When Kathy Patinkin noticed a small, red growth on her nose, she mentioned it to her doctor. After not getting clear answers at several hospitals, Kathy came to 脱衣直播 where a dermatologist diagnosed her with basal cell carcinoma, the most common form of skin cancer.
While basal cell carcinoma is often very treatable and rarely spreads to other parts of the body, it can be disfiguring.
鈥淏asal cell carcinoma most commonly occurs on the face and other sun-exposed areas,鈥 says facial plastic surgeon , who specializes in skin cancer facial reconstruction. 鈥淚t can be sneaky in terms of how big the cancer is. While it may look small on the surface, it can often extend further into the tissue. And that was the case with Kathy.鈥
A care plan
Kathy鈥檚 dermatologist planned to remove the cancer with Mohs surgery, one of the most effective procedures for removing this type of skin cancer. But because the cancer had extended so far into the surrounding tissue, Kathy would be left with a 3-centimeter wound on her nose. Her dermatologist partnered with Revenaugh to put together a comprehensive care plan that included nasal reconstruction to address the wound.
鈥淭his is a very cosmetically significant part of the face, and it is important to recognize the implications of removing something on that part of the face because there could be major problems and disfigurement,鈥 says Revenaugh. 鈥淚n Kathy鈥檚 case, the skin cancer involved a large portion of her nose and just removing the cancer without reconstruction would have left her with a major distortion on her face.鈥
Kathy鈥檚 team explained everything to her, every step of the way from the moment she came to Rush.
鈥淚鈥檒l never forget the day I met Dr. Revenaugh,鈥 Kathy says. 鈥淚 was extremely stressed, and I knew I needed a major surgery on my face, which is scary. When he started explaining what kind of surgery I needed, I told him I really wanted my husband to join us. So, Dr. Revenaugh asked me what my husband looked like and then went out into the waiting room himself to get my husband. It was a small gesture, but it showed me what a wonderful, caring doctor he was. From there, he walked us through everything that would happen in the surgery with such kindness and eased my fears the whole time.鈥
Kathy was also confident in Revenaugh鈥檚 extensive experience in facial reconstruction. In fact, as leaders in the field, Revenaugh and his colleague , another facial and reconstructive surgeon at Rush, helped write the newest guidelines for providers about best practices for facial reconstruction for patients who have skin cancer.
The surgeries
First, Kathy underwent Mohs surgery, which successfully removed all the cancer. Then, 24 hours later, she had the first stage of nasal reconstruction surgery with a forehead flap procedure.
鈥淚n this procedure, we used tissue from Kathy鈥檚 forehead to reconstruct the part of her nose where the skin cancer was removed,鈥 says Revenaugh. 鈥淭he procedure involves rotating skin from the forehead and attaching it to the nose. It鈥檚 hard to imagine, but we (temporarily) leave the forehead tissue attached to the nose to aid in blood supply. I describe it to my patients as having what looks like a finger between your forehead and your nose.鈥
Revenaugh explained every detail of this first phase of reconstruction to Kathy to help her understand what to expect and how she would look. 鈥淒r. Revenaugh showed me pictures of how I would look at every stage, which was really helpful,鈥 says Kathy. 鈥淚t really did look like I had a finger across my face at first. But he had warned me about this, and nothing was a shock to me because he had prepared me for it.鈥
After two weeks, Kathy had the second phase of the reconstruction, in which Revenaugh removed the connection and smoothed the skin to make sure it all blended in a seamless way with minimal scarring. Several weeks later, Kathy had a final procedure to help refine the side of her nose to give her a more natural-looking crease between the nostril and her cheek and to match the contours of her face.
Recovery and results
鈥淩ecovery for these surgeries is relatively quick, and there isn鈥檛 a lot of pain afterward,鈥 says Revenaugh. 鈥淢ost patients are back on their feet after a day. But there is some swelling. And, of course, there are about three weeks between the first and second phase of the procedure where they have the attachment between the forehead and nose, which can be difficult from an aesthetic perspective. Overall, for major reconstructions like this, it takes about six to eight weeks for people to start looking and feeling back to normal.鈥
Kathy took about a month off work selling real estate after the surgery. But she slowly got more comfortable being around people as her face started to heal.
鈥淓verything went exactly as Dr. Revenaugh said it would go,鈥 says Kathy. 鈥淗e never touched me without telling me what he was planning to do and how I would look and feel after it. He was always available to answer my questions and really guided me through this whole ordeal.鈥
Today, Kathy continues to get regular skin checks to help detect any new skin cancers and you would never know she had major nasal reconstruction. 鈥淓verything went great, and I look fine,鈥 she says. 鈥淭here is a tiny scar on my forehead and my nose looks completely normal. It鈥檚 pretty incredible.鈥
