My dermatologist spotted it immediately during a full-body check this spring – an appointment I’d neglected to schedule for two years.
I had noticed the subtle indentation in my right cheek, too, but dismissed it as a stubborn acne scar that was easily disguised with an extra swipe of powder blush. Besides, I’d sworn off sunbathing, years ago, after an earlier brush with basal cell skin cancer on my shoulder. I thought I was free and clear.
But the biopsy report confirmed that a large basal cell epithelioma was spreading its roots deep beneath the surface of my cheek, an inch below my right eye. To avoid as much scarring as possible, my dermatologist referred me to a surgeon who specializes in the Mohs method, a microscopically controlled cancer surgery developed by Dr. Frederic Mohs in the 1930s. Typically lasting from five to seven hours, Mohs surgery involves removing and examining a patient’s cancerous skin tissue one layer at a time until only cancer-free tissue remains.
Afterward, the surgeon might opt to close the wound using plastic surgery techniques or allow it to heal by itself, depending on its location. The cure rate is high — up to 99 percent for some cancers. And while the stellar reputation of my surgeon was equally reassuring, I’d be lying if I said I wasn’t terrified of the procedure and the new scar I’d soon acquire.
Facing Up to Shame
There was a time when I thought I’d waded past the shallow waters of vanity and gained a deeper respect for my aging face and body. In my mid-forties, bilateral hip replacement surgery left me with a matching pair of 10-inch scars on my thighs. During the weeks of rehab after both hip surgeries, I often reminded myself that scars are emblems of a richly textured life — a survivor’s life. Whether we’ve endured car accidents, major surgery, or military combat, scars document our personal history and bear witness to the challenges we’ve met. But a long scar on the face isn’t so easy to reconcile. In our celebrity driven culture, appearance matters more than we’d like to admit.
For women, especially, it’s hard to ignore the standards of beauty trumpeted by magazine editors and product advertisers. And it’s hard not to feel judged if we fall short of airbrushed perfection. While preparing for my Mohs procedure, I happened to be reading Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead (Gotham) by sociologist Brene Brown. The book devotes several pages to the tender topic of female self-image and shame. “After all of the consciousness-raising and critical awareness, we still feel the most shame about not being thin, young, and beautiful enough,” Brown explains.
Brown’s shame research hit home the day after my surgery. Removing the pressure bandage from my face, I was ashamed to show my bruised, three-inch “Frankenstein scar” to my own husband. This took me by surprise because I know the man loves me unconditionally, even in my frumpiest moments. Yet I avoided exposing my wound to him – and everyone else — until I’d made peace with it myself.
Healing Takes Time
As noted in the post-op instructions I was given, scars go through a maturation process and sometimes look worse as they heal. In other words, healing and “maturity” require patience. Ironically, a week before the cancer diagnosis, I’d been scouting local cosmetic departments for the best anti-wrinkle creams available. My crow’s feet and droopy jaw line were underscoring my impending senior status – and I was determined to fight them.
But my skin cancer surgery quickly altered my stance in the battle against aging. Now, wrinkles and age spots aren’t such a threat to my pride. Maintaining the health of my complexion has usurped my quest to appear younger, and wearing a good sunscreen tops my cosmetic priorities.
The new scar is healing gradually now, morphing from dark purple to pink as the weeks pass. My dermatologist tells me it will be a year before the incision is undetectable without makeup. In the meantime, I’m learning what it has to teach me. I’ve stopped wondering if other people notice my “imperfections” or see them as anything other than visible signs of my resilience or humanity. I only wish it hadn’t taken so many years – and a sobering medical diagnosis — to finally arrive at this quiet harbor of self-acceptance.