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 - 2012.    


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 FROM 2009 TO 2012. Each month listed has a photo update. 

235 comments:

  1. just diagnosed with melanoma in almost same spot.. had it excised a week ago and pathology came back and had to excise more! waiting on 2nd report before attempting to close and skin grafts. thank u for letting me know what to expect afterwards.. not looking forward to it but the alternative is not an option!
    Joe

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  2. Hi Joe,
    Sorry to hear you have to excise more. That is such a letdown. I am glad this gave you some idea of what to expect. More recent photos of my graft are on this blog in April & May, in case you didn't already see those. The recent photos show even more improvement than this batch. You're right, not really an option--my doctor said "to cut is to cure". Good luck to you.

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  3. test still positive, really getting depressed, doctor is going to call later to discuss options. this keeps up i will need an entire face transplant! but hey, i could use another one! the spot was so small, amazing how they can spread....

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  4. Joe,
    Sorry to hear this! Have they given you the option of Mohs surgery? Still would probably need some sort of reconstructive surgery by plastic surgeon afterwards, but with Mohs they excise smaller amounts, examine by microscope while you wait, take more out if they need to, and stop when it shows they have taken it all. It takes all day. Sometimes this can be an alternative to taking wide margins and doing grafts. In my case I think they probably took wider than necessary margin. It's a hard call when these things are close to the eye.

    Also ask if your pathologists have used different types of stains on your excised skin slide (Melan-A stain is one type). From what I've read, Melan-A stain could make it look as though there are melanoma cells present when they may not be. But I'm no pathologist and it all confuses me! Is yours Melanoma-in-situ or Staged Melanoma? Hang in there.

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  5. It is a lentigo melanoma stage II, from what I have read it seems they spread laterally rather than going deep. also they rarely metastisize(sp)which sounds good. what i have read about mohs it seems they don't recommend it for melanomas.I am waiting on Dr. to call and I think I will go see him tomorrow even if it's just change the dressing. It's been on there a week and is starting to bother me. thanks for the encouragement and your scars are looking good!

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  6. finally got a "all clear" after 5 cuts.. i really hope none of them were false because of sun damaged skin cells.. but what can u do but trust your surgeon?? 6/30 wed. I go in for skin grafts and to fix lower eyelid that has fallen down. he explained everything to me such as taking skin from collar bone area and the pressure patch that will be sewed on.. i know what to expect thanks to your blog, i'm excited to be getting it done and start recovering, thank you for your blog and know that it helped someone else to know your experiences. good luck and keep on getting better!

    Joe

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  7. i wish i would have researched and read about your experience, or maybe not. i just got the huge rose looking bandage taken off today. i was not prepared at all. i've cried most of the day. i don't get much more hopeful reading your progress my graft seems much bigger, but nevertheless same feelings. my mole that just started growing about 6 months ago measured 1.4, so the surgeon took 2 cm around the entire site, so i figure a 4cm X 4cm area on my cheeck. it is sooo awesome i caught it at this stage, and i do realized that; however, that doesn't take away the feelings of having a huge "pepperoni" left on your face. the surgeon told me it would look like someone with a small fist punched me, but the color was what i wasn't expecting, i guess. it's just all a lot to take in, in a short amount of time. the surgeon did say at the 3 month mark he could do a flap. 3 months seems a long time away. thanks for sharing your story, and having a comment section for me to share mine.

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  8. It is a lot to take in, having such an obvious scar on the face...the first place people look at us. Many times I've wished it could have been any other location except my face. I know it feels long to wait 3 months, but my surgeon said he can't do anything until a YEAR, so I think only waiting 3 months is great! Thanks for writing, and you will be surprised how much the scar contracts in 3 months. Mine is much smaller than the original graft size. Thank you, and if there's a way to share a picture, please do.

    And I also feel bad for Joe who needed 5 cuts before they got it all, and now have to fix the eyelid! Such a stressful ordeal!!

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  9. i had my stitches taken out yesterday,7/5, less than a week after surgery.. big puff-ball on cheek removed too. Dr. said all was looking good and he was proud of himself for "tricky and hard work he did to bring lower eyelid up".. he said i could start wetting it when taking a shower, not done it yet but will try soon. to me whole thing looks like crap but i will give it more healing time before I cry in a beer. whatever, we're still us underneanth and I am thankful it was caught in time and we can wear our scars to show we are survivors!!

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  10. It was so kind of you to document your experience with us. I just had the same surgery. Hopefully I will progress as well as you. Thanks!

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  11. How does it look now, a year post op? I had melanoma surgery to the area just immediately under my lower lip. While it is not awful, my lower lip is now pulled down and to the right. Any revision would require me to have a graft because so much skin was removed, there is not enough to provide proper mouth excursion (like when you smile). A year after stretching and healing and this is the best it is going to get.

    I would have a graft taken from the redundant skin on my neck for a good color match. Now this would leave me with another large scar on my neck, but I think I could live with it if it would provide me a better looking lip area.

    Good luck and I would love to see a more recent picture.

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  13. Thank you for your bravery in posting this. Also well written.Almost 2 months ago, I had Mohs surgery on the right side of my nose by my eye.This USED to be my good side. I had skin flap repair and now have a discolored flap of skin. I wear a bandaid every day cause as you say, people look at it alot and it makes me uncomfortable. It's better than having cancer but it is still hard to have on your face for all the see!! I'm hoping there is a vast improvement within a year as the professionals say will be. I guess it just takes patience. I tend to be an instant gratification type.
    You take good care of yourself and thank you for sharing your experience. Makes me feel not so alone in this!!
    xox Shelly

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  14. Hello Shelly,
    Thank you for your kind words. I have also found it difficult to be patient and wait for the darn thing to heal/blend. I just got back from my "one-year appointment" with the plastic surgeon this morning and he said he's pleased with how my graft is looking, though he doesn't know why it's taking so long to "settle." He was glad to see that the color is lightening (it was dark for several months but is finally more of a normal skin tone). Apparently my scar has taken longer to soften than most people's and there is a ridge of thicker scar tissue near my nose. But he said it will continue to soften, and my next appointment is 6 months away. Hearing from people like you also helps me to not feel so alone in this, thanks.

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  15. Hi again.My 2 month appointment is on Thursday. I will let you know what they say. I have pictures but am a bit computer stupid so I will get my husband to help me post them and you can see what my mess looks like. I am thinking that because it's on our noses, that they skin there is very thin and perhaps why it's not healing as well as some other outcomes I have seen. I have also heard that some secondary procedures may be in order such as dermabrasion, laser therapy etc. Yikes!! People say not to be superficial and it could be worse but these are the people that DON'T have a big scar on THEIR faces!! They have no idea what it is like. I understand that it could be worse but this is our reality and we are living it. By the way, you are a very beautiful woman and I can tell by your writing that you have a lovely spirit about you!!
    I will let you know what happens on Thursday!! Till then, take care.
    xo Shelly

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  16. I had my 2 month appointment yesterday. Which was crazy, as I had to take a ferry to Vancouver because I live on Vancouver Island... so after all the arranging, time and money spent, my appointment lasted 5 minutes!!The doctor said that in the thousands of cases he has seen, he has only seen what has happened to my incision 2 times!! MY DUMB LUCK. So he told me to stop the massaging and start applying this cream. Then he said that I would probably need some dermabrasion to smooth it ...down the road. I will continue to wear a bandaid every day... not impressed!!
    I stated in the previous post that it was on OUR NOSES and I re-read and meant to say FACES. Sorry bout that.
    I looked at some of your pictures and I think you are healing very well!! It is looking very smooth now and more like your skin tone. I hope that I heal as well as you!!
    xo Shelly

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  17. I'm 10 days out and and got stitches out of graft 3 days ago. I've been really worried about the dark spots, etc. Thanks for sharing your experiences with this and the photos. I don't feel so alone.

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  18. Thanks for your comment today. I'm glad this is helpful to others sharing the same unfortunate experience. In time it becomes less noticeable but the first few months admittedly aren't very pleasant. Good luck to you.

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  19. I had basil cell and had MOHS procedure done on Oct. 27th I wore the sponge like thing 7 days. It has now been remove for 7 days. I have a dime size scab as my graph. Does anyone know itf the graph scabs all over, And how long does it take the scab to go away. Doctor did not tellme mich and want to make sure I am not rejecting gaph<

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  20. I don't have any experience with MOHS, but from what I've read it sounds like the large scab is what you should have, and I would guess that it would take a couple of weeks for it to go away, or maybe a little longer. The doctor's office should have given you some information, like whether or not to keep the area moist and covered, and if you should use some Neosporin or Bacitracin on it. I'm sure a nurse there would be happy to answer your questions if you give them a call. Sorry I can't be of more help.

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  21. Thanks for sharing your story. I could have written your story. I am 45 and had a brown age spot on my face. It is almost in the same spot as yours but closer to my eye. It's still unknown if it has caused damage to my tear duct. The dermatologist froze it off 3 years ago. But it came back and I waited to go back. When I went back, she biopsied it and sure enough, it was melanoma. I had the Mohs surgery yesterday. Yes, they do Mohs for melanoma if it's on your face. Tomorrow, I am having my skin graft done by an oculoplastic surgeon. He is removing skin from my eye lids to graft so I'm hoping for the best. It's nice not to feel alone. Thanks.

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  22. Hearing from others going through the same thing helps me feel less alone too. Thank you, and I hope all goes well with your graft today. I had not heard of using eyelid skin for the graft, very interesting. Yesterday my daughter said "Mom, I don't even notice your graft scar any more."

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  23. Your pictures and commentary are more informative than my many discussions with top New York surgeons--thank you so much. I am in the process of having "mapping biopsies" to define the perimeter of a fairly large lentiga maligna lesion rather like yours, but also closer to the lower eyelid and perhaps also in the conjunctival tissue. For other readers, my deep research (sloan Kettering, NYU, Mt. Sinai) suggests that Moh's is controversial for melanoma BECAUSE of the difficulty in reading the frozen sections under a microscope. The surgeons I have chosen do a complete excision with clean perimeters, and that is why we are trying to define the perimeters. No one has yet really explained what is in store for me with the skin graft and its aftermath, which is why I am so grateful for your first hand experience and photos. Very sobering. Very centering. I am leaving in ten minutes for the third of my biopsies (sort of like root canal on your face. Ugh. If you have this, take a sedative beforehand.) Will keep the site posted. Good luck to you all. Get the best information. Get several opinions. But those with early stage melanoma need to remember: death=bad, scars=hat. It's life that counts.

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  24. Well stated. Thank you very much for writing. Looking back, I wish I'd obtained several opinions. I had a second opinion on my biopsy, but wish I had thought to get a third or even fourth. I wish you well as you go through the process. Your surgery may be a bit more intricate since it comes closer to your lower eyelid. Not to cause worry, but in some cases as the scar contracts while healing it can pull down the lid slightly. One of my readers had to go back for a second surgery to correct that issue. Good surgeons ultimately want their patients to be happy with their work. And yes, I've read the controversies about Mohs for melanoma also. Glad my info was helpful to you. Thanks again.

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  25. While I am waiting for the path report from my second biopsy (I posted on my way to it a few days ago) I have a question for the site about lentigo. Maybe you know, maybe you don't-- my doctors have not been clear about it. But as a friend put it, you don't ask if a barber if you need a haircut. If lentigo spreads laterally but does not metastasize, why do a disfiguring excision for it? Are there survival rates for untreated lentigo? (Treated it is supposedly nearly 100%). Or does it eventually and/or inevitably metastasize? And if so, what is the time frame?
    Looking at old pictures, I realize that these shadowy lesions have been there for at least two, and probably more, years. Am very confused. I am ready to do (and suffer) whatever is necessary for survival, but not what isn't. Advances in the treatment and attitude to prostate cancer are perhaps an admonitory case here. They used to perform devastating surgeries before they figured out that "watch and wait" for many men over a certain age was just as prudent. (On the other hand, we all know men who have died of prostate cancer.)
    I am 64, by the way, but youthful and fit, with a 22 year old kid.

    Many thanks for your feedback and support.

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  26. I wish I knew the answers to these questions, as they are exactly the same questions I have. When my biopsies came back, this is precisely what I was trying to research online. Something I read (but didn't keep unfortunately) finally settled my mind that having the graft was the right thing to do.

    My dermatologist said "to cut is to cure" ... and melanoma cells are very alarming to her, even in their early stages. This light brown spot of mine was on my face for about 15 or more years. My dermatologist said lentigo malinga spots are slow growing, but she felt that if I'd waited another 5 years it could have become a much more serious problem with vertical growth. However I don't know survival rates of lentigo maligna. From what I learned, these can become life threatening. I continue to have lingering doubts about the severity of mine and will always wonder if I actually needed this procedure. But I also want to mention that a year after the graft, it no longer looks or feels like a disfigurement.

    A few months after my graft surgery, I was questioning this so my dermatologist drew a diagram for me while explaining how the abnormal cells can get into hair follicles and grow deeper into the skin (forming "nests" of abnormal cells).

    http://path.upmc.edu/cases/case97/dx.html

    These links may be of some help to you, but I have never been able to find the concrete answers that I'm looking for either (which are exactly the same questions you have). And many times I have thought about what you said regarding the older procedures such as those for prostate cancer. I share the same feeling that in the future the medical community will look back and realize these types of grafts/excisions with wide margins were a bit extreme and perhaps unnecessary. But for now this seems to be the widely accepted view.

    This link was very informative:

    http://www.cuh.org.uk/resources/pdf/patient_information_leaflets/PIN2377_understanding_melanoma_in_situ_and_lentigo_maligna.pdf

    http://www.cortlandtforum.com/solar-lentigo-and-lentigo-maligna-melanoma-itchless-pigmented-macules/article/147931/3/

    http://www.pathologyoutlines.com/topic/skintumormelanomainsitu.html

    http://jcp.bmjjournals.com/content/62/2/120.full

    Please note, pathology labs can use different types of stains to read their results. When a second stain was used (for biopsy on my left cheek smaller spot--not the right cheek graft spot)it was determined that the margins of abnormal cells were not as wide as the first stain showed. So I almost went through a second excision which would have been unnecessary.

