September 15, 2010

One Year Has Passed

Today the weather is almost exactly like the day of my surgery last year on September 15th but today I am able to thoroughly enjoy the day. I remember that morning so clearly. My husband was with me and every time he looked at me while I waited my turn I felt like crying. His eyes were reflecting my worry. I felt worried and sad that my face would forever look different, and knowing that when he would gaze upon my cheeks in the future, it wouldn't be the face he fell in love with. He has been so wonderful about the entire thing and all along he has said it doesn't make a bit of difference to him.

That is what I remember most about the morning of my surgery, and also the moment I awoke from anesthesia. I could hear the nurses talking and the first image in my mind was that of our pony's little round buttocks. What a silly thing to think about! It made me smile. Then I got ready to go home, they gave me some ice to hold on my cheek, and I was seeing double all the way home. Probably due to the proximity of the surgery to my eye. I was just glad it was over. The healing felt slow but looking back now, I can see a continuation of progressive healing. And it's still getting better each day.

I had my 'one year' appointment Monday with the plastic surgeon. He was pleased with how much better it looked since last time and said he doesn't know why it's taking so long to settle and soften, but in 6 months he will see me again. At that time the ridge of thick scar tissue closest to my nose may be softened enough to excise as a scar revision procedure. Too soon to do that now because it could just scar more. My hope is that in 6 months it will just be soft and faded enough that I won't feel the need for any additional cutting or "revisions."

So this is what that once-horrible thing looks like after one year...and it is certainly better than having cancer.

September 8, 2010

September 2010 ~ One Year After Graft

It's been almost one year since surgery. Here's how the graft looks without any makeup today. I admit this looks a lot better than last September. Not so much of a glaring mark any more, though makes me feel asymmetrical.

July 3, 2010

June ~ Went to the Beach

Had a nice week at the beach and kept myself covered up with clothing or sunscreen. Didn't get any sunburns! From a distance, can barely see the graft scar. But up close, it's still a circular bumpy discolored patch. The collarbone scar doesn't bother me any more.

June 7, 2010

June

Smoothing out a little

May 28, 2010

How the Graft is Looking 8 Months Later ~ May 2010

From a distance it's not too bad, but up close a definite scar. I've been using so many scar products on it. I'm not sure if they are helping at this point. I also try to massage the scar every night.

April 17, 2010

April 2010 Update

April 2010 pictures, seven months after skin graft on cheek. Perimeter is softening better, ridges and bumps less noticeable. The grafted skin seems to dip since there's not a layer of dermis underneath any more. I will be seeing my dermatologist in two weeks again. Last month the plastic surgeon told me this graft will probably start to blend better by September of 2010 which will be a year after surgery.

March 12, 2010

Recent Pictures ~ Graft Progress

Winter 2010

I don't wear my sunglasses into the stores as much as I did before.
The graft surgery was performed 9/15/09, so these photos show progress at approximately the 5th to 6th month.







March 2010
This shows the new wrinkles (caused by the scar) when I smile.
 

January 1, 2010

My Skin Graft and Melanoma in situ




FOR ADDITIONAL PHOTOS AND UPDATES, click the archives at the upper right side of page. My additional blog entries show photos of the graft from 2009 to present.    


July 2009 was interesting. I went to the dermatologist, after not doing so for at least 5 years, because I had a brown "age spot" on my cheek that I really didn't like. Just vanity, never thinking it was anything to worry about. Not dark or raised, just a tan spot that had gotten bigger over the years. I was tired of putting makeup on it and trying to hide it. I was 47 at that time.

On that lovely July day, the dermatologist decided she should do a biopsy, and a few days later she told me it was melanoma in situ. She offered to send the slide out for a second opinion, which I definitely wanted, because the treatment was to get this thing cut out and most likely would require a skin graft due to its proximity to my eye. This is when the doctor appointments became numerous, and after being so healthy throughout my life I rarely have to go to doctors.

Second opinion confirmed what the local pathologist had seen. So a date for surgery was set for September 15, 2009 to have a skin graft.

