What about a local surgeon?

When we first realized that the nevus on Anikka’s face wasn’t going to disappear on its own, we learned everything we could about congenital nevi and their treatment.  We quickly discovered that there are generally three different philosophies:

• Leave it alone.
• Remove it surgically.
• Treat it with various types of lasers.

We’re all too aware that leaving it alone was out of the question.  Anikka is beautiful and amazing, but we know how kids can be and the kinds of comments/questions even someone as pretty, strong, and smart as she is can expect growing up with such a prominent birthmark.  When we learned about the possibility of a cancer link, any remaining questions were answered.

Most of the literature on the subject suggests surgical excision as the only real way to remove a congenital nevus, an opinion shared by the staff of dermatologists employed by our former HMO.  However, while researching the procedure, we found many, many cases where surgical excision left a patient’s face distorted.  In Anikka’s case, the nevus comes very close to her eye and nose, and touches the edge of her lip.  A botched excision, then, could have a drastic effect on those very key (and very beautiful) features.  Furthermore, many people end up spending years of their lives enduring additional operations in order to correct those mistakes.

Our first attempt to address the nevus was through laser therapy.  We found a couple of cases that looked very promising and worked with a very good doctor in Sacramento for a year or so.  Unfortunately, Anikka’s nevus hasn’t responded very well and we’ve decided that it’s time to focus our resources elsewhere (see “What about lasers?” in the FAQ).

So that brings us back to the original question:  What about a local surgeon?

The short answer is simple:  we’ve yet to find anybody locally we feel comfortable operating on our daughter’s face.  Of course, there’s a little more to the story.

As mentioned, we originally found several before-and-after images of patients whose surgical excisions left them with bad scarring or distorted features.  While some amount of scarring is inevitable, it’s clear that some surgeons are more skilled at hiding and minimizing those scars than others.  Furthermore, many patients who attempt to go with a less qualified surgeon initially to save money end up spending more time and resources correcting those early efforts later in life.  It’s not uncommon, for example, to find cases in which a patient has undergone 10-20 operations in order to remove a nevus and correct results of previous operations.

Financially speaking, it just makes more sense to work with an expert up front and pay a little more to get it done right the first time around.  Psychologically, it’s important that the procedures be completed while Anikka’s still relatively young in order to avoid as much of the taunting and social commentary as possible.

Finally, there are the before-and-after pictures on our chosen doctor’s site.  Take a look at some of the images on Dr. Barry Zide’s giantnevus.com, along with his impressive credentials, and you’ll understand why we believe he’s the man we’re will to entrust with our daughter’s future.