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  27. See this article:

    Melan-A: Not a Helpful Marker in Distinction between Melanoma In Situ on Sun-Damaged Skin and Pigmented Actinic Keratosis.

    Shabrawi-Caelen LE, Kerl H, Cerroni L.
    Department of Dermatology, University of Graz, Austria.
    Am J Dermatopathol. 2004 Oct;26(5):364-6. Abstract quote

    Pigmented actinic keratosis is one of the simulators of early melanoma in situ from severely sun-damaged skin. Close scrutiny of the hematoxylin and eosin stained section does not always allow an unequivocal diagnosis, because it is sometimes difficult to distinguish pigmented keratinocytes from melanocytes. Immunohistochemical stains, such as S-100 and HMB-45, are used routinely to address this problem. Melan-A, also known as MART-1, is an additional melanocytic marker and has proved to be useful in identifying metastatic tumors of melanocytic origin. The usefulness of this marker to discriminate pigmented actinic keratosis from early melanoma in situ, however, has not yet been a subject of investigation.

    In this study we evaluated Melan-A expression in ten unequivocal cases of pigmented actinic keratosis and compared the staining pattern with that of S-100, HMB-45, and tyrosinase. In all ten cases the number of cells highlighted with Melan-A was by far larger than those labeled with S-100, HMB-45, and tyrosinase. Four cases showed clusters of Melan-A positive cells being suggestive of melanocytic nests. Even areas of normal skin adjacent to the actinic keratosis featured prominent staining of Melan-A, but only inconsistent labeling of intraepidermal melanocytes with S-100, HMB-45, and tyrosinase. We therefore believe that Melan-A is a more sensitive marker for intraepidermal melanocytes than S-100, HMB-45, and tyrosinase. In addition there may be expression of Melan-A in keratinocytes and nonmelanocytic cells.

    To avoid an erroneous diagnosis of malignant melanoma one should therefore interpret results obtained from Melan-A stained slides carefully and in the context with other melanocytic markers.

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  28. "LM usually begins as a small, well-circumscribed, tan or light brown macule, that may remain stable or enlarge slowly or rapidly. Although no prospective natural history studies of LM exist, it is likely that the onset of LM precedes the diagnosis of melanoma arising in LM by many years in most cases , and it is not unusual to have a duration of 10 to 15 years or more before LM progresses to invasive melanoma (9). The true risk of invasive melanoma attributable to LM based on available information is difficult to assess. However, based on prevalence of LM and its contribution to melanoma case fraction (4%), it appears that the following are probably true: 1) risk of melanoma developing in LM may be estimated to be approximately 1 in 750 cases per year over the age of 45 years; 2) risk appears to increase with age; and 3)risk to age 75 years may be as high as 2.2 to 4.7 percent, depending on age at presentation."

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  29. Thank you, Quiet One, an excellent clarification.

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  30. Thank you so much for given us all the opportunity to see how you are coping with this problem. It has helped me so much as I had surgery and skin graft just before Christmas and have just found out I need further surgery as not all of the cancerous cells were removed. I know it has to done and accept this if it means getting rid of those damaging cells. However, can you tell me what aftercare you used in relation to your skin graft. Mine looks life a lump of white playdoh and has not feeling in it. I do use E45 creme but wondered if have found anything better? How often and for what length of time did/do you massage your graft? Thank you for your help. Have a lovely week-end

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  31. Hello Feb 19 Anonymous,

    Thank you for commenting, and so sorry you have to endure more surgery.

    About 2-1/2 months after my surgery, I was instructed by my plastic surgeon on how to massage the area. He pressed his thumb very firmly into the scar and said I should press hard like that when I worked on it. I always use a cream or oil when doing this. They recommended massaging throughout the day 5 minutes at a time, and longer periods of time when on the phone or reading (30 minutes). I like Palmer's Cocoa Butter Formula for this.
    This will sound very odd, but around the third or fourth month I also taped a round slice of banana to my graft for about 30 minutes and would press on that. It seemed to help with the healing, though it sounds far-fetched, I realize! Gave me something like a cushion to press against.

    My graft scar has no sensation either. I can feel pressure, but I have no idea when there's a drop of water on it, for example. I think that's how it will always feel, and I'm told that grafted skin sunburns very quickly (within minutes) so I always keep it protected from the sun.

    I have never stopped massaging. Every night before bed I try to massage the scar while I'm reading. The goal is to keep the skin from hardening like leather. Keep it supple, help the tissue soften. Hopefully this will help it blend in time as the scar matures.

    My dermatologist said Retin-A could be helpful so I apply that about once or twice a week. And she said I might want to try hydrocortisone 1% cream to help bleach and soften it. I will try anything a doctor recommends to me!

    Wait until the scar heals enough before you start to massage the tissue. Your doctor should be able to show you some techniques and let you know when it's safe to start that. They wanted me to begin doing this as soon as possible so the scar tissue wouldn't firm up too much.

    Please keep in touch.

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  32. I found this video about scar massage which might be helpful

    http://www.youtube.com/watch?v=ehlPa6PlF6U&feature=fvsr

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  33. Thanks so much for sharing your story. In January of this year, I went to my dermatologist for a rash on my hands. She didn't like the dark spot on my cheekbone and took a biopsy that revealed melanoma. I had surgery a week later and was left with a nasty scar... I'm learning to deal with it, but was grateful (and lucky) for the diagnosis. Had I not had the rash on my hands I would never have gone to the doctor.

    My very best wishes to you!

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  34. Thank you. Sounds so much like my first doctor visit; I actually made my appointment because I was having some adult acne on my jawline, and simply wanted to ask the dermatologist if anything could be done about my brown spot as a side note. She didn't like the look of my spot either, which of course was melanoma in situ. We're fortunate to have had these trained eyes looking at our skin. It makes one wonder how many folks are out there with absolutely no idea they have melanoma and have no plans to see a dermatologist...nor do they have rashes or other reasons to prompt them see a dermatologist. Quite scary. Thank you for taking the time to write. I appreciate it very much.

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  35. For more recent photos of how my graft has healed, I have posted more in "newer posts" throughout the past year.

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  36. i just had one bcc removed and awaiting my fate its beside my eye just want to say ur still very beautiful im scared out my mind so ur story helped

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  37. Hi, I am very glad to have found your site as had a graft a few days ago - certainly feeling the emotional ups and downs. I've had BCC surgery experiences for 20 years (nearly age 50 now), and about 13 years ago had radiation (which give a burn after time), and I think the cancer came back on the edge, close to my eye - so my graft seems a similar size and location! I'm dreading the going out thing. Thanks again. My name is Ruth - the only reason I am putting anonymous is to post this.

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  38. Thank you Ruth. I'll be 50 this year. I just had two more biopsies last week and should hear results in a few days. Most of my "stuff" seems to be occurring near my eyes also. I hope you're healing well.

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  39. im still smearing medicinal honey all over it and it does appear to be working

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  40. i dont want to say how traumatised i am at the moment as i know u been thru hell and back urself but people will not stop staring at me.. i am to the point i wont go to a shop or into a garage . i had a bcc removed beside my eye i posted on april 24 ive scoured the internet for what this might look like its pulling at the side of my eye slightly i can deal with that but the plastic surgeoun doesnt want to see me for 4 weeks i enforced 2 to explain but they seem to refuse more surgery too early on

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  41. also i cannot stop crying for my face now i wouldnt say mine is worse than urs its on the nose but pulling on my eye but the tears just come like just know its never going to be the same and i guess its what u must of went thru its like people just wont stop staring with like this shocked look and i cant hide my face i cant go overseas and its not there anymore its there now ...everyone just says be glad ur alive or ur going to be ok i just cant stop feeling like sure my face is well my face is .. i dont know .. thank u for having this page .is all i can say

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  42. i cannot rave enough about medicinal honey i put it on the bottom and still smearing it on it is better than parafin wax it helps collagen i think even old scars u can benefit from using it ask at ur health shop..sorry if i sounded a bit dramatic im just sick of all the people around me being so positive that ill be ok when i dont feel ok i know maybe itll be ok just sick of hearing people say OH ITLL BE OK UR FINE.

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  43. Lost a big chunk of my face to melanoma... now have a skin graft from my left wrist and my radial artery in my face. I would never wish this on my worst enemy, but strangely, it has made my life better. I am happier having faced death and survived, and having realized that so much doesn't matter ... Made a lot of changes in my life, including a job change, divorce, change of living situation, but overall I'm really good. Still, a bit self conscious about the face...

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  44. I posted last winter about my various mapping biopsies--four in all--an unusually vast area--for melanoma in situ. Having done tons of homework, I came to the inescapable conclusion that surgery was the only sane option. One doctor did tell me that if I had a skydiver's appetite for risk, I could choose not to operate, as lentiga grows very slowly and may not become invasive for years. I did have the surgery, last March--a large chunk of cancerous skin wrapping around the eye and the upper cheekbone was excised and skin taken from my inner upper arm was grafted into place. It did not look as terrible as I had feared, although it certainly looked as though I had been through a bad accident. I could hide it behind sunglasses. Some of the graft was perfect--both flat and the same color as the rest of my facial skin-- but a section in the middle became necrotic. The post-op biopsy also showed some remaining cancer in the upper eyelid. As the graft healed, the eye drooped, but I had been warned that it probably would. When I went for my six-month follow-up, some more potentially cancerous skin showed up under the Woods' Lamp, lower on my cheek, and I am waiting for those biopsies. A second surgery is scheduled for June 21. If I am lucky, it will remove the remaining cancer in the lid, and the doctor will also revise the granulated and ugly patches of the skin graft and correct the drooping eye.
    The original surgery was almost four hours under general anesthetic, and I am still recovering. The next one will probably take as long even though there is less cancer to excise. The surgeon, said to be the best in his field, is optimistic about an "excellent" cosmetic result--down the road, when the graft has healed and he can dermabrade its edges. I will lose the lashes in the corner of my upper lid. (I have already lost them in the lower corner.) I had a pair of light-tinted glasses made, to wear after dark (it is hard to see with sunglasses in low light conditions.) But somehow, it is not that horrible, not that traumatic, and I am not that self-conscious about it, though I probably would be much more miserable if I were younger. (I am sixty-four.) There is even something sort of dashing--like a duelling scar. This is not to deprecate, at all, the anguish that facial surgery causes. It does. But cosmetic surgery works miracles, don't forget it, and most reconstructive surgery is covered by insurance.
    QUESTION FOR THE SITE: I have not gone back to my yoga practice, fearing that the rush of blood to the face might somehow damage the graft, and I cannot get an expert opinion that I trust about this. Does anyone know how long after a facial skin graft it is safe to practice yoga and do inversions?

    Quiet One, please also let us know about your new biopsies. I think we are all so grateful for this site and the solidarity on it. Courage, everyone. You/we will get through this. It does have an upside: you make life decisions with a heightened sense of what is precious and important and what is simply vain and mindless.

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  45. Beautiful comments posted this week. It's wonderful to hear the positives. I learn so many things from what people write here. Many of you have gone through so much more extensive surgeries than mine. I appreciate anything positive you can feel after a skin graft on your face -- especially that you can view it as "dashing scar" ... made me smile.

    I don't have an educated answer to offer about the yoga, but I'm going to venture a guess that the 3 month mark should be okay. If you feel any throbbing in that area when you do inversions, then I'd wait even longer. I remember that throbbing feeling when I bent over the first couple of weeks. As the nurse said to me one day at the plastic surgeon's office during a follow-up visit, "you'll know when you can do things" (she was referring to washing face again, or putting creams on etc). Any uncomfortable throbbing would be a sign that your graft isn't ready to be upside down yet. I can't remember when that feeling stopped for me, but I know it's long gone now.

    Thank you for asking about my biopsies. Everything was fine this time, phew! What a relief! And I'll probably have a very minor scar revision in August or September to remove a raised ridge from the graft where it had the most difficult time healing. The plastic surgeon said my scar tissue is finally soft enough to perform a revision right there in his office (though very, very small).

    Very smart to get the light-tinted glasses. I remember trying to read labels in the store with sunglasses on, which was quite a strain on my eyes!

    And a reminder to people who have had melanoma-in-situ on their skin, it is recommended that you also have your eyes checked by an eye doctor.

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  46. Hi

    I've recently had my biopsy back - malignent melanoma on my lower leg. I did point out that only recently I have had an age spot appear on my cheek, which was examined at the time, but was told more than likely it is what it is...an age spot. After reading your story, I am going to investigate this more. You have a beautiful face, thank you for sharing.

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  47. Hello,

    Your site has been such a gift. I have to say thank you straight away.

    I am a very fair skinned person who was 'baked' in the sun by my mother all through my childhood because the doctors told her that it would toughen up my skin. This was back in the 1950s. I of course never tanned and remember years of having the skin peeled in sheets from my back.

    As an adult, I stayed out of direct sun for the most part.

    Of all places for me to get my first melanoma (my doctors have warned me that this probably won't be the last one because of the extensive scarring on my back) I got my first one on the top of my dominant hand.

    First was a biopsy by a dermatologist who didn't think the raised "freckle' looked suspicious at all. I told him it had raised up and we both agreed it wouldn't hurt to have it biopsied.

    A week later while I was standing, in all places, in a cemetery doing 'ancestor hunting' my cell phone rang and it was "the call." A strange calm came over me. It was a surreal experience.

    Next step was the Mohs procedure and removal of two freckles that were laterally placed on either side of the melanoma. I was relieved that my 1st dermo surgeon decided it was a good idea to just get rid of them.