This was stressful, as it would be for anyone. I was searching for information on the internet about this subject and skin grafts on the face. I am younger than most who need to have this done. My skin isn't very wrinkly or loose yet, so there wasn't a lot of extra skin to work with. The surgeon took skin from my collarbone area and put it on my cheek. He also did a biopsy on a brown spot located on my chest the same day just to rule out melanoma there.

I decided to post some pictures here for people who are in a similar situation and might be having trouble finding photos of the whole graft thing. It's all new to me, so I still look at it every day to see how it has changed or possibly healed a little bit more overnight. I intend to continue to post pictures as the appearance of the graft changes. It's now 3.5 months since my surgery and I still hate my graft. It is taking a very long time to heal. As instructed, I do scar massage every day at least twice a day for 30 minutes or more. I am considering the scar revision surgery in the future, but my plastic surgeon said it can't be done "for a long time." I guess that means a year or so of waiting, but hopefully not that long.

A few hours after surgery









Morning after surgery


September 16, 2009 evening


The entire process was somewhat interesting in a scientific way, if I could remove my emotions from it (but couldn't really). My new appearance caused me to feel vulnerable and unattractive, and I wanted to hide it. The yellow pressure bandage had to stay on for ten days. I didn't go anywhere for those first ten days. There wasn't any pain, but definitely some swelling and a bit of a "black eye."

September 19


September 21


I had absolutely no idea what to expect. The medical people didn't really explain what was going on with the skin. I was told not to exert myself or sweat, and definitely don't get the graft wet yet. So my husband washed my hair when needed as I leaned my head way back over the bathtub. Good thing I'm flexible!

Around September 23, the sutures were removed from my neck and chest. They removed the hard yellow thing (pressure bandage) that was constantly in the way of my vision, but couldn't take out those sutures yet from the grafted skin until a couple days later. They used surgical tape for the places where the sutures were removed, just to hold it together a few more days. Those places were looking pretty good. Face was still awful to see, and I still hated it. I was glad to hear that the pathology report showed clear margins and all the cells appeared to have been removed. The doctor patted me on the back and said "You won't have to worry about that any more." Well...I guess not, but the scar left behind is a bit of a challenge at times. Seeing that in the mirror when I look up can be startling. Occasionally a whimper would just come over me...I couldn't believe that was going to be part of my face for ever more.




From what I gathered, most grafts heal a bit better than mine and don't always have the black areas of necrotic tissue. Nurse said to leave it alone and it would eventually come off like a scab. Hmmm. She also told me that grafts on this particlar part of the cheek don't do as well. Lucky me (heavy sigh). I was feeling a bit sorry for myself during this phase.

At this point it looked like there was a piece of pepperoni stuck on my cheek. Like, oops, I mistakenly left a piece of pepperoni there! It looked so terribly large, so much skin removed from the area just because of that dumb brown spot. And the brown spot they removed wasn't even THAT ominous looking.

September 25



So, I kept putting the bacitracin on it (as instructed) and I was able to take a shower by this time if I remember correctly. I was so nervous about letting water run down over it. I didn't know how delicate it was, or if I'd feel a sting. But as I trembled that day and worked up my nerve to let the water touch it, there was no feeling, no sting. Just felt good to get clean. Had to continue to be so careful about the area for a while though. Couldn't bend over or it would throb as blood rushed to my head.

Sutures were removed...

I REALLY WASN'T KIDDING ABOUT THAT PEPPERONI, Sept 27

Now October...

Still red and ridged



October 9, 2009

Note the other cheek has a couple freckles

First attempt at makeup to cover it up

Makeup just looked plain silly at this point. The scar was was too raised. It will always need lots of moisture and SUNSCREEN. Can't emphasize that enough how to use sunscreen on the graft. My dermatologist told me how quickly this grafted skin will burn (a few minutes). It was already red enough!

