What is `H' closier after MOHS? + Efudex?

[Murphy]

BCC is deep & will have atleast 3/4 to 1" final cut on forehead. Today Dr.
did pre-op misc. & said `could leave bandaged to fill in w/ scar tissue' or he
could attempt `H' closing w/ sz. 6 thread for better appearance. Scheduled
for next Monday & he said he wouldn't know best outcome until MOHS was
completed & we would decide then. He had to get into surgery so I asked
nurse abt it. She said `H' is a under skin stitch pulling tissue together & then
few outside stitches but depends on many factors. I was told a flap-over
could be done later if this didn't heal fairly good. That means more slicing of
good skin. Does anyone have any thoughts or experience w/ `H'? I'm sure
either way, I'll be wearing bangs & make-up. Another spot is @ brow &
extending onto eyelid tissue midway to crease. Said MOHS will distort tissue
but best. Or, I could try 9 weeks of Efudex & repeat biopsy. Any thoughts
on Efudex? Told it's a painful burning crusting process.

[Murphy]

Just got an answer re: `H' frm Dr. in the UK! For those that wondered, it is a
invisible H pattern the surgeon uses as a guideline to nerves/muscles after a MOHS
of considerable sz. Reserved for forehead & undereye since these areas pull multiple
expression muscles many directions. The hole has fat pulled into center w/ stitches
to support new growth/scarring. Then multiple flaps from different directions are
stitched over w/ ultra fine thread. Flaps are cut `fuzzy-edged' in hopes it blends
more natural when healed. Guess my surgeon knows his stuff. UK dr. said it is the
most popular procedure over last 2 yrs that the interns are learning because of the
best appearance outcome. I'm feeling pretty good now & will share later. Thanks UK!

[Belle2003]

How were you able to get in touch from the Dr in the UK?

[Murphy]

Back in `02, I was looking for another solution to cutting surface BCC. I found an
email to a Professor in Australia that was doing trials on Aldara Cream. US was just
starting on trials & always behind the pack! He was kind enough to email info on it.
I wrote him w/ a brief ? abt `H', thinking he probably wouldn't answer it. To my surprise, he forward it on to a division of the `Imperial Cancer Research' in UK. A Dr.
was so nice to take the time to email me a procedure sheet the students use there.
BCC is very high in UK. US only uses a few type flaps. They use many. He said I should be glad I found a Dr. that will take the lengthy time after MOHS to do `H'. I
guess most send you to a plastic surgeon for that. Guess my doc will do his best! UK
also just sent me a copy of info off the BBC News saying: US *FDA just approved
Aldara in July `04 for sBCC on body but not face. I'll research that after my surgery.
I know that they don't want serious chemicals near eye area but perhaps it's used
off-label on face? One BCC @ a time...