    It was your site that gave me the idea of what might happen if it was decided to have a skin graft. It also gave me the idea... why not have a professional photograph the Mohs procedure itself? I had a very cool first dermo surgeon who said "Cool. Bring the photog with you." So I have photographs taken of the removal of the skin from my hand. My area is about the same size of yours. Further pathology besides the Mohs pathology had to be done underneath the removed skin just to be sure it hadn't spread too far under the skin. Before she covered it up, we had a fun lesson on how the tendons work in the hand because the tissue removed was all the way down to the tendons. I found it fascinating to see them.

    I ended up having to have a hand surgeon do a split skin graft using skin harvested in a sheet from my thigh. No photographs of the surgery. Two hours under general and I was in the recovery room.

    I've been taking photos of the graft as they have uncovered it to check it out and then the next visit to remove the staples. The grafted area is now starting to contract and that concerns me. I have kept it covered (my surgery was at the end of August) and have kept it dry as directed. The center looks pretty good but a lot of the border is scabbed up. I had to finally touch the thing just to see how it felt. It's really hard but it is also viable with no sign of sloughing off or anything. A hand surgeon did the skin graft because of the location.

    All of this is to say thank you for reducing the fear of the unknown. I'm an extremely visual person and knew I would wince at the post op photos but I had to look at them to know more before I had mine done. As I look at my hand now, I think of it as a point of pride that I took care of myself and didn't just let this go. I think the same could be said for the resulting changes you underwent.

    Thank you very much for what you've shared. You've helped a fellow traveler, me, so much.

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  48. Thanks for sharing your unfortunate, yet beautifully written, experience. I'm glad my photos helped you prepare for your own surgery. Grafts contract and get dry, so keep yours moist. Interesting that you thought of bringing the photographer. Wow, all the way to the tendons! You're brave to be able to discuss that during the procedure. Such a relief that you took care of this and I hope you don't have any more in the future.

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  49. I just want to Thank you for your honesty and candor. I recently had 4 surgeries in June on my right cheek. (It was 11 hours of mohs surgery followed by 4 flaps and 1 skin graft. I had spent my time and career on camera as a journalist prior to this. It has been the most horrifying experience I have ever gone through. My doctors at Mayo have been amazing and I don't know what I would do without them. I lost my face, my ability to work and my husband just served me with divorce papers. I am trying very hard to hang on and am desperately trying to keep a positive attitude. Your posts have really helped me. Thank you so much! -Lea

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    1. Hi, i've been reading your comments and others. I feel inspired to tell my story of two moh's surgeries on my face. The first was 6 years ago on my left foreheard. The removal of my skin was large extending from my eyebrow to my hairline. A skin flap was placed on the removal site. after two months a skin expander was placed under the skin under my right forehead. Every week for 6 weeks fluid was placed into the expander from the port that was on the top of my head. It was very painful and disfiguring at the time. My only saving grace was that it was kind of hidden by my bangs. The skin expander was about 3 inches long and pretruded 2 inches. I kinda looked like I was growing another head. I kept a very positve attitude and humor about it and that really helped matters. I have to say in the end. It looks fabulous. It took a series of 5 surgies to revise and correct the damage. The result has been excellent, I am only left with my left eye being slightly hooded on the inside corner and the scar is flat and nearly invisible. In fac, it doesn't bother me at all. Its kinda sexy..really.

      So, that was my first experience with facial moh's surgery. Now my most recent was only 1 month ago. This time the placement of my skin cancer is definitely more noticeable. the skin cancer (basal) was above my lip. In the bow of my mouth. It was just a tiny red scaly spot that looked like scar tissue from previous cold sores. Anyway, the dermatologist had to perform 5 moh's surgeries and removed skin about the size of a half dollar between my lip and nose. A skin graft was placed on the site immediately. After a week, the bandages were remove and I saw the extent of the damage. They even removed the top part of my lip including that cute little bow area. I am left with a skin graft that looks like a triangle starting at my nose and ending at my lip. I have gone through a very difficult time adjusting. Liking it to Post Traumatic Stress Disorder. I went through about 3 weeks of tough adjustment. But one day I decided that the plastic surgeon will do all that he can do through revisions and in the end I will adjust like I did with the other disfigurement on my face. It is still very early in the process of healing. Is there anybody out there who has gone through mohs surgery in the same place. I am eager to hear about the long-term outcomes from these brave people. I have searched the computer sites and this is the first one that seems to give me inspiration.

      I hope that my first story of skin cancer gives those who are suffering helpful. If anyone would like me to send photos of the first repair, I would be happy to help. To all the rest, thank you for your courage

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  50. Lea, thank you. I'm so sorry that on top of everything, you also have to deal with a divorce. You've been through a lot. I felt like I "lost my face" for a while too, but now I've seen firsthand how skin changes, heals, repairs itself. Keep thinking healthy, positive thoughts. I wish you the best with your healing. I'm very happy that my posts were helpful.

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  51. Thank you for the time and energy you put into not only sharing your own experience, hardship, adventure, but educating those of us with so many questions, unaware of the journey ahead. I certainly appreciate your time and wish you the best in the future...hope the "Melanoma Drama Series" as I call it at our home, has no further episodes in your life! I am a firm believer that each hardship we endure, if we chose to...in the future it has the ability to help someone else...I appreciate you making the choice to help. Today it's the arm we're dealing with, but like you, w/past burns from younger years, keeps me aware of the reality that my face may be next! But with your thoughtful blog, I feel more educated and less ignorant of what to expect...thank you!! Elizabeth

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  52. Elizabeth,
    Thank you so much. This is one of the nicest sentiments I've ever received about my blog and it means a lot to me. I'm glad this has been helpful and hopefully your "Melanoma Drama Series" won't have any further episodes either.

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  53. I just stumbled on this site and am so glad I did. I marvel at the advice, information, and stamina of all who posted about their surgeries. I, too, had a melanoma removed from the top of my foot, close to my toes. A surgical oncologist did a sentinal node biopsy to see if it had spread. Thankfully, it showed no advances. All the tissue was removed down to the tendons of my toes. The dark blue dye remains as a 2x5 cm stain in the area. The graft looks just as dark and is very ugly. I can't tell if the graft took because of the dark color. Also the graft just sunk in over the area being about 1/2 cm lower than the rest of the area. Neither doctors told me the stain would remain or the area would be so sunk in. It has only been 2 1/2 weeks, and the doctors told me only hours after the surgery while I was in la la land that the ugly dark blue dye would probably remain. I just wonder why this was not even mentioned before surgery. I go again next week to both doctors to see what they can tell me. Also the area in my groin where the two nodes were taken is swollen and a hard lump is there. I hope that eventually goes away. I am thrilled the report showed no further cancer, but if this ugly dark blue sunken area can be improved upon, then I want to know. Thanks again the all you brave souls for sharing.

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  54. Thank you so much for this blog - it has made me feel so much better. I had a basal cell carcinoma removed from my left nostril a week ago using the Mohs procedure, leaving a 9mm x 7mm hole in my nose. I had a plastic surgeon do the repair the same day using cartilage from my ear and a flap from an adjacent area of my nose (what a long day that was - much more difficult to do both procedures in the same day than I though it would be).

    Anyhow, my flap is now scabbed over and edges are black - she thinks the flap might not be taking properly and I am terrified of what might happen now. Seeing your site made me realize that there are other women my age (43) out there dealing with the same issue (it seems like everyone in the dermo's office with BCC is about 80...not that it's any less difficult at that age, but I just can't relate to them). My friends have been incredibly supportive and helpful, but there is nothing like hearing from someone who has been through it.

    I feel blessed that this cancer is not a threat to my health, only a threat to my vanity. Nonetheless, it is still hard to stare at it in the mirror every day.

    Thanks again, and please post more to let us know how you are doing. Good luck!

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  55. I had both doctor visits on Tuesday of this week, and though the places look horrible to me, both doctors said it was healing slowly. It will take about a year for it to look as good as it is going to get. If the place is still very noticeable, something else may be able to be done. I am optimistic about the blue dye now, with small sections slowly disappearing. I can walk a little better and the swelling is better wearing the wrap around my foot. The doctor took off 30 ml of fluid from the hard knot in my groin. An empty sack is there from the node removal and it filled with flluid. It may fill again and have to be drained. Slowly it should take care of itself, over the months. I can start lifting light weights with my upper body and that will make me feel human again. Hope everyone sees improvements, even if they are tiny. Keep up your spirits and trudge on.

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  56. Appreciate your input CE and Sue. I'm not familiar with the blue dye. Good to hear you're improving. Tiny, gradual improvements are better than none. It took at least a year for my scar to settle down.
    Like CE said, this experience was a threat to my vanity rather than to my health, and my little skin graft seems extremely minor when I hear the humbling experiences of others.
    Excellent advice Sue: keep spirits up and trudge on.

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  57. Now it looks as though a small part of my skin graft did take and looks much better than the rest. The most part looks like it did not take and you can see the tendons and the raw looking areas. Does anyone know how long you have to wait to have another graft if the first one actually did not take? I am considering getting advice from another plastic surgeon in the near future. Any knowledge would be appreciated from readers of this column. Thanks.

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  58. I've never looked as good on my best day as you looked on your worst day!!

    But, I'm a guy, and having enjoyed an ill spent youth surfing, skiing, sailing, and not paying much attention to sun protection, I can't complain that now I have to deal with a minor addition to my face's "character".

    I'm scheduled for 8am next Wed. to have an "In Situ" Melanoma removed from the right side of my face. No skin graft, just a scar. If you see a guy surf fishing on the beach wearing long pants, long sleeve shirt, long hat, gloves, etc. Stop by and say Hi, Jim, it will probably be me. Best of luck and health. jim

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  59. Thank you and good luck next week Jim. You made me chuckle! The actress Helen Mirren said in a TV interview that she thinks scars on faces are interesting. Gave me a whole new perspective. Yes, we have added character now.

    I went to the beach two different weeks this year--once in August and then October. I stay pretty well covered, but not as much as I thought I would. Wherever clothing isn't covering me, I do put a hefty sunblock on at the beach. Always a hat & sunglasses too. I'm very aware of where sun is touching me and what time it is (I try to avoid hours of strongest sun rays), but I'm not paranoid about it like I was 2 yrs ago when first diagnosed. Keep enjoying the things you love. Thanks very much for commenting.

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  60. Went to the doctors again this week, and as I thought the skin graft did not take. No where to be found. Next step is to have surgery #2 with a type of mesh made from shark cartilage and bovine collagen stapled to the wound. Third surgery will take place 2-3 weeks later with another attempt at a skin graft. Surgery set for Nov. 17th. This is fixable, it is going to take a bit longer than we thought. Just another bump in the road. Still staying positive....cancer is gone.

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  61. I'm having my stitches out today! The Dr. called yesterday and advised that the Pathology report was "all clear" for my margins.

    I've had some double takes from people for sure.

    If it is a guy that is staring, I tell him that I was in a fight with a couple of Hell's Angels at a biker bar.

    If it is a lady doing the double take, I tell her I got the cut saving a puppy that fell down a well. That one works pretty good. ;-)

    Sue, great positive vibes. I will be thinking of you tomorrow.

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  62. I have been diagnosed melanoma in situ on my right lower leg and my left mid thigh. I will have surgery this Friday to remove more and I really was blessed to find your blog. I have been a bit anxious, cooking, cleaning and nesting before the procedure... And finally my emotions poured out tonight. Bigtime. Ironically, I am a health and wellness specialist. I have been really encouraged by your words, your photos and your beautiful face and heart and I will also take pictures.

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  63. Sue I hope all went well with your surgery today. I agree with J.C. - great positive vibes while faced with these challenges.

    J.C. you are funny!

    Tracy, thank you so much for your very kind words. Glad this has been of help. Good luck to you tomorrow!

    Today was my 6-month skin screening and I had two biopsies and an excision. Neck, chest and forehead. I was joking with the receptionist as I left and she said hardly anybody leaves there without a bandaid.

    Thanks everyone.

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  64. Thanks Quiet One, as all did go well with surgery. And J. I love your answers for the looks. I know they will work. I went back for post surgical visit Tues. and all looked good. Last surgery will hopefully be Dec. 15th. 4 cuttings on one melanoma. That is enough. Hopefully the skin graft will take this time. Hope everyone had a nice Thanksgiving. Stay positive all, things will look better tomorrow.

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  65. You are a very ballsy dame. I appreciate your frankness. I am going through something similar and it helps to hear how you felt. It's sort of a comforting echo.

    Thanks a lot!

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  66. I enjoyed your comment, thank you (ballsy dame made me smile). I'm also glad to have been a comforting echo.

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  67. I would like to thank you for your courage in posting this site, especially the photographs. I am recovering from a skin graft on my left cheek due to a malignant melanoma - the pressure pad and sutures were removed yesterday and the graft was redressed - my surgeon says I'm not allowed to see it until next week when there will have been more recovery. (My husband saw it and has gently warned that it is not pretty!) Again, thank you - it has been good to read about the experiences of others.

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  68. Just to add that my surgeon said that all was clear which was the best Christmas present I have ever had!!

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  69. You're welcome Julie. That's indeed the best news you can get from your doctor after going through this. Keep in mind, when you get your first peek at it, that the area will continue to look better each week and the graft will start to look smaller over time. The redness will fade too. I remember when it started to feel smaller under my fingertips as I massaged it day after day (wait until the doctor tells you it's ok to massage and then be sure to do so daily).

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  70. Well, another surgery has come and gone, 4 since Aug. 2. Sure hope this skin graft takes this time. I did not get sick from the surgery this time, and i am so thankful. The last 2 surgeries made me dizzy and nauseous for 2-3 days each time. I go back Dec 27 to get the bandage taken off and check it out. Hope everyone has a wonderful Christmas and a Happy New Year. Keep up your spirits fellow survivors and improvement will come, one day at a time.

