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Old 10-08-2012, 09:37 PM   #1
Join Date: Oct 2012
Location: west virginia
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nikki1980 HB User
Question Skin graft after bcc, now their talking scar revision?

Hi everyone. I had a small BCC on my nose, had MOHS surgery done. They ended up taking a dime-sized chuck out of my nose. Anyway, I went to the plastic surgeon the next day, and he did a skin graft. He said I didn't have enough loose skin or elasticity for a flap. But today (2 months later) I went back for 3rd follow-up and was told the skin graft took, but turned out thick and discolored. They want to do a scar revision using a flap, in 2 surgeries over 6 months. So they want to take the top half of the graft off, pull surrounding skin to cover. Then wait 6 months (after first surgery heals) to do the bottom half. Has anyone ever heard of or experienced anything like this? I'm really stressing about it, and don't completely understand all this.

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Devere (11-06-2012)
Old 11-28-2012, 08:27 AM   #2
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nyiaca12 HB User
Re: Skin graft after bcc, now their talking scar revision?

Hi. Unfortuantely, having scar revision surgery isn't that uncommon after Mohs/plastic surgery (although they don't tell you that beforehand).

Although, I haven't heard of doing a flap to cover a graft--but I'm no expert.

Although, how does the scar look to you? Does it bother you terribly?

I don't know how forthcoming your doctors are, but I'm curious, if you didn't have enough skin before, how do you have enough now? (A flap pulls skin, it has the possibility to create ASYMMETRY. You should ask if you will have asymmetry from the procedure, possibly scarring, will it effect your nostril. How are they going to connect the two pieces?)

I'm just wondering out loud here. It may be just fine.

But, if you are not happy with the answers you're getting, or anything like that, you can get a SECOND OPINION. Another perspective helps.

Good luck.

Last edited by mod85; 11-28-2012 at 10:48 PM.

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Old 11-28-2012, 09:03 PM   #3
Join Date: Oct 2012
Location: west virginia
Posts: 5
nikki1980 HB User
Re: Skin graft after bcc, now their talking scar revision?

Thanks for your reply, nyiaca. Its been 6 weeks since the doc told me he wanted to do the scar revision surgeries, said it would take 6-8 weeks to get insurance to approve it. I'm still really not sure what to do. The graft on my nose still looks a little thick, the color has improved somewhat. It only bothers me if I look too close. lol.
The way I understand it, the flap won't go over the graft, he is going to remove the graft, do a flap over the top half. Wait 6 months, and do the same thing with the bottom half. He said that waiting 6 months would be necessary to let the skin stretch and heal before he does the second procedure.
I do have the concerns you mentioned, he had already said he couldn't do a flap. Now claims I'll have a better cosmetic result if he does it in 2 surgeries. I am worried about asymmetry as well. I may be better off with what I have now, a place on my nose people notice only if their within 5 ft. of me. It seems to me like they could do dermabrasion or something like that to give the scar a more smooth appearance, and I'd be happy. When I mentioned that to the nurse, she said "well, that wouldn't help the color any."
I did call around about getting a second opinion. I have medicaid insurance, and will have to get referalls and approval before I can do anything. I'll also have to travel a few hours to see a different surgeon. I need to get motivated to do it. Thank you again for your input.

Old 11-29-2012, 07:02 AM   #4
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Join Date: Nov 2012
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nyiaca12 HB User
Re: Skin graft after bcc, now their talking scar revision?

I have to be honest, that doesn't sound good to me.

He's admitting it will stretch your skin. which will leave your skin pu;lled tight in one area, which wuold make your fae asymmetrical. Symmetry is cornerstone of beauty.

Second, he's talking about walking around for a year with your nose looking messed up.

third, why didn't the skin graft work? Was that his fault too?

Overall, will you look better?

Sorry, I'm just suspicious of doctors. I used to be under the impression plastic surgeons could do anything, but they can't.

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nikki1980 (11-29-2012)
Old 01-07-2013, 11:54 AM   #5
Join Date: Jan 2013
Location: Oklahoma
Posts: 1
okieone HB User
Re: Skin graft after bcc, now their talking scar revision?

Hi Nicci1980, I had Mohs/skin graft for a small area on my nose in December. The doc told me the same thing - not enough loose skin for a flap. They took skin from behind my ear. Everything I've read says it takes a long time to heal and the graft appearance will continue to improve for many months. It's been 24 days for me and mine still looks pretty aweful. I believe dermabrasion is supposed to reduce conspicuous skin color and lumpiness at the graft margins. Did you ever get a second opinion?

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