinner with no makeup on and 2 day old dirty hair (which I don't do - it is NOT cute on me). I put clothes on but I would have much rather stayed in my pajamas.
That night I could take the dressing off for the first time and finally got my shower. I broke down again when I saw the stitches. I just wasn't prepared. For any of this. The next day I was in a good deal of pain (mostly achey) and managed it with over the counter meds.
WARNING: AFTER PICTURE OF MOHS SURGERY STITCHES COMING UP!
Each day got a little easier. But I had to wear this gigantic dressing. I got a lot of looks. The tape was still pulling on my skin. It was hard to tell if the stitches hurt or if it was the tape.
So I was extra cautious and held my head in odd positions to baby my neck. I ended up super stiff and with headaches. So lame. And I became depressed. Self diagnosed, but still counts I think.
I didn't want to go anywhere, I didn't want to see anyone. All a sudden it had become a pretty big deal but most people didn't even know about it. How do you ask for help or support when no one knows you need it?
It really wasn't a big deal. The cancer can grow but not really spread anywhere. It is highly curable. So I was conflicted. I chose to spend a lot of time in bed. I left only when I had to.
The tape made my skin SO angry. I hated wearing the dressing more than anything else. Now, years later, my new dermatologist says most people react to the tape and are usually fine with the stitches.
If you are sensitive, be sure to let your doctor know in case there are other options they can use.
The day that I got the stitches out I was a wreck. I think I started crying before they even did anything. It wasn't really that bad but it didn't matter. I'm sure the office staff still talks about me and my crazy emotions.
Mohs Surgery Scar Pictures
At my check up, the doctor liked how the scar was looking so he put something called a steri strip on it. They glued it to my skin and it would fall off on its own in 1-3 weeks. When it fell off, I was to go back to the dressings again.
I did everything I could to make sure that steri strip stayed on so I didn't have to put that awful tape back on.
It stayed on until my follow-up appointment about 3 weeks later. They removed it and were very pleased with the progress. They told me I didn't need to use dressings anymore which was a dream come true. I was okayed to exercise. Eff that.
I am so grateful for my family for taking such good care of me. My husband was a trooper and was so strong. He comforted me, he let me sulk, he handled the boys. I really couldn't have done it without him.
A very dear friend, Kayla, was a rock for me. She let me cry, she always knew what to say and she would just send me texts letting me know she was there for me.
But I also thank those people who would have been there for me had they known. I know there are many more people who would have dropped everything to help me if I had given them the chance.
My head was just so jumbled. I was in a pretty dark place for those couple of weeks.
This is how the basal cell carcinoma scar looked on Christmas (about a month after the Mohs surgery). I had minor (really minor) pain for a month or so. And because of the placement on my neck, sweaters would rub right there.
You can see how my basal cell carcinoma scar looked a year after this surgery in this post.
Thoughts on my Mohs Surgery Journey
Everything we go through is an experience. I think we go through life trying to be so stoic and act as if we are unflappable. But we are all vulnerable. It is okay to be scared of things that others might be fine with.
It is okay to call your friends up out of the blue and tell them you need them. And it is okay to spend lots of time at home in your pajamas watching Bravo if that is what you need to do.
The scar was kind of red and little puffy on one side for a little while. I had a follow up appointment in February and then was released and went on about my life.
I see my regular dermatologist every few months. We evaluate moles and other marks and talk through what we need to do about them.
I finally feel like I know what questions to ask about how we will handle these and other moles going forward. I always learn things I didn't know about skin cancer before and I feel really good in his care. I feel like we have a plan and I have to rely on that.
I can't say that I'm not worried about finding more or other types of skin cancer. But I am a little more versed in it now. It took awhile to not feel depressed. I told myself I could cry about stitches if I wanted to. And I could take as long to recover from these procedures as I wanted.
Since this Mohs surgery, I had to have multiple places removed and biopsies. Some have looked like regular moles. One was a purple mole that looked like my kid drew it on me with a marker.
For that one, they wanted to take a larger area to biopsy which would require stitches.
Which meant more stitches. That I cried through. I had even gone to my doctor for Xanax but my anxiety proved to be too strong. In all of this, I found out I'm pretty much a sissy when it comes to medical procedures. And I'm ok with that. I will just take each biopsy as it comes.
Have you ever had to have basal cell skin cancer removed with Mohs surgery? Skin cancer sucks. For real.
After the basal cell, I began the journey of having moles biopsied pretty regularly. Over my first few visits, the dermatologist evaluated my moles and skin (head to toe check!) and we've set about prioritizing what we need to focus on first.
For the first few years after the basal cell I was seen by my dermatologist every six months. But over the years it has slowed to about every 6 months. Find a dermatologist you like and talk to them about what your journey should look like.
If you are about to get the procedure, I wish you luck! However you are feeling is right. Sending best wishes!
I thought my experience was pretty crazy so I wanted to make sure to share it in case it would help someone else. And what I'm finding is that many of you have similar experiences.
If you're looking for Moh's Surgery pictures, hopefully, these will help you plan for your own procedure and know what to expect.