“It took eight hours for them to cut everything out.”
Dermatologists recommend we must wear hats, slather on sunscreen, and have a skin cancer screening every year. But what happens if your doctor actually detects something? In order to remove basal cell carcinomas or squamous cell carcinomas (BCCs and SCCs), the two most common types of skin cancer, you need to go for Mohs surgery.
The procedure has a 98 percent cure rate and leads to pretty minimal scarring, says Bruce E. Katz, M.D., director of JUVA Skin and Laser in New York City. But what getting this surgery is really like? We chatted with four women who underwent this surgery, which we want to share with you. Here we go!
Michelle Charlesworth, 45
When I was 30, I was covering a story on liposuction for ABC. It was odd since I don’t usually do health stories. I was interviewing a dermatologist, and as I was leaving, the doctor came over to me and said, “What’s this on your face? How long has it been there?”
I get facials two-times in a year, and every time, the aesthetician would remark about a little skin-colored bump by my mouth and try to pop it. I discovered they were trying to pop my cancer. You can’t pop cancer.
The doctor then examined it, and told me it was basal cell carcinoma and that I would have to have surgery.
The surgical team kept cutting, checking, cutting, checking. [In the course of the operation, surgeons remove a tiny chunk of tissue at a time, checking the skin under a microscope after every cut to ensure they have removed all of the cancerous skin—while sparing all of the healthy tissue they can to check excessive scaring—says Skin Cancer Foundation spokesperson Lisa Chipps, M.D., a dermatologic surgeon based in Beverly Hills.] They just kept telling me, “More has to come out.” I’d say, “Give me a mirror.” I would look and see part of my face was missing. I couldn’t imagine it would ever go back to normal. I cried. I was really scared that I wouldn’t be able to work as a television reporter anymore. It took eight hours for them to cut everything out, and it smelled like a barbeque, them cauterizing my skin. I wasn’t in any pain, but I could feel the tugging.
The hole that was left to close up was approximately the diameter of a dime, five dimes deep. I was left shocked by the size of it. To close the crater 100 stitches were made on my face. And in just a few weeks I was back on air. I would interview people in profile so the TV wouldn’t show the scar. I just got around it. A couple of months later, it had mostly faded and finally I got to to show my whole face on air again—with some makeup.
Now, the scar is hardly visible. It sits right in my laugh line. I didn’t have one 15 years ago when I had the surgery, but now it’s just a happy accident. If you’re planning to go for Mohs surgery, reach out to other women who’ve had it. Ask any doctor you’re thinking about performing your surgery and closing the wound if you can speak with and visit their patients personally. See their scars, and ensure that you’re happy with their results before you trust anyone with what you’ll look like after your surgery. I’ve had coffee with scores of women and just allow them to look at my face. Once they see how little scarring is possible and that, no, they won’t be deformed for life, it takes so much fear out of the whole process.
Skin cancer saved my skin. Now, I wear sunscreen daily. People ask me what’s secret of my young-looking skin, and what night cream I use. I tell them, “It’s not what happens at night, babe, its what happens during the day.”
Megan Gillean-McMerrell, 32
I had a little mole on my right upper cheek. It at first looked like a little freckle. Approximately six months ago, I noticed that it looked like a pimple had developed right beside it. It was red and swollen right under the mole, so I treated it as a blemish. After pounding it with everything I had, the pimple and the mole both scabbed up and flaked off. They vanished.
I didn’t bother about it for some months until I noticed the mole had grown back into what still looked like a freckle. Nonetheless this time, it was irregular and had a black area on one side of it. I recall looking at it pretty close with a mirror, noticing the dark area was a little bigger, and experiencing a strong gut feeling to get it checked out. At this point, it alarmed me even though it was still so tiny. Around a month later, I saw a dermatologist who did a shave biopsy, sawing it off with a razor. 12 days later he called me up and told me that I had melanoma. I was then referred to a dermatologic surgeon who performed my Mohs surgery. I have three beautiful daughters, and secretly, my diagnosis terrified me. My grandfather and a cousin were both detected with melanoma years back, so I knew all too well how serious it actually was; I had the most deadly form of skin cancer.
The excision was done over the course of three days, with the surgeon forwarding the tissues off to a lab after every cut. In the course of each excision, the area was numbed with lidocaine injections, which were more uncomfortable than the surgery itself. The swelling after each stage was bothersome, but on the whole it was nothing that a couple of Tylenols and an ice pack couldn’t help. On the final day, I was left with a hole approximately the size of a quarter that needed to be closed up. I was numbed again and sutured up. The surgeon is very good at what he does. He took nearly 30 minutes to sew me up. After the final repair, I had some pain. But, it was tolerable. The soreness lasted some days, and the tightness has gradually improved over the last month. The incision line was done very carefully, in addition to internal stitches that will dissolve within three months. It was an incision around two inches long. After six days, the outer sutures were removed, and I was given a silicone patch to wear day and night to help prevent scarring. I wore this patch religiously for a month.
I must say that though I was amazed that my surgeon closed the wound without performing a skin graft, I was shattered 48 hours later when I removed the bandage. The results were shocking. I cried alone in the bathroom looking at my face in the mirror. The skin was pulled so tight that my right nostril and upper lip were lifted. I felt deformed and so unsightly. I have always struggled with insecurities about my look, so I kinda felt like this was a lesson from God—a way for me to forget about what’s on the outside and to focus more on what really matters. I’ve wasted so much energy on painful insecurities over the years, and now I refuse to let it hurt me any longer.