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  71. Quiet One,
    I want to thank you for starting your blog about your journey with melanoma and skin grafts. I googled 'skin grafts near eye' and am so glad I clicked on your blog. I had Mohs for BCC 3 weeks ago and watching my skin graft healing is scaring me because not knowing what to expect, I was having grandiose scary thoughts. I am 48 yrs old and had way too many sunburns and the doctor says this won't be the first one either. I have been having things carved out of me for 20 years now but this is definitely the scariest for me.

    Thanks to you, I know that what is happening is normal and I need to have patience. I too will be blogging about my ordeal, even though it has nothing to do with my blog about what I do for a living. Yet, I deal with the public and have been having the very thoughts you have about what it looks like.

    If you don't mind, I will be linking to your blog because it is very important to me that people be informed about what seems like an otherwise harmless bump or freckle on the body. Knowledge is power and I must admit I am feeling powerless over this ordeal but reading everyone's comments makes me feel better so I am also thanking everyone else who has participated in this conversation.

    As my dad says, it's just a speed bump and I'll get over this too!
    Tammi

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  72. I like what your dad said! Thank you for your nice comment. Sounds as though we have had similar experiences in this, unfortunately. It is helpful for me to hear from others who have traveled a parallel road. And I'm always pleased to hear when my blog is helpful to people going through similar procedures.

    Your blog site is lovely and I look forward to spending some time reading more of your posts in the future (a link to your site was included in the notification email).

    Thank you for another positive way of looking at one of life's speed bumps.

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  73. Thanks for explaining your procedure. I'd been trying to find more info on melanoma for myself.

    I had a PINK spot on my nose which my dermatologist (cancer specialist) said last June was broken blood vessels. He advised laser and said to return in a few weeks if not better. Went back a month later and was told by his PA that they didn't laser it enough! Guess what?! In November, since it had gotten bigger a biopsy was done and this same doctor called me at night to tell me it was melanoma and it must be excised immediately. He didn't recognize it 6 months prior because it was an "albino melanoma". I had an area the size of a quarter removed from my nose and went back 2 days later for closure (skin graft) and was told they had to remove more as 3 of 6 quadrants were 'in situ'. I was devastated. They cut more (from tear duct to other tear duct). 4 days later (over a weekend) I finally had a full skin graft from clavicle area. Bandages came off 10 days later and sutures removed. I cried when I saw it -- dark red/purple. Just like you, I was afraid to touch it or clean it. It's a very scary thing.

    My husband is wonderful telling me that we had the best Christmas present ever - yes, but now the scars! I've been taking homeopathic medicine for bone and tissue growth and the improvement has been remarkable. One week after having bandages removed, the nurse couldn't believe the improvement. Now it looks much better but still a bit "raw". I was never a sun person but did have a couple of bad sunburns from skiing as a teenager. Now I'm 50 and what a return! Thank you for your postings.

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  74. Harriet I appreciate your note. So sorry you had to get bad news that you needed more removed over that period of time, tear duct to tear duct, ugh. Though it's good to hear how much improvement you've seen already. I, too, have a pink spot (on my other cheek) that my dermatologist continues to reassure me is just a broken blood vessel. But it doesn't go away and I ask every time I'm there, every 6 months. I will definitely ask her to look more closely next time since I have heard your story.
    Thank you.

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  75. Thank goodness I found this site as it is so therapeutic to read the stories of others and to hear about progress and emotions. I live in England and guess that most other contributors are American? The internet is so amazing at bringing people with mutual concerns together.

    My graft was done three weeks ago now and is healing brilliantly. Virtually all the scabs have gone so the "pepperoni" appearance has disappeared. I am a part- time primary teacher and go back to work next week so keep practising in my head my response to the barrage of questions I will get from the children about my graft.

    I think one of the big issues regarding a skin graft on your face is that you just can't hide it from others - your health has become a very public issue. I have decided to be totally open about it. (You never know, it might prompt others to get moles checked. I never thought I had a problem mole - I had to go to my GP about something else and mentioned the mole as I was about to leave as an aside.....two weeks later, I had had a mole excision and skin graft and emotionally had been hit by a railroad express!)

    I hate the appearance of the graft but have decided that every time I see it I have to thank God because without it I had a life-taking disease and it really is a small price to pay for my health.

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  76. Thank you Julie. Exactly how I feel about the internet bringing our mutual stories together. I'm in America, but this blog gets many views from other parts of the world including many from from Australia and New Zealand (according to the statistics tracker). Skin cancer diagnosis rates in Australia are quite high.

    Thank goodness you mentioned your mole to your GP. Then the whirlwind of facing what had to be done about it. Now the healing begins.

    Regarding the school children, I found that my daughter and her friends were the LEAST concerned with it actually. I mean, they cared, but were very accepting. I explained it in a non-frightening way, letting my daughter know I was ok and it didn't hurt. Her friends would look at it with a polite expression of "oh that's interesting" and then really didn't seem to notice it any more. Children never looked at it the way adults did.

    Thank you for sharing your lovely comments. I am touched that this site offered a therapeutic feeling for you (a lovely word, thank you).

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  77. P.S. This blog apparently has been viewed by several UK and Canada readers as well.

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  78. It is indeed, and I'm one of them. I've just read the blog and the comments from the other respondees and it's helped me. I've had a BCC on the side of my nose. 2 years ago it was treated by excision but a small spot re-appeared about 6 months ago. Finally got to a plastic surgeon for skin graft 10 days ago. Spent a week off work with that awful sponge bob lump of dressing on the side of my nose and had that removed last thursday. The nurse seemed to think the skin graft had taken well but I wasn't so convinced, but then what did I know, so followed advide given all weekend.

    Main problem seemed to be that the skin on areas of the graft wouldn't heal over and continued to 'weep'. Eventually had a proper shower last night and allowed the graft to get wet. Afterwards the top layer of skin on the weeping area of graft came off, just the very top paper thick layer. The skin underneath had a black shadow at one end of the graft nearest the eye and an area that which was a deep plum colour. This didn't look anywhere as 'settled' as the rest of the skin graft which seemd to be blending nicely with the edges around the nose and cheek.

    Anyways, I left it to dry and went about my business for the evening and when I looked at it in the mirror later the weeping area has just turned black and shiny and crusty, looks like the shellcase from a black beetle! :)

    So great... half the graft has necrosis by what I can gather from the net. Searching for more info. about how to deal with it bought me here. Seems I have nothing to do but just leave it completely alone and let my body deal with it, let it fall off when it's ready. I was hoping I'd get some kind of prognosis about how long this would take and what would be left behind but info. like that seems very scarce.

    Echoing some of the comments above, it's the having to go to work that's the problem. I'm 43, and an IT consultant. Thankfully i'm on a long contract at the moment becuase I would feel incredibly self conscious going to an interview with a new client with a big plaster on my nose. For now I'll go back to work tomorrow with a small plaster on the side of my nose and see how long it takes before I feel comfortable going in without it. I've a feeling it's going to be weeks and weeks if this necrosis is going to take weeks to drop off, and then who knows what's gonna be left behind?

    I do feel that the medical profession doesn't quite appreciate the impact on people's confidence of these kind of operations. It's all well and good to say "Well at least you've not go to worry about the cancer", but that doesn't really help when you get back into the non-medical real world.

    Anyways, I've rambled on enough. OP, you've come through a lot and I can well appreciate how sorry you must have felt for yourself at times, but you're looking pretty good again, very pretty indeed. :)

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    1. I'm sorry! When I hear about post-graft issues like these, I keep thinking there must be a better way. My hope is that your skin will heal nicely over the months, even where the necrosis is taking place. I read one blog about a guy who had mohs on his cheek (rather large area) and chose NOT to have a graft. His skin closed up and healed from within, little by little, and looked pretty good after several months. He didn't like the concept of a graft, so he let it heal on its own, and it worked out for him.

      I have felt the same as you many times about people saying "at least you don't have to worry about skin cancer" ... But of course the way it looks does have an impact on the confidence of the person walking around with this. When the wound is fresh and raw (and yours is very dark now) it is something you can't hide, as much as we want to hide it. It's a distraction when it's bandaged, and a distraction if it's left for the world to see. Not a comfortable feeling when dealing with the public.

      Thank you for sharing your story, and I appreciate your compliment in the last paragraph.

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  79. Hi
    Was just wondering if anyone else had pain around their graft. For the first 6 weeks, the pain was minimal but now I can feel the graft nearly all the time and the edge of the graft is really tender. I feel discomfort most of the time. I often feel a ring of needles around the graft and sometimes this is very painful. This is probably good healing but I just wondered if anyone else had found the same. Also, it is really painful when it gets cold - does anyone find this?
    I agree with anonymous about the impact on confidence of a facial skin graft. I still get the stares - two days ago I spoke to an acquaintance who made no eye contact but just stared at my graft.
    The children I teach have been fascinated by my graft. Several have asked what has happened and I have been totally honest and they have all wanted to look behind my ear to see where the skin came from. Another said , "It looks like skin has been sewn into your face," so I just told the child that she was absolutely right.
    Many thanks and very best wishes to everyone who has/needs a graft and reads this blog.
    Julie

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  80. Hi Julie,

    I didn't experience pain, but others have written of some pain, especially associated with the cold air. I presume you're keeping it very moist since grafted skin dries out easily. Maybe the sensation you're feeling is part of your healing since the graft is contracting/shrinking (which would be a good thing). I started scar massage around 2nd or 3rd month--numerous times per day--and was instructed to press very hard so scar tissue wouldn't harden.

    Your student was exactly right!

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  81. Hi, I just wanted to say thanks so much for sharing your pictures and story. My husband had a skin graft on his face for melanoma this January, and your blog is the only place I could find "real" pictures to prepare me for what was about to happen. He has healed up really quickly, or at least, after reading your blog I feel he has had it easy (if there is such a thing in this case??). Anyways, thanks!!

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  82. Hi - I just found your wonderfully helpful blog while searching for "graft healing" as I had my first graft a week ago and was just curious about the healing mechanism. My graft was to repair a superficial squamous cell ca from the corner of my eye onto the side of my nose. At one week, my graft seems to be doing very nicely so no complaints so far. Mine is hidden under my glasses so that will be a plus. I am 70 now and am the unfortunate veteran of many facial bcc and scc but such is my life and things could be so much worse. It was unfortunate that my very first bcc in 1987 was my "monster" - one that I thought the mohs procedure would take off my entire nose and part of a cheek but turned out to be a silver dollar plus sized lesion removing half a nose and a good part of cheek. A note about doctors that is not comforting but just a fact of life - all are not equal in skill levels. I went to several plastic surgeons who played around for a couple of years with my difficult repair but accomplished little until I found one who rebuilt my nose just beautifully. I have very little advice on how to find plastic surgeons and dermatologists like those I now trust other than ask many questions of everybody and get several opinions. I don't mean to imply these other physicians were anything but well meaning but... as in any profession, some people are more talented than others. Fact of life. At the beginning of this 1987 adventure I was in the frame of mind that many of your other blog posters are in. I was scared, embarrassed, didn't want to go out in public, talk to anyone about it and was uncomfortable in the extreme if people brought it up. I just want to let all of you who feel this way know that things get much better and probably much faster than you expect. It took me longer than I am proud to admit to come to this attitude but I found that like your daughter, others accepted it as just a fact and eventually, I came to accept it like that too. It never seemed to bother my wife, kids or friends and was always much more a problem to me than anybody else who I was close to. When my grandson looked at my current large bandage a couple days ago he just grinned and said "cool". Unlike today, in 1987 I had no support group of others who had gone through this or internet blogs like yours to share feelings with and to listen to other experiences so I want to applaud you for taking the time to do this. I know it would have meant the world to me back then! I also realize my history of bcc and scc is very different than those of you who are going through melanoma in terms of life threatening fears but I still thought I'd share my feelings of what I went through during the loss of what I felt at the time was the removal of a major part of the middle of my face. It was very hard at the time for several years but trust me, it gets better!

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  83. Thank you so much. Your wisdom is evident in what you've written. You certainly had a monster version to deal with 87. It's good to hear from people such as you who have been there and can assure others that it does get better with the passage of time. Acceptance comes along with the healing. I just have to say, on a selfish note, I hope I don't have to go through anything like this again in 10 or 20 years.

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  84. thank you to everyone in this blog. I had 2 bcc's removed from my nose both on the top and tip of it. I go on the 23rd for a skin graft. I now feel a lot better about what will happen after that, even if it does fail all your information has at least given me a more realistic view and some very good tips on how to cope. I am 68 and if someone I don't know asks me what has happened I tell them I have had a nose job done. The entire top of my nose looks awful but at least I can still wear my glasses.(only just thought).

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  85. I just had mohs surgery on the 6th. The cancer was on the right side of my nose. To me the bandage was awful because it was so bloody and the smell was awful.They did a flap from above my lip Which is sort of a skin graft. It took them 6 times to get it all and it was probably the worst day of my life as I was awake and aware of it all, I kept thinking how much more can they take.. they did get it all. Anyway it is now day 12 and there is a lot of puss around it. and it smells awful. I did notice today the puss is a little less but it has turned dark.. I am so scared it didn't take. I was a smoker and did not stop 2 weeks before as I did not know to. I haven't smoked since the surgery. That is hard to..Have any of you had a flap and experienced the awful smell??

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  86. Wow - 6 passes is a lot. That must have been extremely difficult. You are a very patient soul. Good luck to you on your recovery.

    I wanted to respond to your post because my flap did turn black after the graft (I'm not a smoker but the doctor did ask me if I smoked because she usually does not see this in nonsmokers). I did not notice a smell, but I was also not allowed to remove the bandage for a week until the dr took it off and we saw that the whole flap was black. There was pus in the wound, which made her think there was an infection.

    There was a lot of dried blood on my wound, so that made it look even worse. But once we cleaned off the blood, the flap still appeared to be one giant black scab, which is not normal, and appeared to be a failed flap.

