Adventures in Skin Cancer

Apparently my face was jealous that my lung was getting all the attention, so it wanted in on the action, too. Hooray!

Last year in the middle of all my heart/lung procedures, tests, and diagnosis, I noticed a flat patch of pink skin right above my upper left lip. It didn’t hurt, but sometimes it bled slightly if I scrubbed my face. And occasionally it would get a little flaky. I ignored it for a while until I was over all the other, more urgent hurdles, then made my first dermatology appointment. The doctor took one look at it and said that it was skin cancer. A biopsy confirmed it (basal cell carcinoma, not melanoma), and I was referred to a oncology surgeon who specializes in Mohs surgery, a procedure I’ll be having next month.

The kind of skin cancer I have isn’t dangerous, but it can be invasive and disfiguring. And the Mohs itself isn’t a big deal, but the plastic surgery to repair it afterward will be. If the lesion – what an ugly word – were on my cheek or forehead or neck, the closure would be simple, but lips and noses are apparently trickier. Apparently I don’t know how to have run-of-the-mill health issues.

After six weeks of consults with my whole medical team (I have a team! Go team!) my plastic surgeon was able to tell me yesterday with confidence that he’ll be able to do the repair under sedation rather than under general anesthesia, which is a big relief. If you google pulmonary hypertension + anesthesia risks, you’ll understand why I’m really happy about this. I’m scheduled for February 9th.

So, here’s what will happen, in six pictures:

ME, BEFORE:

STL_beforeHere’s my face as of this morning. The arrow is pointing to the skin cancer.

This tiny little spot is causing a lot of trouble.

ME, AFTER MOHS:

STL2This is the size of the hole my plastic surgeon says to expect from the cancer removal.

ME, AFTER PLASTIC SURGERY (SCENARIO 1)

STL3If all goes well, this is how I’ll look afterward (that’s supposed to be an incision and stitches, not a caterpillar).

He’ll cut on a curved line from my nose all the way through my upper lip, which, because of the way the skin & muscles move when the mouth moves, gives the best cosmetic result down the line.

Here’s how another woman looked 3 days later after a similar procedure, though he says my mouth may be pulled up more for a while. Note the super sexy swollen Angelina lips:

mohs-day3

PLASTIC SURGERY, SCENARIO 2

If the hole from the Mohs surgery is bigger than expected, the plastic surgeon may not be able to close the incision without pulling my skin together strangely, so he’ll have to do what he called a “lip swap” procedure where they turn my whole mouth upside down:

STL4

JUUUUUST KIDDING.

The lip swap would actually take a chunk out of my lower lip, & then he’d flip it around and slap it over the wound on the top lip, then close both incisions. It’s obviously a more involved procedure and he hopes to avoid having to do it.

STL5If he has to do this, I’ll have to have another surgery about 10 days later to “re-form” the corner of my mouth. We’re obviously hoping for Scenario 1.

3 MONTHS POST SURGERY

STL_afterVoila! The surgeon says to expect a really good result, with little visible scarring.

Eventually. After 2-3 more small procedures.

I will admit to feeling overwhelmed and anxious after my first consult with the doctor, and I got upset for a few minutes – really the only time I’ve been really upset through this whole medical adventure. 30% of it was feeling sad about my face, and 70% was the fear of the risks involved. But I’ve had a couple of months to get used to the idea, and I’m feeling ok about it now that I don’t have to worry about going under general anesthesia. I’m sure there will be moments along the way where I’ll feel really sad about how I look, but I think I’m in a good place, and I’m confident that this surgeon will get me the best possible result. Lately I’ve wondered…hmmmm, what else should I have done while he’s in there?! Heh. But more than anything I’m just ready to have it done and stop going to doctors for a little while. It’s been a heck of a year.

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2 Responses

  1. Tara says:

    You’ll do great! I thought you were serious with the lip swap! Lol. I am relieved that’s not a real thing and happy to see you have maintained your sense of humor through a difficult time!

  2. Katy says:

    You are so beautiful Shelley no matter what part of this journey you are on! I am thrilled that the doctors are going to do it in a way that is safe for your health. We are here for you! Xx

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