A behind the scenes look at Karen Abernathy's skin cancer surger - WLOX.com - The News for South Mississippi

A behind the scenes look at Karen Abernathy's skin cancer surgery

It started with a tiny spot on the tip of my nose. Little did I know that this basal cell carcinoma would lead to more than 60 stitches down the center of my nose.  (Photo source: WLOX) It started with a tiny spot on the tip of my nose. Little did I know that this basal cell carcinoma would lead to more than 60 stitches down the center of my nose. (Photo source: WLOX)
BILOXI, MS (WLOX) -

My first experience with skin cancer was almost two years ago when I had a melanoma, the most deadly form of skin cancer, removed from my calf. But one month ago I faced a second surgery for a more common, but less dangerous form of skin cancer - basal cell carcinoma. But the location of this cancer made it scary.

It started with a tiny spot on the tip of my nose. Little did I know that this basal cell carcinoma, diagnosed after having a biopsy at my dermatologist's office, would lead to more than 60 stitches from top to bottom right down the center of my nose. It's pretty scary for anyone, but I had the added worry of getting back on camera. That's where my Mohs surgeon from the Hospital of the University of Pennsylvania in Philadelphia, Dr. Christopher Miller stepped in, to help alleviate my fears.

Miller assured me that, "After a three or four month period you'll have a hairline scar and a normal shape to your nose that blends in to your nose and is hard for the casual observer to notice."

Dr. Miller is the head of dermatologic surgery at UPENN and a member of the American College of Mohs surgeons. That was one of the most important things I found during my research to look for in choosing a Mohs surgeon, because that membership means they've undergone an intense fellowship training in a very selective Mohs program. Mohs micrographic surgery is highly specialized technique named for the doctor who developed it, Dr. Frederick E. Mohs. It's used primarily on cancers on the face because it's conservative, taking the smallest possible margins around the tumor and then putting it under the microscope right away to see if the margins are clear before closing the wound.

Miller explained, "The primary goal is to make sure the cancer is gone. So we take it out and look at it under the microscope before reconstruction begins. And because you're looking under the microscope at 100 percent of the edge you don't have to guess and you can start the surgery at a conservative margin so you don't take extra skin unnecessarily."

In my case it took two times to remove all of the cancer. It was all done under local anesthesia; numbing the nose with injections.

"Once we numb it up, there will be no pain." And Dr. Miller was right; I could feel him working; but there was no pain during the procedure after those injections. 

Once all of the cancer was removed I was left with a dime sized hole on my nose. And this is where good surgical skills become even more critical.

"One of the things challenging on the central face is even though the lesion is relatively small it takes more work to fix them up so the scar looks good when it heals," Miller said.

And the tip of the nose is more difficult to repair and reconstruct than the side or top of the nose.  Minimizing the scar line is only part of the equation. 

"One of the most important things is that the contour look good; the shape of the nose, lip, eye is the way it was before we started. And we often have to lengthen the scar even when the wound is small after we remove the cancer."

In my case, minimizing the scar in the long run led to more than 60 fine sutures on top of and underneath my skin.

"We take great care to make sure the scar is precisely aligned and the edges are as hair line as possible." 

Then the healing process began, slowly but surely. And within a week the exterior stitches were removed.

Miller reminded me that,  "Scars take about three or four months to settle down so during the first two or three weeks everyone is nervous."

And even though I knew I was in good hands, I was a bit nervous those first few weeks. But as the days go by, improvements continue. And while I still have a ways to go, after four weeks of recovery and healing, I felt comfortable enough to cover the scar with make up, and get back on the anchor desk - cancer free.

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