    The dr thought she would have to re-do the whole procedure (my reconstruction used cartilage from my ear to rebuild the nare and then a flap from surrounding skin covered it). But we gave it a week to do some healing, and she put me on a much stronger antibiotic, and I used a prescription topical antibiotic as well. I also had to clean it twice a day with wound wash and do a wet-to-dry bandage on it. (which is a gauze bandage wetted with saline solution on the nose, then put a dry gauze on top and tape them both on)

    Slowly, the edges began to heal (i.e., 2mm of new skin after 1 week). So we gave it more time, and after a month it had completely healed over. The dr still has no idea what happened. Her best guess is a MRSA infection but I tested negative for it (although I had been on antibiotics for 10 days when she tested me so that would mask it).

    If you haven't seen your dr recently, I would go in tomorrow and have it looked at. If I had been put on stronger antibiotics earlier, it wold have helped a lot.

    I know that the thought of having to re-do the reconstruction is almost beyond bearable. But hopefully there is something that can be done now to prevent that. My would looked absolutely beyond repair 10 days post op, but it has healed well now. Keep up the positive thoughts, and good luck to you.

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  87. Thank you for your story.. I could not look when she took the bandage, but she said it looked good. When I changed the bandage for the first time it made me sick.. It didn't get puss until the 2nd day and today is the 3rd day.It is on the side of nose and so hard to keep it bandadged..I have been on antibotics for 13 days now.She emailed me and said not to put vaseline , just wash and dress. Of course this is Sunday. I am going to call the office in the morning..

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  88. Mine was on the side of my nose too - it is indeed hard to keep a bandage on that slope.

    I went to a medical supply store and they had some really good tape that worked better than my first aid tape. For starters, it did not take off a layer of skin every time I changed bandages (my surrounding "good" skin was getting very irritated from the constant pulling off of tape), and it had a bonus of being flesh-colored, which was a nice break from the white tape that screams medical procedure. Use a long piece of tape and the odds are better that it will stick.

    I also got a nice quality gauze at the medical supply store (very thin, not like the standard thick gauze you get at the drugstore) which was easier to keep in place because it was more flexible around the contours of my nose.

    Hope this helps!

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  89. Do you mind if I ask. Did you start out putting vaseline on yours.. Thats what I was doing until today when she said just put dry. I', using telfa pads because I thought the gause would stick.. Now I feel like I should be keeping it wet????????I am so unsure about everything thanks for talking to me

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  90. I'm sure all situations differ a bit, but I was advised to keep it moist since grafted skin dries out quickly. They gave me bacitracin ointment (consistency of vaseline) and said to always keep some on it. Your doctor may advise differently since there is pus (?) I'm sorry about what you're going through. They really don't seem to give us enough information about how to properly take care of the wound. I recall worrying about it quite a bit between doctor visits, unsure if it was healing right.

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  91. I never was told to use Vaseline at any point.

    For the first 7 days post op I could not take the bandages off at all. After I went to the dr for my first post op on day 7 and we discovered the mess on my nose, she gave me the following instructions:
    (1) wash 2-3 times a day with wound wash (sterile saline solution)
    (2) cover the area with the antibiotic ointment
    (3) use the antibiotic ointment in each nostril (she thought that I might have been a MRSA carrier and was carrying it in my nose)
    (4) cover the wound with the wet-to-dry bandage and secure with tape
    (5) take a stronger oral antibiotic

    I don't know your doctor's reasoning for having you use vaseline, and I am not a medical professional so I don't want to go against what your dr says.

    The wet-to-dry bandages had the effect of softening the scab and slowly leeching it away. My dr is a plastic surgeon - perhaps this is a technique they use in plastic surgery?

    These are good questions to ask your doctor tomorrow. Good luck!

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  92. I went to the doctor today. She asked me to email a picture, which I did, and then she said she would like to see me.. It's an hour drive, but I was concerned. She cleaned it up and then took something an pulled off some stuff. She put a bandaid on it and told me stay on the antibotics for another 10 days. Now mind you I had a flap and a very large section cut out.6 times,.I don't use vaselene or anything else and go back next week. I don't know if we're doing it this way because I will have to have another minor surgery to fix something around my nose. To me it still looks awful, but she thinks it is healing well..I can't believe all doctors are different in how they treat.She is a plastic surgeon.

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  93. I know exactly what you are taking about. When I went in for my second post op appointment a few days after the first appointment, it looked worse than ever to my untrained eye, but the doctor saw improvement. And a week later there was 2mm of new skin and it continued to heal after that, albeit slowly. Even a month post op the area over my cartilage graft was not healed and the doctor was uncertain if it would take (because the cartilage itself has no blood supply so its hard for skin to take over it), but after another 2 weeks it was healed over too.

    It sure is hard to wait in between visits to get those updates. It was by far the most stressful month of my life. Not knowing if it is healing or not, or if you need another surgery, is a very uncomfortable place to be in. I found that saying affirmations like "my graft is healing well" helped keep me from going too negative in my head.

    Good luck, and hugs to you. This blog was the most helpful information I found during this very hard time, and I am grateful if I can provide information that will help you though this.

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  94. Just "popped in " to this site after not looking for a few weeks. I just want to send best wishes to all those who have recently posted here about their grafts. This site is a God send" and I really want to thank "Quiet One " with all my heart for the help and comfort her site has given me since mid`-november when my facial melanoma was diagnosed. (Virtuallu identical graft, except on other cheek!)

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  95. Extremely nice to know that this has been helpful to others. Thank you.

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  96. I have just came back from the plastic surgeon and have been told I have two options, radiotherapy or skin graft. Not sure what to do. Anyone else had radiotherapy? I from Australia and just found this blog while randomly searching, so thanks it's helped heaps!

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  97. I am due for two skin grafts at the end of this month. (I'm in Australia but the cancers are the result of the African sun in my twenties.) One will be on my lower cheek, the other above my left eyebrow. I am 81 so I shouldn't really care what I look like but I am really terrified of the whole thing. Ones face is ones-self! I've read all the postings on your blog and some make me feel better and some worse! I'm an amateur entertainer, reciting my own comic poetry, so I'm hoping I can bear to be seen in public after the treatment. I like the idea of medicinal honey. I've read somewhere that honey is a great healer. I may try it. I'm going to report on my treatment on my own blog.

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    1. Hi Rinkly Rimes, Did you try the medicinal honey and, if so, what effect has it had on your graft?

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  98. As if one graft weren't enough, you will be having TWO. That's a double whammy and I'm sorry. I can see how some of the postings made you feel worse. At first it's a little rough (for a few months), but I sense you have a youthful positive spirit (I just quickly read a few of your poems at Rinkly Rimes) -- I suspect you'll heal quite well. Please let me know your opinion of medicinal honey if you try it. I agree with you "ones face is ones-self" no matter what our age.

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  99. I have a lot I'd like to say after reading all this and seeing your photos, but at this late hour and before I get distracted by my new baby I just want to thank you for your courage in sharing your experiences and also -you are beautiful! Your eyes are such a warm, deep shade of green. I wish you all the best and thank you agin for sharing.

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  100. I just came across your blog. I am wondering how you are doing and how your scar healed ?
    My daughter was diagnosed with Melanoma in June 2009.

    She had the surgery in July of that year. So far she is clear.
    I posted a bit about it and the pictures are very graphic.
    Thought you might take a look-see.

    http://cryominute.wordpress.com/2012/04/08/my-favorite-rendition-of-somewhere-over-a-rainbow/

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  101. Cynthia, thank you very much for the link to your photos. Your daughter went through quite an ordeal and had a very large area removed. Her scar is looking quite good. After all that I am sure it was wonderful to hear she's been given a clean bill of health. My scar continues to go through small changes, and I'm pleased with the way it has healed for the most part--just glad to be healthy really. Thanks again for sharing this.

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  102. Thank you for sharing this. Last year I had melanoma in situ in my left arm. They took a tuna-can sized chunk of my arm that left a large, raised scar with "pooching". I had another biopsy done on my left breast and I was feeling pretty sorry for myself. The waiting is really scary, as you know. I'm single and 37yrs old and vanity rendered me tearful in the shower. I was thinking "grafts" when I happened upon your blog. All sorts of perspective afforded here. Thank you.

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  103. I found your website last night while looking for reassurance. There's so much they don't tell you. I cried on & off all day yesterday, and this morning. Feeling sorry for myself, and bad about feeling so vain and sad when people have much greater concerns. I have a pretty fresh graph on my lower eyelid, and developed a lot of bumps over the weekend. I am a yogini and find not doing yoga the hardest thing. The Dr told me I can do anything after 2 weeks, but...I don't like that feeling of blood rushing to it. Your information that it took months for that to stop was depressing.
    I unthinkingly...did do some yoga last week, only briefly with my head down, and wonder if that or herbs I'm taking to counteract the antibiotics could have resulted in the bumps. So afraid I did something wrong. The post op directions only said don't put the head down for 2 days! I only had basal cell, with MOHS surgery, (2 'swipes" only gratefully) but because the plastic surgeon who works with the Dr was out of town, I had to wait 5 days for the graph. Apparently that wasn't good. What did I know. Twice the Pl. surgeon said, "well you used to have a hole there" like I should be happy for this. It feels awful still, and looks awful. I am struggling with my vanity (I'm 54, but...) as someone said, your face is your face. Its what we put out to the world. I wear glasses, and people don't usually look at you very closely, so most people won't know, but I KNOW! I guess time will help. I saw a quote today on Facebook about survival depending on adapting to change. I initially thought I was doomed, but I think it will just take time. So many lessons here. So many people have stories that are so much harder than mine. Did you get little bumps?
    My Dr said to start massaging with vit E after 3 weeks. I don't know if he knows about medical honey. I'll have to look for that. I emailed a photo of my face this morning, waiting for a reply from the Dr's office about the bump. Its a 2 hrs drive each way....don't really want to go for nothing.
    Thanks for this, and good luck everyone! I would highly recommend anyone who has to have a MOHS to self medicate first. That was awful. Having my eye sewn shut for 2 days wasn't a picnic either, but at least they had me on meds then! Alot of bravery expressed here! I am struggling with my lack of it.

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  104. I forgot to say you are very pretty. What does it look like now? I hope you are cancer free now and stay that way.

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  105. Thank you, Ms. Kirkwood!
    My grafted skin was somewhat bumpy, but I don't remember noticing little bumps. That area of my cheek still isn't as smooth as the surrounding skin. I was unknowingly bending my head down earlier than I should in the first couple days because nobody told me otherwise. The sensation of the blood going to the grafted area was a enough to make me intuitively think I shouldn't be bending my head down so much. But I would think a few weeks would be long enough--ask your doctor or nurse about that next time you go. You just don't want to feel that throbbing feeling when you bend over. You might be able to order the medicinal honey online, or try a health food store. I definitely saw results from massaging the scar with various oils. I use pure Argan oil which I ordered online and organic coconut oil from the grocery store.
    Thanks for saying I'm pretty! Thankfully I haven't had any additional cancer worries. The most recent photo of me was posted here last week, so take a peek at the April 2012 update to see how my scar looks now. I'm 50 and still struggle with the vanity also.
    Having your eye sewn shut sounds extremely unpleasant. Sorry you're going through this. Thanks for writing.

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  106. I posted several times in 2010 and 2011, (as "anonymous") after my own diagnosis of melanoma in situ surrounding my eye. The blog and the posts and the pictures were incredibly helpful to me. Between November 2010 and January 2010, I had seven mapping biopsies, each one turning up more melanoma in situ, and five surgeries (four kept turning up more cancer.) But it was all NON-invasive. My lower eyelid was pretty much entirely excised, I had extensive skin grafts. There were complications--the first grafts became necrotic--and the eye drooped badly after the second surgery. It looked really horrible. But I am happy to report that I had the reconstructive surgery in January, and while the scars are visible and will probably always be, the eye is now symmetrical with the "good eye," and the grafts are flat and a decent color, and while I do not have the same almost invisible results that Quiet One has, I feel fine about it. If I use makeup, you would never know, at least at night, by incandescent light, that I had all that surgery. I have to go every three months for a while--there were some precancerous cells in the conjunctive tissue--and that is nerve wracking, but I have my life back, I am also back to work, with a newly reenergized gratitude to be alive. I started a meditation practice which has been of tremendous comfort, especially as I could not exercise for long stretches of the last eighteen months. Courage everyone. Scars fade, and reconstructive surgery can do absolute miracles. PS. I also do yoga, but an Indian doctor, from Kerala, told me that most docs don;t understand yoga, and they tell you it is okay to do it after three or four weeks, but you should actually wait three months, as inversions are counter-indicated. You can, however, do seated yoga. Just don't invert.

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  107. Thanks for your update! Very nice to hear your eye is symmetrical with the other now. Your yoga advice is so sensible, there are many yoga poses one can do without inverting. I wish my scar was invisible, but there's still a "dent" and scar tissue. But oh what an improvement time has made on it.

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    1. This is Carolyn (Just posted as Anonymous on 5-31-12) My mom just had Mohs surgery for basal cell and has a big crater in the same place as yours--although a little closer to her eye. She's 83, and had such a difficult time with the surgery because it was so traumatic for her after 7 hours. I was there with her, and I think she did really well, but she didn't feel the same way. Her nurse said that she might be able to just let the wound heal without getting a flap or plastic surgery. She goes to see the doctor in 2 weeks. What have you heard about just letting it heal? My doctor said I might be able to just let my wound heal too---he'll let me know the day of my surgery. Since the surgeries will be on my arms and leg, I don't mind what it looks like--but concerned about infection, pain, etc. I'm a planner of details, and this waiting and not knowing and having to make quick decisions is unsettling for me.