Well, it was time for a follow-up visit to the dermatologist in late October. I'd never had a full body screening, so it was about time. She took several photos and measured various freckles. She biopsied the left cheek, a very small freckle in photo above. Found out November 3 that it too consisted of atypical cells and she called it melanoma in situ as well. I am certain that I had blistering sunburns on my cheeks in my younger years, so I don't doubt it. But I just couldn't believe this. Why on my face? I wouldn't mind surgery on any other part of me--but why my face!? It was upsetting. I asked the dermatologist if I could wait a while and she said "she never sleeps on melanoma." Scary things to hear from your doctor.

This is not the invasive type of melanoma, just the precursor to skin cancer, called melanoma in situ. Cells that are on the surface and could eventually become skin cancer.

found out this needs to be cut out too
November 3, 2009 where biopsy was just performed


Fortunately, the procedure on the left cheek was much simpler. It was done in the surgeon's office chair, not an operating room like the graft in September. Phew! Just some local anesthetic and I was ready to go within a half hour.

Left cheek November 10


November 12, 2009

I was feeling a bit butchered by this time. Scar face. Yuck. Still hated the graft side. Was feeling hopeful about how the left cheek would heal since it was a much smaller incision.

I was very happy when I was able to wear a Halloween mask to go trick-or-treating with my daughter. It was so much easier to be out in public with the scars hidden behind a mask.


Scar progress November 18, 2009





I was very pleased with the left cheek. But he said the results showed that some cells went to one of the margins and it may need to be re-excised in a month or so after the scar softened. When would this ever end???
......................................
I headed back to the plastic surgeon's office December 14th, fully expecting to have the left cheek re-excised but upon re-reading the pathology report, he didn't feel that it was absolutely necessary (yet). There was no pigment left at the site, so he would just be guessing about where to cut. He said if we monitored it closely, it would be alright, if I wanted, to leave it alone for now. He also offered to re-excise it, but I chose not to. I'd been cut enough. I am willing to keep an eye on it and let it heal. He did such a nice job on that side. I am dealing enough with the putty-looking glob on my right cheek right now. And after all, Christmas was fast approaching. So that was a nice Christmas gift. I felt relieved as I drove home that day. I also wanted to know more about skin pathology and I'm on a new quest to learn as much as I can about atypical cells and melanocytes. What exactly constitutes "melanoma in situ". Sometimes I wonder....this spot had the potential to become skin cancer, but wasn't really cancer yet?


December 14, 2009


When I wear makeup, I look like there's a piece of gum stuck on my cheek now. I guess that's better than pepperoni. It's not quite as red, but still very discolored. I am willing to go to the store or a restaurant without wearing my sunglasses to hide it, but people who don't know about the surgery do sometimes look at it and try to figure out what's on my cheek. I feel the need to explain it sometimes to put them at ease. Or is it to put myself at ease? I don't know.

The graft does contract and heal. It's gradually getting smaller. I definitely have to stay with the massaging to try to keep it soft. I can see it changing from week to week. I always wear sunscreen on it, actually all over my face now. Dermatologist recommended Neutrogena with Helioplex, and I use 70 SPF. Plus a hat on cloudless sunny days.

I will continue to take photos of the progression of healing. Skin heals in a fascinating way. And I may eventually get the scar revision done, which is a series of small sections of the graft removed over many different visits to the surgeon's office until it becomes a smaller scar. But it will always be a scar there. A reminder of the cancer that could've been. If melanoma gets into one's bloodstream, that's a bad thing. I don't feel like I was dealing with cancer, but the potential for cancer.

Of course everyone knows one of skin's enemies is the sun. I finally believe that now after all those years of tanning and sometimes burning. The truth is, though, that I'm going to miss having a sun-kissed glow in the summertime. I always felt healthier-looking after a day in the sun. Life's full of little ironies.

IF YOU ARE INTERESTED IN SEEING ADDITIONAL PHOTOS AND UPDATES, PLEASE GO BACK TO THE TOP OF PAGE AND CLICK LINKS AT UPPER RIGHT. ADDITIONAL BLOG ENTRIES SHOW PHOTOS OF THE GRAFT. Each month listed has a photo update.