What a great community! It has been helpful to read your posts.
I was newly diagnosed from a punch biopsy with Lentigo Maligna LM (melanoma in situ) on the side of my nose in March. Prior to that my dermatologist had done two laser treatments (2011) of what had been considered a large lentigo and it kept coming back. I asked for a biopsy. He recommended Aldara cream. A second and third opinion recommended surgery. I had 2 pathologists review the slide: one said it was pre-cancer and not melanoma in situ; the other said it was melanoma in situ. I’ve been doing some research online and interviewed several surgeons and found the information conflicting. Meanwhile, the LM is growing and changing. How do I choose the best surgical team since they all seem to recommend something a little different for treatment? For example:
One says MOHS for excision with margin control to minimize tissue loss since it’s on my nose and close to my eye. Another says to take it all out with 1 mm margin and biopsy it, then do an extra 4 mm where needed. Another will do a staged excision with 4 mm all the way around using a radial cut technique. Peer review literature is also conflicting on margins on the face and best practice.
I was told to go to a “facial plastic surgeon” for the reconstruction since noses are difficult. Of those I’ve interviewed: one says a graft from my cheek would be done and another said I’d have a scar down to my lip in my smile line or up my forehead. I hope to minimize the scars.
I am amazed at the way so many of you are handling this frightening illness and the knowledge base contained here. Thank you for sharing your experiences and any ideas you might be able to suggest.
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