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  108. I had a carcinoma removed from the corner of my right eye (somewhat into the socket area) and a skin graft taken from behind the ear on April 30 2012. On every visit to the surgeon he told me it was doing well and looking fine, but it is still an angry red colour, sore to touch and, just below the graft the skin has a hard ridge which is numb to touch. The surgeon told me it is okay to get it wet but dry softly and put a little moisturiser on it after. My eye doesn't stop weeping, my nose runs constantly and I've had nose bleed several times. Does all of this sound normal to those of you who have had the same thing done? I'm reluctant to keep going back to the surgeon because his fees are astronomical and, even though I'm privately insured, get very little back from my insurer after each visit. I live in Australia, supposedly the skin cancer capital of the world, but, after reading others' posts think we're all in the same boat! I read the yoga comments with interest as I've just began going back to class after the surgery - perhaps I'll not do the inverted poses just in case. Thanks for the advice.

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  109. Hi! As everyone has commented, I am also very thankful to you for posting your photos and comments. They have helped me so much as I enter into this craziness called melanoma. I was just diagnosed with melanoma in 3 spots that we know of. I'm having surgery on one or both arms on Monday (June 4/5 2012)in the office of my dermatologist. He calls it "Slow Mohs" since after surgery, he sends the tissue to a pathologist, and I go home. The next morning, I return to the office to see what the pathologist recommends. My dr. and the path. dept work closely but not like a regular Mohs procedure since a large incision will be made. Then, it will be decided about how the wound is closed. This sounds so yucky to me. My dermatologist says that he can do the plastic surgery if needed, but I'm so confused right now. I just turned 60 and retired from teaching kindergarten two years ago(27 years in teaching.) My husband and I are both retired now and enjoying our life together. I will keep you all updated...

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    1. Hi again. It's now June 10, 2012, and I had my first surgery 5 days ago. I have 30 stitches on my arm (7 inside and 23 outside), and the pathologist says the doc got it all in that site! Zero is My Hero!!!! My name is Carolyn, and I really have found this blog to be the most helpful of all! Stitches come out in a week with more biopsies also taken at that time. Then, the next surgery on my other arm is done July 2, 2012 (stage 0.51.) My leg surgery is done two weeks later. But, I just keep thinking..."Been there, ROCKED that!"

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  110. Sorry you have to go through all that. Sounds like a very time-consuming procedure (slow Mohs). I've heard there is an option to let the wounds heal on their own, or have plastic surgery after you see what they look like. I saw someone's blog a couple of years ago showing photos of a young man who allowed his large circular MOHS wound to heal by itself and it really looked quite fine. Best of luck to you next week.

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  111. I wanted to thank you for your blog and for sharing your pictures. I really enjoyed seeing the progress your graft made over the months and years. It gives me hope for my graft! I am 34 years old and was diagnosed with Stage 1 Melanoma last month and just had surgery 2 weeks ago. I had a big 2 inch circle of skin removed around the melanoma which was located right in the middle of my chest, plus skin for the graft taken from my groin. They also checked lymph nodes under both arms to see if the cancer had spread so I have 4 inch scars under each armpit that are still draining lymphatic fluid. It's been quite a nightmare and the graft looks absolutely awful right now since it's still so new. I even still have the stitches in but expect to get them removed next week. I just hope the graft "takes", heals and I'm looking forward to the day when it looks as good as your graft does now. Thanks again for sharing your story, you look beautiful! Kat

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  112. Thank you Kat. You're so young! You have many places to heal all at once! I've had some spots removed from my chest (not a graft there but pretty large incisions) and they have healed quite well. Take care of yourself, stay hydrated, eat healthy foods ...I've heard eggs are good for skin, probably several other foods too. Wishing you well with your healing.

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    1. Thank you so much for your kind words! I'm still in a daze about everything since it's just a month yesterday since my biopsy diagnosis, and here I am 2 1/2 weeks post surgery now. It's hard to take it all in, but all I can do is move forward and make each moment count. And I'm finally feeling a bit better today in terms of incision pain, so I'm very happy to be on the road to recovery and feel more like myself again. Again, I hope you understand how much your blog and pics have helped me, and others. I read every single journal entry and looked at every picture and it's amazing how much it helped me deal with my own situation. Thank you for sharing your story and experience with us. Take care of yourself and thanks again for taking the time to create this important, informative blog. Kat =)

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  113. Kat, I'm very touched by your note. It's good to know that my pictures and story have helped you and others. I appreciate what you said so much!

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    1. I also wanted to let you know about silicone gel sheets to help improve your scar even more. I had a friend who had thyroid surgery and wore the silicone daily for a few months and you can't even see the scar on her neck at all! I bought some myself and have just started to wear them on my scars and hope it'll work as well for me. And you can use them on older scars so it should work on yours, too. Apparently, you can also find it at Walgreens under a different brand name, ScarAway I believe? The one I bought was called Epi-Derm by Biodermis. Very pricey, but the ones from the drugstore are much less expensive. Just a thought in case you haven't heard about that and/or tried that and were interested. Take care! Kat

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    2. I have used those silicone gel sheets! After wearing the silicone overnight I would definitely notice a flattening affect. I was very pleased with that product (although I agree about pricey)! I also sometimes taped a piece of banana peel over the graft for a couple of hours during the day and noticed similar flattening affects. The peel enabled me to apply pressure/massage effectively too. Thanks for mentioning it.

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    3. You know I read that the silicone sheets need to be used at least 12 hours/day for 8-12 weeks for best results. Your graft already looks really good, but it may be worth a try if you have time to try it again long term. I found some you can order online from Walgreens that aren't too expensive, and just ordered some myself. I'm not able to use anything on the graft yet, but have started using the silicone on my other three scars and plan to do it religiously for the whole summer to see if it helps. Here's the link to the Walgreens silicone sheets I just ordered - only $17.99/box. (http://www.walgreens.com/store/c/scaraway-silicone-scar-sheets/ID=prod6019237-product#BVRRWidgetID). Thanks for the tip on the banana peel, I'll try that too! Off to get my stitches out of the skin graft tomorrow morning, hoping all goes well and isn't too painful. Kat

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    4. I used Blaine ScarCare brand silicone sheets week after week, night after night. I truly believe it helped. I just checked and still have some of it left so I'll see what it might be able to do for me at this point. You cut a piece of it to fit your size scar, and can re-wear the same piece a few times. Good luck with your appointment tomorrow. The stitches being removed made my eyes water a little, but it was brief, not too bad.

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    5. Yes, definitely try more of the silicone if you have the patience/time. Maybe just from evening to morning so it doesn't bother you during the day. From what I've read, it can really help new and older scars alike. Can't wait to get the stitches out tomorrow so the skin can start to really connect/heal...skin or collagen appears to have grown over the stitches in several areas so it definitely seems time to have them removed. I'm feeling prepared mentally so I'll just grin and bear it regardless. Thanks again for your advice as always!

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  114. Hi, nineteen days ago I went to my beautician friend for the first time, only to stop her from nagging at me. During the facial she said that a blackhead that was on my nose looked 'suspect' to her. To me it looked like all the others that surrounded it. However this one did bleed occasionally, I always put it down to my menstrual cycle, and had done for at least three years that I could remember. Anyway to make my girlfriend happy, I made the appointment. The doctor agreed with my friend and the biopsy was done the next day. A week later I was told it was a 'Basal Cell Carcinoma' and that it had to come out. This thing was on the tip of my nose and had been there for years, so a fair bit of the tip of my nose was going to come off and a skin graft taken from in front of my ear put on. I didn't go in for surgery like others that have written in. I didn't know that I had that choice. So, I sat in a chair and had it done under a local, whilst I was wide awake listening to what was going on. The doctor cut the size of a thumbnail and a bit from the tip and went down to the cartlidge. Seven days after the procedure the results came back and I was told that she had cut it all out of my nose, I'm very relieved. Now eleven days later I'm told that it looks like the skin graft hasn't taken, but nobody can tell me what to expect now and what will happen next.
    All of this is a scary thing. As soon as someone says you have any type of cancer you start to worry, but now this has just made it even worse. I'm hoping that I don't have to have another skin graft done. I was scared enough the first time I sat in the chair under a local, while the doctor cut my nose and face up.

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    1. Very scary indeed, and I hope nobody ever has to go through it more than once. It was good that your beautician friend said something to you about the spot.

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  115. It seems that iam the only one who was diagnosed with invasive squamous cell carcinoma..a very tiny wart appeared on the upper part of my right palm,I scratched it and eventually after doing this it became big something like a volcano and a cluster in the middle of it..it was excised completely but the doctor said that we have to do another operation to be sure that the edges were clean ,so I went into another surgery and they took the graft from the middle inner part of my hand, the part that they usually take your blood tests..it hurts a lot and was o inconvenient..i told the doctor I wanted unremivable stitches cause the firstnoperation,removing of the stitches was painful.

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  116. Thank you for an honest blog. I am about to start treatment for lentigo maligna on my face which may result in a skin graft. I have started a blog to also share my experience: www.emmachoules.wordpress.com
    I wish you well.

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  117. I just had the in situ melanoma cutout from the left side of my nose. For years, at least 8 years, I figured it was just a 1/4 to 3/8 in brown freckle or sunspot. Upon initial examination by the dermatologist said he was 95% certain it was just a sunspot and nothng bad. He shaved it off and upon examination by the lab said it was determined to be in situ melanoma.
    So today the surgeon cut out a 3/4 inch chunk of flesh from my nose(1/2 centimeter beyond the spot) and the lab is currently examining it. The doctor says i have a choice: I can have a graft or cut and pull down a piece of skin extending up the middle of my nose to fill the hole. How should I know which is best? I asked what he would do and he said he was "60% cut and pull skin down vs 40% skin graft".
    I would be interested to see how your graft has healed at this point in time.
    Thank you for this blog.

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  118. At the upper left side of my blog (just below the "pageview count") there is an archive section. Click those archives for progress photos of my graft, including recent months. I have added photos here throughout the past two years.

    I don't know which is best for the nose, but I just did a search and came up with this support discussion:

    http://www.dailystrength.org/c/Skin_Cancer/forum/12110449-advice-skin-graft-nose-not

    Thank you for your note. Best of luck with your healing.

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  119. You are such a beautiful woman... your face glows with joy and honesty. Thank you for sharing your experience with us all. You are an encourager, your spirit seems warm. I am using Effudix cream at the moment to treat pre cancerous cells on my face. I came online to look at how to minimise the redness it may leave behind as this has become an everyday concern for me, every time i look in the mirror i think 'WHAT HAVE I DONE?" Then i stumble across your story and i realise how rediculous my regrets and concerns are and i thank God that i decided to do this treatment now to possibly avoid a similar situation to you later. Anyway you're beautiful and thank you xx

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    1. Thank you so much! There is an ingredient in some creams/lotions called "feverfew" which has a calming affect on red skin.

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  120. I cannot thank you enough for writing this blog. I too had Moh's surgery in July where they removed a large portion of my nose. It's been a very similar journey and when I read your blog for the first time on Sunday I cried. It meant a lot to me to read words that were so familiar. Thank God for science which heals us and also vanity which led us to diagnoses and ultimately a longer life.

    I had my nose tip grafted and then in October, my doctor did a complimentary dermabrasion (which at first looked worse than the missing tip of the nose). He said the best way to make the graft blend in was to do the dermabrasion on the rest of the nose, so it actually reduced the overall size of my nose.

    I’ll send you a before and after photo. It’s amazing what the doctor was able to do. Ironic thing is that I’ve always felt that my nose was a little on the generous side, but I was too chicken to get any ‘work’ done ...

    It has been almost a year since the original surgery, and the graft looks pretty amazing- if I do say so myself :) I use a loreal powder concealer (use a small brush to apply) which tones down the redeness. To the person posting June 18th - I would recommend getting rid of the cancer- it won't be pretty for at least 10 months, but then you can hopefully put it behind you.

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    1. Thank you! Your doctor sounds like a good one. Always nice to hear about positive outcomes, and it's helpful for others to know that these things can actually have an upside.

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  121. Finally, I saw this on CNN - http://www.cnn.com/2012/06/22/us/aesha-update-surgery-begins/index.html
    This poor girl has been through so much, please include her in your prayers!!

    Thank you again for sharing your story!
    Audrey K

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  122. This blog has really helped me prepare for what is to come. My dermatologist was "almost positive" that the ugly mole on the back of my neck was nothing but an ugly mole, so he removed it and sent it to the lab for confirmation. Melanoma in situ was yesterday's phone call. Greatful that it wasn't worse, but am worried about the whole process. Am expecting a call from the surgeon's office on Monday to start the ball rolling. I am pretty sure this will not be the last of it, as I have had more nasty sunburns in my life than I can remember, and have more suspect-looking areas on my face and leg. Just very curious about how they will treat an area on the back of the neck...my doctor mentioned I may have to wear some type of neck brace to keep the stitches intact. The journey begins. Thanks again for this blog to help me prepare for the road ahead.

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    1. So similar to how my dermatologist thought mine was "probably nothing" yet I got the phone call with the words "melanoma in situ." That was a scary phone call, and I went straight to the internet but couldn't find any photos of skin grafts (for skin cancer). That's why I started this blog, and I'm glad to hear it's been helpful for you as you prepare...although I wish you didn't have to be going through it!

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  123. Dear Quiet One and Fellow/Sister Sufferers
    I have blogged on numerous occasions, beginning in 2010. (As Anonymous.) I had numerous mapping biopsies, four surgeries, and one reconstructive surgery for widespread lentiga on my eyelid, under-eye, conjunctive tissue, and cheek. After the last surgery, in January, I started getting my life back, and was really pleased with the cosmetic results. Unfortunately, my last six-month check-up turned up more cancer in the margins of the graft on the cheek. There is (potentially) too much face area involved for more biopsies and excisions, and I am exhausted from all the surgeries (general anesthesia, etc.) So my doctor at Sloan Kettering wants to try a three-month course of Imiquimod (Aldara.) It is surely better than having more chunks of face removed, but the pictures of the Aldara treatment are upsetting. Has anyone on the site been through this? Aldara is off-label for melanoma, but it has been used with apparent success for some years. (There are no reliable long-term recurrence statistics.) it creates a violent, though ultimately curative, inflammation that boosts the immune response of the skin, and specifically targets cancer cells. When the inflammation subsides, your skin supposedly looks better then before. But there are a lot of "ifs." I am resigned to this: I cancelled all my summer plans (you cannot have any exposure to sunlight and you look scary) and I will hunker down with books, music, work (I am a journalist) and meditation. But it would be wonderful to hear other experiences.
    I also want to say how grateful I am for this little island of shared woes, hopes, solidarity, and experience.

