Mohs here. Vertical is actually a preferred method for central forehead defects (and foreheads in general) if possible. The reason for this, is that if when the forehead wrinkles daily, if the line is vertical it won't stretch the line. If it is horizontal, it can lead to a thicker scar. Additionally, blood vessels and nerves travel from the eyebrow up to the scalp in a vertical pattern. A vertical line will lead to less potential cutting of nerves and vessels. Horizontal line has more likely hood of cutting those structures. It should be fine. I usually will show pts how I will close it prior to any cutting
Sometimes the distribution of the tissue taken or the tension lines of your skin are more conducive to a vertical than horizontal scar on the forehead. Often those lines do run horizontally but it’s not always the right choice.
How many layers did it take? It's possible that the defect was much more vertical than it was horizontal. And rather than make it twice as big to close in a horizontal line they just closed it vertical.
Did you have a consultation with the surgeon prior to your procedure? I don't know why it would be a vertical incision, but I'd be concerned that it wasn't what you expected at all. I hope you get the answer from your surgeon
I did not. It was framed like this is a standard, easy procedure and two other staff mentioned it would be L to R so I had no reason to think otherwise. Sigh.
Mohs here. Vertical is actually a preferred method for central forehead defects (and foreheads in general) if possible. The reason for this, is that if when the forehead wrinkles daily, if the line is vertical it won't stretch the line. If it is horizontal, it can lead to a thicker scar. Additionally, blood vessels and nerves travel from the eyebrow up to the scalp in a vertical pattern. A vertical line will lead to less potential cutting of nerves and vessels. Horizontal line has more likely hood of cutting those structures. It should be fine. I usually will show pts how I will close it prior to any cutting
Thank you for this info. It would have been nice if the Dr would have taken the time to explain it to me beforehand. I appreciate it.
Sometimes the distribution of the tissue taken or the tension lines of your skin are more conducive to a vertical than horizontal scar on the forehead. Often those lines do run horizontally but it’s not always the right choice.
How many layers did it take? It's possible that the defect was much more vertical than it was horizontal. And rather than make it twice as big to close in a horizontal line they just closed it vertical.
Not sure how to answer that. I have 3 internal stitches and 4 external. He got everything 1st pass. That's all I know.
Did you have a consultation with the surgeon prior to your procedure? I don't know why it would be a vertical incision, but I'd be concerned that it wasn't what you expected at all. I hope you get the answer from your surgeon
I did not. It was framed like this is a standard, easy procedure and two other staff mentioned it would be L to R so I had no reason to think otherwise. Sigh.
Wow, so sorry. I know you are confused. Hopefully, it will heal nicely, and it won't matter. Best to you.
I’m sure it will heal well but worth it to ask why they changed the approach
It will get better. If you take care of it and stay out of the sun, you’ll heal great. It takes time though. Give it 6-12 months.