nose rec onstruction

[annanana]

I recently had a successful procedure to remove an SCC from the right side of my nose. This meant that I also had about 50% of the right side also removed. I am waiting for 9 sessions of radiotherapy and when that is over and my skin has settled I then have to make a decision on future treatment: 1) reconstructiion involving a forehead flap skin graft ; 2) a prosthesis; 3) do nothing and live with the hole on the nose (which I cover with a plaster when going to public places); I would love to hear from anyone who has had any of these procedures please to help me decide what to do.

[EvaChangingFaces Partner]

Hello annanana , Welcome the the Changing Faces Community and thank you for posting your thoughts on here. It sounds like you've got a lot coming up in terms of treatment and understandably you might be feeling a bit nervous about it all. There are members here in the forum with experience of all different forms of visible difference and I'm sure ther will be people who will recognise some of what you're saying or might have been through a similar process themselves trying to decide how to proceed in terms of treatments and they might be able to offer you their thoughts on how things were for them.

However, everyone is different and no matter how you choose to proceed it's important to trust in yourself and your judgment to guide you through this situation as it has done before in life and believe that you will be able to manage whatever comes your way.

That being said I hope you find people here that are able to relate to what you said and connect with them and share your thoughts about this part of your journey.

Take care,

Eva - ChangingFaces

[ILJ15]

Hi

I am so sorry to hear that you are going through this and wish you all the best in the days and months to come

I had Mohs surgery on the tip of my nose and also needed reconstruction to “close the hole”. They did consider a forehead flap but in the end, decided on bilobial flap. Is this something that would work for you?

When I had my surgeries, what helped me was:

- who would do the surgery? It’s so important to trust the person who has your “future face” in their hands so ask the doctor to show you pictures of previous surgeries they’ve done

- how much (more) can I cope with right now?

- what are the risks?

You mention that you cover the wound with a plaster. Maybe ask yourself: what discomfort can I live with (long term) moving forward? Am I okay putting a plaster on every day? Do I feel comfortable with a prosthetic nose? Can I handle the discomfort of forehead flap and recovery time, is the trade-off for an “easier” future worth it?

I guess what I mean is: what kind of future do you envisage and how much can you accept in the short / long term?

In the end, whatever you decide to do, please make sure that you ask every single question that you have so that you are fully informed and thoroughly prepared.

All too often, we don’t ask questions or we feel rushed by the doctor. Please don’t allow yourself to be in that position. Your voice deserves to be heard.

I hope this helps you a little moving forward.

All the best

[annanana in reply to ILJ15]

Thanks for your reply. You are the first person I have found who has had a similar situation. I have not been told of a bilobial flap - is that taken from the cheek area? How long was that in place for? I will also have to have cartilege taken from my ear to support the skin graft and the shape of the nose. How long was it from having the Mohs to finishing your reconstruction? I am 81 and would prefer not to have to spend much of my precious time having treatment. I have also been offered radiotherapy which will improve the chance of not having a recurrence if the cancer by about 5% which almost seems a lot of disruption for little gain. So much to make decisions about. And a prosthesis would need to have magnets inserted into the bone beneath the nose to keep the prosthesis in place And when I take it off at night it would stand up by itself on the fridge!!! At least my grandchildren would remember the grandparent who coukd take of their nose!!

[ILJ15]

Hi

It’s actually a bilobed flap. Apologies as somehow it “autocorrected” itself.

Maybe you can speak to your surgeon or research it online. I obviously don’t know whether it’s an option for you but hopefully your medical team can help.

I am sorry you may have to go through radiotherapy. At the same time, you mention grandchildren so provided the treatment isn’t too horrendous, I’m sure they’d love to have you in their lives for much longer

It may be worth asking how radiotherapy might impact on your skin and underlying tissue. And in the longer term, whether it will make the skin more difficult to manage should you opt for the forehead flap.

Obviously these are not things that I know much about, so definitely ask questions

From what I’ve seen / heard / researched about forehead flap: when done right, the results can be amazing. Yes, it’s uncomfortable for a while but it does look pretty amazing when finished. When I discussed it with my surgeon, he said that the scars can be positioned in natural wrinkles or areas where there is shade. It all depends on the skill of the surgeon though (and maybe how many wrinkles we have to hide the scars

In the mean time, please be kind to yourself. This is undoubtedly a really stressful situation and not knowing “the best thing to do” is rough.

If you can, reach out to Maggie’s or some of the specialist centres as they may be able to help out with medical suggestions or practical advice.

I wish I could help you more, give you some advice, but really this has to be your decision

If you can, talk to your family and be as clear as possible with the doctors. As I said before: ask questions and do your research.

Kind regards

[annanana in reply to ILJ15]

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