View Full Version : Plastic Surgery or Mohs?

05-30-2007, 03:52 PM
Just got results back today from my skin biopsy. It came back as an atypical lesion - keratoacanthoma - could possibly turn into squamous cell. Dr. did cut it out during the biopsy, but wants me to have Mohs to completely get rid of all areas. It's on my back - should I do the Mohs or would it be just the same to have a plastic surgeon remove it? I know the Mohs is a more extensive surgery, but its not on my face and I'm not too worried about the scarring.

06-01-2007, 04:26 AM
Nobody have an opinion? Is Mohs surgery mostly for cancers on the face? Should I do it for a spot on my back or just have plastic surgery?

06-01-2007, 06:36 AM
With a MOHS procedure, the doctor has more certainty that h/she got all the cancer and took as little healthy tissue as possible. If you are being given the option by your doctor it may be beneficial to consult with your insurance company as they often dictate many healthcare choices. If you are in Canada, then your could choose either.

MOHS is something you are awake for and have many shots of zylacane. On the other hand, a plastic surgeon would probably sedate you. It all depends on what you are comfortable with.

Good luck with your procedure.

06-01-2007, 11:09 AM
My insurance company will pay for it. I would rather be sedated. Don't think I could take all those shots. I'm waiting for a callback from my regular doctor to talk about it with him - the Mohs doctor not in the office today - I already made appt with him, but still not sure yet. Why would the plastic surgery guy sedate me rather than just numb me?

06-01-2007, 01:45 PM
It may depend on the surgeon. When I had a lesion removed from my eyelid, the doctor who performed the procedure was a plastic surgeon for eyes. He put me into a twilight sleep, but took it a little further at my request. So I was pretty much out for the whole thing. It's something to ask the surgeon about. I would opt for that over being awake for any lesion that wasn't on my face, but that's just me. With the eyelid lesion, I didn't have much of a choice. I was referred to the doctor who removed it because the eyelid can be a bit tricky, but if it were anywhere else on my face, I would go with a MOHS procedure because of the minimal scarring. Soo, both choices have their strong points.

06-01-2007, 02:18 PM
Well, the lesion is on my back, so you think I should just go for the plastic surgeon instead of the Mohs? I'm really not that good with shots, and don't think I could handle all that waiting around.

06-02-2007, 06:48 AM
Well...ultimately, it's your decision. Any treatment you get is going to require Post-op care for the incision area. My dermatologist usually gives me polysporin to apply for a few days and instructs me to clean it after those first days have past with hydrogen peroxide and to continue applying the topical antibiotic for about a week. My opinion is that MOHS is typically the best option for any lesion on the face, however, the other options may be a suitable choice if the lesion is somewhere else.

I know, I'm not committing here :dizzy: . Once you get the information about both options from physicians, it's best to go with what you feel comfortable with. I think that most people aren't fully informed about MOHS and if they were, it might influence their decision if the lesion is not in a visible area. MOHS is wonderful for what it does and the healthy skin it saves, however, if the lesion is larger than expected, like mine was, it can be pretty drawn out. I'm happy with the results, but want to avoid it again by catching those SC's when they are small.

Good luck to you and I hope your choice has the best results.

06-03-2007, 08:08 AM
Thanks for your reply. I will try to speak to the Mohs dr. tomorrow to see what he thinks. The surgery is not scheduled till July 5th - so I still have time to change my mind (or dr.).