I was never a sun worshipper or anywhere near to an extreme tanner, but I used to tan easily in the sun and availed each opportunity to get that “golden glow” because I felt more attractive with it. I rarely wore sunscreen prior to my diagnosis.
Although I adore the look of a tan, this experience overall has made me so much happier in my own skin. Sunscreen is now part of my daily routine. I apply it before I leave the house, and I limit my exposure to the sun. I’m also taking extra precautions with my daughters and their skin. I’m so thankful that I had the spot on my skin biopsied when I did. Listening to my gut instinct saved my life.
And my scarring is healing well. I still have some tightness and indentation, but it has significantly improved since my surgery five weeks back. The incision line scar gets lighter every day. It’s horrible in the beginning, nonetheless if you just hold on and be patient, it keeps improving. I’m learning to see the true beauty in scars.
Patricia Lowmiller, 45
In 2010, I visited the dermatologist’s office with my son, who had acne problem at the time. Suddenly, the dermatologist leaned over to me, looked at my face, and said, “I think we have skin cancer here.” I was stunned. I knew I had a little white-ish bump by my lip, but I just believed it was a blemish. I recall trying to cover it the year before when I’d gotten married. Nonetheless the dermatologist cut it off right then and there and sent the cells in for examination. After some days, I discovered I had basal cell carcinoma. I didn’t know anything about it. I began researching who to go to and mulling over whether I wanted the surgeon to do the repair or if I wanted to go to two separate specialists: one who would remove the cancer and one who would close the wound. [To reduce scarring even further, either the surgeon performing the removal or a plastic surgeon use reconstructive techniques to close the wound, says board-certified plastic surgeon Julius W. Few, M.D., founder of The Few Institute for Aesthetic Plastic Surgery in Chicago.]
I chatted with a few people who had had Mohs surgery, but they were in their eighties and really didn’t bother much about scarring. I did. My cancer was on my face, and the dermatologist wasn’t sure if it had spread to my lip or not, so it was likely that during surgery, part of my lip would have to be removed, too. I made up my mind to have a Mohs surgeon do the procedure and a plastic surgeon close up the wound to play it safe.
On the day of my surgery, I first went to the plastic surgeon, and he marked my face with a Sharpie, showing where my smile line should be. The plan was that in the course of the wound repair, he would place the scar right in the line in order to make it less noticeable. Then, I walked across the street to the hospital. My Mohs surgeon performed the procedure, and then I walked back across the street, this time with a hole in my face, to the plastic surgeon. I was numbed for the whole thing. It was weird since, although I could only feel pressure, I was awake and could see the thread going in and out of my face. I tried to close my eyes as much as possible. It was truly a surprise when I was done and saw the stiches. I thought, “This is never going to heal.”
It took a good year for it to get level and for the redness to fully go away. But finally, it did. Now you can barely see it.
Bridgid Duffy, 44
I found out I had skin cancer in the course of a routine appointment with my dermatologist a couple years ago. I was having a full-body skin cancer check, and I showed my physician’s assistant a little spot on my forehead that I had been dealing with for a good six to eight weeks. It was right by my left eyebrow, and initially, I just thought it was a zit. But it kept scabbing up, bleeding, and just not clearing up like a zit should.
The physician’s assistant examined it and advised we have it biopsied. She explained it did look questionable, similar to basal cell carcinoma, but the results would tell us for sure if it was malignant or not. She explained that basal cell is concerning but can be easily treated and that the surgery is very effective. She promptly numbed me up and cut a small sample of it out with a scalpel. It was so small, a little Band-Aid took care of it. She said that the biopsy results would come within a few days and that we would make plans based on the results.
A few days later, I received a call and got the news that I did have basal cell carcinoma. The news left me anxious and in fear. I was in shock. I thought, “This doesn’t happen to people my age!” I knew several elderly people with skin cancer that needed surgery, but I was far too young to require surgery as a treatment, right? I was sure the dermatologist was going to tell me that he could quickly laser it off, but that wasn’t the case.
He sat down with me and explained the kind of skin cancer I had. He explained how common it is and how effective Mohs surgery is. He explained the procedure and gave me an opportunity to address my questions, concerns, and anxiety. After the chat I felt confident that this was going to be well handled and that I wouldn’t be permanently scarred or deformed.
The Mohs surgery was an outpatient procedure, meaning I was awake during it. I scheduled the surgery for first thing in the morning so I didn’t have to spend an entire day being freaked out waiting to go. On the day of the procedure I was first prepped for the surgery. Then my doctor put something over my eyes and a paper drape over my face so I couldn’t see anything—thank God. He also numbed my forehead so I couldn’t feel anything at all. He cut a layer of skin that was essentially a hole around the basal cell spot. After that he examined it out under a microscope and told me more would have to be cut out. Once all of the cancerous tissue was gone, the surgeon stitched up the hole in my forehead and bandaged me up. I was surprised how calm I was.
I knew I was going to be swollen and bruised, so I planned to spend a a few days at home afterward. I had a black and blue eye for nearly a week and a half, but my swelling subsided in a couple of days. I had zero pain. I was banned from strenuous exercise and lifting heavy objects for a couple of days. I also wasn’t permitted to wash my hair, which felt gross. The scar was almost gone in six to eight months.
I want to send this message across to all women that I was covered for most of my life with sunscreen and a hat and I still got skin cancer at a young age. So you must get a full-body scab once every year. Use a pen, and circle any marks or questionable areas you want your dermatologist to look at.