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  124. Reading this made my heart sink for you. I'm sorry. I don't know anything about Aldara treatment. In some ways it sounds better than all the cutting, but I know it's not going to look pretty for a while...and you have all the uncertainty and "ifs" to wonder about. Yet, if the treatment works after 3 months and your skin can look even better, it sounds like a good option. I hope someone who has tried this course of treatment will read this and respond.

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  125. Anonymous of 6/24 - I just posted for the first time yesterday, and talked to my mother today (we love each other, but the time difference gets in the way). She had an excision done two years ago, and did not have a skin graft. I last saw her two years ago, and just looked at pictures from then (she's camera shy), but I cannot see her "mole" nor scar. She says there's a little a "dent" in her face, but she's 79 now and could care less - she does have wonderful skin, though. I believe a have an area on my face that has melanoma, and although Quiet One's results are good after much patience, I cannot say what my decision will be if and when that time comes. I have not heard of Aldara - I am new to all of this. You are fortunate if you can work at home and be secluded while you heal. I think I would get a bit stir crazy in the house, but if you keep focused for the cause, you can do it! It DOES sound better than all the excisions, but the unknown is always frightening, too. Although this is Quiet One's blog, I want to thank you for posting what you have, and will be interested in anyone else's (and your) experiences in Aldara...I believe I have a long road ahead, and this blog is REALLY helping me. Thank you, Quiet One! ~Heidi

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    1. Thank you!

      http://stvincentsdarlinghurstmalenurses.blogspot.com/2011/02/aldara-skin-cancer-treatment-patients.html

      I was looking at this man's blog today...maybe it can be of some help to those considering Aldara.

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  126. Dear Heidi
    If you "think" you have melanoma, see a good dermatologist WITHOUT DELAY. It will either allay or confirm your suspicions, I hope the former. But then you can deal with what you have to, and prompt action will insure that you have the best prognosis. There is a more than 98% survival rate for early stage melanoma after ten years! So please do this for yourself, your loved ones, and for all of us. And Quiet One, thank you for the Aldara reference. xxxxx

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    1. Good point. Anyone who suspects they have something unusual going on with their skin should have it looked at.

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  127. A late night thought I would like to share with the community. After the five surgeries, endless biopsies, the unexpected recurrence, and the prospect of Aldara, I have also developed acute Achilles tendonitis (unrelated to melanoma, I hasten to say) which makes it really painful to walk. (Luckily, I will have three months of house arrest, with the Aldara, to keep my feet up as my face swells!) But that's not the point. There is an upside to pain, and that is heightened consciousness. If you have never suffered, you really do not know yourself, and you cannot really feel compassion, which literally means "fellow suffering." I am not being Pollyannaish about this. I would hate for anyone to have to go through what I did. But pain teaches you about everything in life that you take for granted, such as putting one foot blithely in front of the other, or walking out the front door into the sunlight, or seeing your familiar reflection in the mirror. No one gets out of life alive, and the wise course is to seek the depth and richness of the moment, of true feeling, of love and friendship, and of all the qualities and unexplored capabilities within you that vanity or anxiety or convention or the ambient noise of anger and fear in our brains obscure. It is too much to ask--too complacent to say--you should take your trials as a "gift," but it isn't too much to suggest that you might take them as an opportunity to consider what is really precious to you. This community has been precious to me, for example. How else, without cancer, would I have found you?
    Good night and blessings.

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    1. Thank you. Beautiful. Absolutely true.

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  128. I had a busy, but productive week. I was scheduled to have an excision on Tuesday with just a local anesthetic, but when I arrived, the surgeons decided the surgery would suit them (and me) best if I was knocked out, just because of the delicacy of the location on my neck, and its size. All done, still numb, but the best part was that I have stitches that are "sub-dermal" - not sure if that's the correct medical term, and he GLUED my skin over the stitches. The scar is 2 1/2 inches long - which is about half the width of my neck, but it looks clean, and I can wash my hair tomorrow if I want. The only post-op instructions I have is to take pain medicine as needed. I can surely handle that! If I need any more excisions in the future, I hope they're as smooth as my first...

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    1. Hi Heidi,
      I had an excision on my chest last fall, about 2.5" with the same type of stitches your describe, plus the glue. That was the first time I had experienced the glue method. It healed very well, not much of a scar. I had the local anesthesia for that, but the doctor kept chatting with me so I wouldn't focus on what was actually being done. The neck is a very delicate location, so I'm glad they "knocked you out" first. So far I haven't needed any pain medication after any of these things, even the graft. Always nice when you can wash your hair the following day!

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  129. Quiet One,

    How many excisions have you had? I am aware of two on your face, now one on your chest...have there been more? I need to have one on my face checked out - looks very similar to the one you got the graft for, but smaller. Same type of looking one one my shoulder, too. The one on my neck looked more like a birth mark, although not there from birth. Have been doing well, since Thurday's surgery - no pain at all - the skin is just a bit tight, but that's to be expected. A bit tired, though. Went to the eye doctor today and he dilated my eyes, and that always makes me tired! Not much of an appetite, either, but I've done absolutely NOTHING for three days. My husband won't let me do anything...he's just worried about me. I'm lucky to have him in my life. Thank you again for your blog to just be able to share my experience with those that can understand.

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    1. Your husband is taking very good care of you :)

      Yes two excisions on my face, and then the chest spot was removed by my dermatologist in November because it kept getting larger over time. It had been biopsied in 2009 (not cancer) but it started looking more suspicious to her in 2011. She thought we should remove it before it became any larger. She did a very nice job and I'm a fan of the skin glue method now.

      I don't know enough to answer your other question about "in situ" with other areas being more advanced, but I would assume that could indeed be possible.

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  130. P.S. I haven't been able to find any material on this, but is it possible that one area is "in situ" while other areas are a more advanced stage? I would assume so, but haven't been able to confirm it.

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  131. Thank you for being brave enough to publish this. I had a large BCC removed from my temple 6 weeks ago and left with a large '7' shaped scar but healing well and not too bad. I had another mark biopsied at the same time which turned out to be another on my forehead. I had this removed with a graft last week and just been today for the pressure pad removing. I was horrified what it looks like. Approx 5mm deep and 30mm across looks horrendous like it will never look ok.
    You've made me feel a bit better so thanks again.

    PS you look great. x

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    1. Thanks for writing Steve, and I appreciate the compliment. It takes time, but it'll look better. It's tough to see oneself right at the beginning when it looks so large and horrendous. Sorry you had go through two procedures so close together.

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  132. My melanoma insitu, diagnosed 2 weeks ago, is in the same area as yours is,Quiet One. You are pretty and lucky you have a loving husband to support you. I am glad that you are healing well. I am very independent and live alone. I have noone to get me through this. I do not think I could live with a facial scar as I have spent a couple of decades lightening a port wine birthmark (same spot as the melanoma and also above my upper lip)with various lasars. Wondering if the lasar treatment had anything to do with it. I meet w/ plastic surgeon tomorrow to see what reconstructive surgery he plans on doing. Don't want a graft because I can't stand the thought of scarring up another part of me. Last August,2011, I found out I had cardio myopathy after a routine EKG came back abnormal. I have no symptoms and turned down the idea of getting a defiblerator implanted. I wish assisted suicide was accepted as a positive option because I am done with trying to be positive. Death is out to get me.Not looking for sympathy....really don't think I want to live hiding my face for a new reason.

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    1. This is upsetting to read and I'm sorry you feel so anguished.

      I believe I would have gotten through it alright on my own, just as you can. You have a lot to cope with and it's certainly hard to find anything positive when you keep hearing bad news, but you can weather the storm. Melanoma in situ is on the surface and, if removed, it's unlikely to ever become life-threatening. My dad has been having skin cancers removed for 30 years and he just keeps plowing forward.

      There is makeup created specifically for scars and birthmarks, and the graft scar won't look bad forever.
      [Dermablend Makeup] http://www.dermablend.com/aboutus.aspx

      My cousin is 50 years old and has had a pacemaker for two years. It has eased her mind.

      Don't give up.

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    2. wish I knew how to respond better. I've never "blogged" so am not good at it. I saw Anonymous' post of July 20th, 2012 and can understand how she/he feels. I just was diagnosed with Melanoma on my back and am a single working woman living alone. My kids are fairly grown now and far away. I'm sure there are support groups for us, but I don't know how to find them -- or create one of my own. I don't give up easily and am still looking, but understand Anonymous' post of not wanting to go out to stores feeling deformed nor wanting to constantly fight a body starting to be like a leaky bucket, impossible to fix.

      I took care of both of my parents when they were diagnosed with terminal cancers of different types. My mom fought it with surgeries, feeding tubes, radiation, medicines, contraptions to suck fluids out of her lungs and suffered greatly at the end. (She showed me it's easier to say you want to die than to actually give up life.) My dad, who lived 10 years after she died, didn't fight the lung cancer he had and his death was what I'd have to call gentle and at his own choice of moment -- in my home and with me sitting next to him on a sunny spring morning. He died right after I noticed he was missing a breath or two. I said "dad, I love you and if you need to go, it's OK" and he did. It was enlightening. What did I learn? Perhaps to evaluate what I gain for what I lose with every treatment I choose. (To be more proactive. Going to the dermatologist was a blessing.) Life is usually worth the fight, if you have support. Being single, I learned to look for support from others not related to me and going through the same things. There are others out there who will help you. I would write the person who wrote July 20th, if I knew how to. I don't care what you look like. You need a friend and someone whose been through something similar. Someone who knows the fears and despairs and perhaps some of the ways to get through it all. Depression is part of this, but there are so many people going through the same things. I feel we can help each other just by knowing there are others going through it. Thank you, Quiet One. It was good to read your thoughts tonight.

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    3. Hopefully the person who wrote on July 20 will see your heartfelt supportive words. Definitely was helpful for me to hear from others who were going through it. I'm sorry about your parents (especially your mother's suffering) yet inspired by how, even as they were dying, they taught you valuable things about life. You've been through a lot, and you have wisdom to share with others. I don't know how to contact anyone who signs as "anonymous" but I wish I could help direct you to the person who wrote the July 20th blog comment. Thank you for your kind words.

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  133. Thank you for such a informative and supportive site. I am in the process of having two more biopsies on my nose after finding melanoma in situ at the tip. This is to make sure that the margins are identified. I will be scheduled for surgery in three months (various reasons can't do it now) and have been assured by my dermatologist/plastic surgeon that that is an acceptable wait given that this type of melanoma grows slowly. I will be receiving a live graft from my forehead which will necessitate a later surgery to detach it and clean the edges. I am told that I will have to use a antibiotic salve on it and that I will need seven weeks for recovery to ensure the graft takes. And that this type of graft has a better outcome. I may be able to drive after a week, but no exercise except walking.

    Does anyone know about the three month wait? I know if it is a more aggressive melanoma it needs to be surgically removed immediately. My best to all of you who have gone through this. Scary isn't it! I try to keep my sense of humor and enjoy the good things.

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    1. Thank you. My wait was about 2 months from the time it was discovered to time of graft. I think 3 months should be ok (but I'm no doctor). From what I've read, melanoma-in-situ is slow growing. Wear sunblock as an extra precaution until your surgery is performed.

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  134. I came upon your site while searching for information about moles. I found 4 pretty creepy looking moles on my back, had my husband take pictures of them so I could see them, then searched the internet for info while I waited the 4 days for my appointment with a dermatologist.
    I have the exact same spot as yours, only on my chest, so filed that to tell to the doc.

    Today was my appointment. I should have known what to expect when I walked into the office. The nurse that took my information had worked for this doctor for 43 years. She literally had to help him into the room where I sat with no shirt on and a paper cloth around me. A very sweet and kind but extremely old man!

    The "exam" took all of 2 minutes where he said my skin looked good and froze a mole on my right earlobe. When I expressed concern about the markings on my chest and the moles on my back he waived it off and said it was all fine.

    I am glad to have a positive diagnosis, but don't feel like I was really examined appropriately. Should I go to another doctor? My husband is thinking I'm over reacting, but am I?

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    1. Honestly I'd prefer a young dermatologist. But after that many years looking at moles, I assume your doctor must have a good eye for suspicious-looking areas...then again, his eyesight might not be so good any more. My dermatologist always uses a magnifier and gets an extremely close look at my spots. If you have a feeling some of your moles are creepy, it's never an over-reaction to get examined properly.

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    2. Thanks for such a quick reply!
      I, too, thought at least a magnifier would be used. I will think it through some more. I just had such a funny feeling when I left the office.
      How are you doing now? I am super impressed with your courage and wish only the best for you on this journey.
      Jodi

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    3. I'm doing well, thanks. Life is good. My scar is part of me now, and I'm pleased with the way it has continued to change and blend. I see the dermatologist every 6 months, get things frozen or biopsied almost every time, but nothing serious has come up in recent visits. I always advise listening to your gut feelings. Thanks very much for your kind words.

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  135. I visit this site regularly, having had a melanoma in situ removed in December 2011. My graft is healing well and I would like to offer support and much needed reassurance to all those receiving the dreaded diagnosis of skin cancer and consequent skin graft. This site is just wonderful and has given me so much help and support. Factor 50 has become an integral part of my daily routine. In fact, as a primary teacher, I apply it whenever I go outside for PE lessons or even playground duty - the children remind me to do it!! My graft is fading although it is still very visible. I am very good at standing and sitting with my back to the sun! My target of the graft being disguisable by my son's graduation in June wasn't met but I made sure the right side of my face was in the photos!! I am now used to my new appearance - I don't like it but know that a graft is better than a melanoma.

