This past Friday, the day before Halloween, I had Mohs surgery to remove the tiny spot of skin cancer I had on the tip of my nose.

Well, it looked tiny from the surface, but it wound up being a little more invasive than I had realized. But more on that later.

What is Mohs surgery?

It’s basically a simple out-patient procedure used to treat skin cancer. It involves cutting away thin layers of skin until the cancer is completely removed. It’s a fairly common operation.

As I mentioned previously, it was the Grok AI that initially diagnosed me. I had been dealing with a bleeding spot on my nose for about 9 months that wouldn’t go away. I thought it was acne or some kind of deep cyst at first. I had those when I was younger, so I was no stranger to weird shit happening on my face. I fed all my symptoms into Grok, and it spat out a list of possible ailments, chief of which was BCC. Afterward, I quickly made an appointment with a dermatologist in Boulder, CO. There, I underwent a biopsy, which came back positive for skin cancer. So I then scheduled surgery for October 30th.

What is Mohs surgery like?

It’s perhaps a bit like going to the dentist. They led me into a large surgical room with a reclining chair. It was a seriously over-sized room for such a simple operation on such a tiny spot of cancer. But oddly that made me feel better. After signing a consent form and some other documentation, she had me lay back on the chair. Shortly after, the surgeon came in–A nice, friendly guy with long scraggly black hair. We talked for a bit. He gave me a brief overview of what to expect. He circled the spot of cancer on my nose with a purple marker of some kind. Then he left the room. Afterward, the technician injected my nose with some local anesthetic, which numbed me up pretty good.

The surgeon returned a few minutes later and the procedure began. Following the purple marks, he cut around the cancer cells on my nose, and sliced out a plug of flesh. A technician then made several very thin slices of the sample to determine whether all the cancer has been removed. Mohs goes layer by layer until all the cancer is gone. So, what’ll happen is the surgeon will do the first pass, bandage you up, and then take the sample to the on-site technician. During which you just sit in the waiting room with a big wad of cloth on the surgical site while you wait.

Sometimes, it requires multiple passes. I was fortunate in that the surgeon only needed to do one more pass just to remove a little bit of BCC that remained. So, after waiting about 30 minutes for the results, I was led back into surgery for round two. Then afterward I was finished with the surgery. Cutting out the cancer is relatively simple and brief. But afterward, I had a dime-sized hole missing from the tip of my nose.

Apparently, many BCC patients are surprised at how invasive the surgery actually is, even if the cancer looks small from the surface. I’m no different. I had a giant gaping wound on my face! But cancer cells can reach down deep, and the surgeon has to remove the “root ball,” so to speak.

Following the removal, the surgeon next stitched up my wound with dissolvable stitches. I’ve since watched a few videos of this being done, and I have to say, it’s a bit of an art. The surgeon has to stitch the deep layers together first, working his way upward to the surface. Then he applied special brown bandages meant to stay on for about a week. Then he placed a final white bandage to my nose that I had to wear for about 48 hours.

Does Mohs surgery hurt?

It’s pretty painless. It’s perhaps no worse than having a cavity filled at the dentist. Though your mileage will vary depending on where on your body the surgery is performed. The nose is a sensitive area. It’s also one of the most challenging areas to stitch up, as well. I only began to feel discomfort about an hour or so after I’d left the office, when the anesthesia began to wear off. And I’d describe the pain more as a mild itchy annoyance. Presently, I’m more concerned about the potential for scarring and infection, though I was told those generally keep to a minimum.

If you’re someone who stresses over going to the doctor, or has anxiety about anything more invasive than a check-up, I think you’ll find Mohs fairly tolerable. The only real stress I had was more related to having to drive back home to ND from Boulder, CO. Plus the mild embarrassment of having to walk around in public with a giant white bandage on my nose. I guess if you have to do this procedure, it’s best done the day before Halloween like I did. You could possibly wear a mask afterward and nobody would think twice. I garnered a few curious looks anytime I went into a gas station. I even had one curious cashier ask me what happened. But aside from all the social unpleasantries and the pain of driving a long distance, the whole ordeal was largely manageable.

Now comes the healing part. I was informed that skin heals at a rate of one percent per day. So it’ll take roughly three months before my nose is completely back to normal. However, I’ll be able to wash my face like I regularly do after about a week, and go swimming in two or so.

For now, I look a tad “Frankensteined” with the football-style stitching on my face. Hopefully, there is little scarring. My nose is a big enough protuberance that I don’t need it making anymore of an unsightly spectacle of itself than it already is. But time will tell. I have a follow-up appointment in December, and by then I’ll be able to determine how much damage (if any) has really been done. 🙂