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    1. Thank you for your kind words. I feel so much the same way. Awesome to hear that the children remind you to apply your sunblock! I'm constantly reminding my family to put theirs on too.

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  136. Hi,I would just to say I found your story very helpful indeed,and seeing your recovery pictures were very reassuring.I was diagnosed with a thin melanoma (less than 1mm) on my left temple.Had a skin graft 3 days ago,where they removed 1cm in diameter around the scar as a precaution.I knew expectly what the procedure involved,but wasnt expecting the "yellow mushroom " to be so big!! Been very difficult to sleep as where it is and cant wait for the end of the 7 days to have it removed. The consultants have told me this is a precaution,but you cant help thinking what if its not?? What if the graft doesnt take?? Will I have to go through this all again !!
    I never thought it would happen to me,nobody does.So the outcome of this has made me think,its not important to have a tan,and made me very very aware to protection myself more and my children.x

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    1. Hello Julie,
      Yes that "yellow mushroom" certainly felt strange. I went through the same questions and doubts in my mind, especially since the graft was hidden underneath the yellow thing for the first week! Thank you for writing. Come back any time to post an update.

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  137. Hi, thankyou for your reply.Had "yellow mushroom " removed today,I was told it was going to be bad but was in more shock at seeing it for the first time ,than the actual shock of being told it was a melanoma.Came home and cried my eyes out and thinking how can I ever go out like this again.Now ive just sat in front of the mirror just looking at it for the past hour.Have also calmed down from the shock.I know it could have been worse ,thats what I keep telling myself.Im hoping the magic cream will preform "magic".Will post again in a few days x

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    1. It definitely is a big shock. I remember that day and it sure was a low moment. But your skin will amaze you as the days and weeks go by, healing all the time little by little. The graft area will get smaller. I didn't go anywhere for the first couple of weeks. Healthy eating always gives skin cells a boost (fish, eggs, fruits, vegetables).

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    2. Hi, Day 2....Well its looking better already. Have my moments where I could just stare at it and cry and think Ive got this on my face for the rest of my life,but could have been worse I keep telling myself.Im off to see the nurse today for her to check that its all ok and how to care for it as wasnt really told anything at the hospital,just put on the magic cream.Do I clean it? Does it dry out ?? So hopefully she can answer my questions.Still havent ventured out with my patch over it,not ready for public viewing yet.x

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    3. Glad to hear it's already looking better! Public eyes didn't see my face without coverings (bangages and sunglasses worn indoors and out) for a couple of months. I was advised to keep the ointment on the graft all the time because they do tend to get dry. I'm sure the nurse will be very helpful answering your questions. What is your "magic cream"?

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    4. The nurse was very helpful today, so Im glad I went.She too advised to carry on with the magic cream (chloramphenicol ointment)which is the antibotic cream and then perhaps move on to the bio-oil which Im using on my neck where the graft was taken.I actually had my hair washed today and got it wet for the first time too.How long do you think yours was healed enough to wear makeup over it? They told me a week,but Im not so sure as it still looks "raw " to me,and I wouldnt want to agravate it.x

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    5. I waited 3 weeks before putting makeup on it. I remember how good it felt to wash my hair and allow the graft to get wet. Neck skin (collarbone) was what they used for mine also. I love oils - I've been using argon oil, coconut oil, and just got some emu oil.

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  138. I am surfing around trying to find info on skin graft healing when I came upon your blog. I'm so sorry for all of you for having to go thru this trauma as if life isn't challenging enough already. I had a melanoma removed from the bottom of my right foot Sept. 17 on the ball just behind my big toe. They cut out a piece a little larger than a silver dollar and grafted a week later. I was told recovery would be 2-3 weeks, but after 3 weeks the wound is still quite "raw" in most places with only about 50% taking to the graft, so I am quite worried. I'm normally very physically active, so hobblying around on crutches and lying with my foot raised most of the day isn't fun. For some strange reason, it's good to know that I'm not alone with this misery so thanks for listening.

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    1. Hello Eric,
      Glad to hear it helps you to know you're not alone. I would expect it to take longer for a graft to heal on the foot just because of how much the foot has to do for us during the day! But sounds like you're being careful to avoid putting pressure on it, and keeping it raised. Not easy for an active person to do! That's a large area to heal (silver dollar size). I hope you're getting it looked at every couple weeks by the doctor.

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  139. Hi again! Well its been 4 weeks now and I got my results today and they were clear !! Im so relieved,have been so worried.The scar is healing well,egdes already starting to blend,but still red so have a long way to go yet.Using a mixture of creams and gels,mederma scar gel,cocoa butter scar gel and aquacous cream,3-4 times a day.I would like to thankyou for all your encouraging messages and pictures they have been so helpful.I have visited your site at least twice a week to read others stories and to get top tips in what other people have used on their scars.Ive only just recently come across your recent photos,and I would like to say how amazing you look,cant even see your scar!! If mine looks like yours I will be over the moon.Thankyou again for sharing your story ,not only to myself but to others ,and its nice to no we are not alone.I will post again in a few months x

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  140. Hi I've just been signed off by my surgeon and am so pleased, I've had four bcc removed from my face, two with mohs surgery the last one on my nose requiring a skin graft, this was the worst to get through as it took two lots of surgery and covered more area than expected, having a phobia about bleeding I was very nervous but the surgeon and nurses were all lovely, I kept my eyes shut and although I could feel things there was no pain, just 15 needles to numb the areas and a day from 8am to 4pm in the hospital, afterwards I looked like Miss Piggy with a cover sewn on my nose and bandages on top, I didn't go out for the week then went back for the removal, it did look very raw and I felt everyone was looking at me, the stitches left in were ones that dissolve but did take a long time to come out, I had a bump and sore patches that weeped, but continued covering it in cream as I was told and didn't put any bandages on it, very slowly it has improved and I now like the shape of it, the colour is slightly darker one side and I have a small red mark but nothing major, I went for my three month check up and my lovely surgeon said its not just looking good its beautiful, that really made me smile, I know its possible more may occur but the feeling at being signed off is fantastic! good wishes to all having problems x

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    1. Thank you for writing. That was a long day you had, and many needles for numbing! Wonderful to have a surgeon tell you it's looking beautiful!

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  141. Wow, that nust be a alot to take in having all that surgury done. Im still young and my dermatoligist requested that I come in and have a biopsy done to see if an atypical mole I have on my face is melanoma. At my age, this is the craziest thing to have to deal with.

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  142. Hi thanks for the pictures and all the useful information. I have just had what you have had. My carcinoma was in exactly the same place as yours but not quite so big. I have just had the stitches out yesterday and go back for the stitches near my collarbone out next week. I must say it is not a good experience but as you said the pain was minimal and I did not feel it being done in the outpatient dept. took about 50 minutes in all. I wish you well and hope the scar has healed well. I now wait to see what mine is going to turn out like.
    Denise

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    1. You have a very good frame of mind about it Denise! Thank you.

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    2. Your site is a real encouragement especially to read about others who are going through the same thing. Its now 3 weeks since I had mine done. My scar looks like its is bubbling (like blisters do) do you think this is normal? I massage it as much as possible. It is looking good with no scabbing now but it was just the funny bumps I have. I go back on the 16th May to get the full results taken from my face. All the best. Denise

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    3. Glad you're massaging the scar. Mine had raised areas, sort of ropey around the perimeter. I can't even remember now if it bubbled the way you describe. My guess is the bumps might be scar tissue forming. If it feels like scar tissue, keep trying to flatten the bumps gently when you massage--it really works. ...But I'm no doctor. Thanks for keeping in touch.

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    4. Hello I have now had the all clear on my face and Dr told me it is normal for it to be lumpy as it is scar Tissue and I need to massage it as hard as I possibly can against my cheek bone and it will soon flatten out. I go back in 6mths for a quick check on the scar. I must say it is improving every day and does not look as bad as I thought it was soing to. I hope you are now keeping well. Thanks again for your site. Denise

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    5. Lumpy scar tissue must be the norm. Great to hear that it doesn't look as bad as you expected! Thank you.

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  143. MY dad is 83 and was just diagnosed with a greater than 1cm melanoma lesion on left cheek..they have delayed things from the initial biopsy almost a month ago... it is interesting to see the progression ... hopefully its just in situ but greater than 1 cm

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    1. I hope all goes well for your dad.

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  144. Dear Quiet One,

    Well, I got the call from the dermatologist tonight, melanoma in situ, same exact spot as yours, slightly larger lesion, about a nickel size. Found your blog immediately, thank you for documenting your journey! I cried when I saw your post op pics. I've had many surgeries for skin cancer and pre-cancerous moles (this is my first melanoma), and I know how much it, well, it sucks. I estimate this is going to be like that times 10. I am 34 years old. I am very scared about the future, but I hope that reading others' experiences will help me feel not so alone.

    Thank you,
    Carolyn

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    1. Good description: it sucks. Sorry you have this so young! Thankfully it's in situ. I appreciate your note. Best wishes to you. Please keep me posted.

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  145. are you supposed to cover the scar from sunlight for one year?

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    1. After it has healed it is to be protected from the sun with sunblock, forever. Every time I intend to be outside for more than a few minutes I wear sunblock and put extra block on the graft. Grafted skin darkens (and will get a burn) faster than the surrounding skin.

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  146. Hello Quiet One, I was browsing for images of wide local excisions (as I have just had both one WLE on my leg and an atypical mole removed from my back two days ago) when I came across your photo and read your blog.

    I also have what I think is 'age' spots on my face but will asked for them to be checked out by the Doctor when I go back for my results.

    I was told by a doctor that I had a severely atypical nevus/melanoma in situ. However, it was graded as a pT1A by a pathologist. Of course, I am researching endlessly now. It is a strange and frightening feeling being abruptly thrown into the world of melanomas. Especially, if like myself one was oblivious to this life-changing disease.

    All I would like to say is thank you for your brave blog and for sharing your story. Whenever I think of you I will think of you as 'Pretty Woman' as you remind me of the actress in that film. Besides, an attractive woman with a couple of scars still remains attractive. Just remember that :o) Take good care x





    So thank you for sharing your story, and know this

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    1. Wow, thank you for your nice note! I am so flattered. My husband thinks I resemble that actress too.

      Yes, online research certainly does become part of the experience. That's why I posted so many pictures for others to browse, because I was having no luck finding photos of what a graft of this type looked like, and what it might look like after the passage of time.

      Some of my "age spots" don't seem to be worrisome, but I ask about them every time, just to be sure the doctor looks and doesn't miss anything.

      Thanks again for your kind words.

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  147. Hello again Quiet One

    You are very welcome and I am glad your husband agrees. Julia Roberts possesses natural beauty which is rare these days.

    Being a female in the same age group as yourself, I am well placed to recognise that skin cancer has many implications. One has to manage, in my case, the unknown, the steep learning curve, the fear of prognosis, the pain of surgery, the anxiety of waiting for results, the challenge of deciphering pathology reports, doubt of whom to trust and whether to get second opinions, the life changing impact that results from such a diagnosis, and last but not least, acceptance of the aesthetic impact of surgery.

    I add to that the reactions of people involved, not just friends and family but the medical field also. Their attitudes can alleviate or compound, what I have experienced as incredible feelings of loneliness. This can come from a lack of support, lack of knowing what to do, or just the sheer shock of it all. It is a shame that when what is really needed is compassion, understanding and support, even today, so many people (medical professionals included) struggle to talk about cancer - especially in the UK where I am located.

    So thank you again for your tremendous generosity for sharing your story and photos. This takes not just bravery but precious energy too.

    Take good care.








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  148. Dear Quiet One
    Could you give me a little advice about when to wash my hair and also when to wash my whole face?

    I have had a similar thing to you - lentigo maligna - and have just gone through a skin graft on my left cheek. I presently am waiting to have the donor stitches out this coming Friday from behind my ear. They're feeling very tight and uncomfortable. My graft is feeling as if there are little creatures running over it, also very uncomfortable and itchy. I have also been diagnosed with matching lentigo on the other side of my face! They've said wait for a couple of months and get over this first one and then they'll excise the other one. So very similar to you. I'm dying to wash my dirty hair but scared to let any shampoo at all go on the graft. Ditto washing my face.

    Its been 13 days now. I'd appreciate your thoughts. I've phoned my surgeon about it and he's waffled on about leaving it a few days - that was last week. I think now I can wash but wouldn't mind your thoughts on it just to double check.
    Cheers
    Del

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    1. About two weeks after the surgery it was ok to wash my face normally. If you're concerned about shampoo and soaps, my thought would be that you could at least wash with plain water by now. Just use a very gentle touch. My husband helped me wash my hair the first couple of weeks - I would lean back over the tub (facing the ceiling) and all the water and shampoo went away from the face. When it was ok to take a real shower and water finally did run over my face (very low water pressure from the shower) I was worried it would sting, but there wasn't any pain at all. And it felt really good to be clean!

      Our situations sound very similar. Mine was also lentigo maligna. Sorry you're going through this and have to get the other side excised too.

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  149. Sorry, it's me again. Can I just volunteer some information that may be helpful to some.

    One of the problems for my surgeon has been finding the boundaries of my lentigo which has meant I've had to have surgery several times to "get it all". I've just found out there is a thing called Invivo Confocal Imaging which is non-invasive and it enables them to see where the lentigo's boundaries are before surgery. Some of you may already be knowledgeable about this but I wasn't.
    Good wishes to everyone
    Del

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    1. Thank you for the info! I have been recently reading about these new devices that can detect skin cell abnormalities. I'm hopeful that my dermatologist will implement things like this in the future.

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