“I’m one of those old Irish guys who never goes to the doctor,” said Andrew O’Connor, a lifelong New York City resident and a former employee of the MTA.
It’s not an unfamiliar sentiment. Perhaps it’s not so much an Irish thing as it is just a thing in general — people don’t enjoy going to the doctor. In fact, fifteen percent of people in the United States do not make annual doctor’s appointments. But call it whatever you will - coincidence, divine intervention, or the pressure of a loving wife - eventually O’Connor did make that doctor’s appointment and it ended up saving his life.
Andrew O’Connor had skin cancer, and he had absolutely no idea. Not only that, it was a type of skin cancer that can be fatal, and it had spread so viciously that it required one of the most extensive facial surgeries to remove it. So when we say this visit saved his life, it’s no exaggeration.
The cancer looked like bumps. Just tiny little bumps that he would knick when he shaved. They didn’t look like much, or anything at all. Still, his wife urged him to go get them checked out.
“I have to be dragged [to the doctor],” said O’Connor. “It’s not that I’m not smart enough to know, but [it's more that] I never get sick. One day my wife told me to go get checked out and to take advantage of the things I pay for with insurance.”
To his relief, the doctor who initially examined him gave him a couple of cortisone shots and sent him on his way. That, he thought, was the end of it. That was 20 years ago. Two decades later, his wife pushed him again. This time the dermatologist decided to take a biopsy.
From that point forward, for a man who never visited the doctor, things started to change pretty quickly.
“The tissue they found was cancerous,” said O’Connor. “It was one of those good news-bad news situations. It wasn’t pancreatic, but it was more of those, ‘you gotta go and have a consultation.’ After that, it all happened within a matter of days.”
Yes, it was cancerous. But like we mentioned before, not only was it cancerous, but if left any longer, it would have become fatal. It had to be operated on — and quickly. It’s not that O’Connor was scared, necessarily. But he recounted multiple times how often his jaw hit the floor upon hearing the news. A grown man with grown children, who never had so much as a broken bone or a cavity, was facing lethal skin cancer — and he had had no idea.
The dermatologist who took the initial biopsy referred O'Connor to Dr. Hooman Khorasani, who was going to be the one performing his skin cancer surgery. Dr. Khorasani is a fellowship trained, triple board certified dermatologic and cosmetic surgeon, who is one of the leaders in the field with respect to Mohs surgery. The Mohs technique allows him to remove the cancerous tissue, while preserving as much healthy tissue as possible. Dr. Khorasani also performs the reconstructive surgery after the cancer is removed, in order to ensure maximum recovery, with respect to both health and aesthetics.
"I met Dr. Khorasani and he told me what he was going to be doing and how Mohs surgery works," said O'Connor. "I said let's just get it on. I have to do what I have to do."
O'Connor was motivated. His mindset was to skip the worry, do what had to be done, and move on with the rest of his life. "It doesn't help to feel sorry for yourself or to whine. It's counter productive," he said.
It's a unique quality — few patients who hear the word 'cancer' are as matter-of-fact about it as O'Connor. But his motivation to get back to a cancer-free life worked in his favor, because things started happening lightning fast from here. In part, he said, it was due to the confidence he had in Dr. Khorasani.
"I really liked him off the bat," said O'Connor. "He had a good vibe. His confidence made me feel confident. When I look back, it couldn't have worked out better. I got the best doctor. His whole staff was full of really nice people."
The procedure was going to happen in less than a week. That's little time to prepare, especially for a surgery that was going to be so extensive, but often when patients wait so long between checkups, moves often have to be made quickly.
As fate would have it, another patient called to cancel and all of a sudden O'Connor was offered surgery the very next day.
"I had a little bit of apprehension," he said. "I thought, 'okay, this is happening now. It's going to be tomorrow.' I was locked in."
It was at this point that O'Connor felt the anxiety creep through his body — a completely normal, and natural feeling before undergoing any kind of surgery, but that feeling gets heightened when the surgery is for cancer.
"I didn't know what I was stepping into. It was literally three days from when I first saw him."
Unfortunately for O'Connor, the cancer had burrowed so deeply into layers of his skin, that Dr. Khorasani had to actually cut from his earlobe, up to his temple, down to his nose, and down to his chin. To put it simply, it was half of his face. It's an unheard of level of cutting when it comes to removing skin cancer.
But O'Connor remembers feeling reassured because Dr. Khorasani had taken him step-by-step through the process, and he knew exactly what was being done. He remembers thinking, when he looked in the mirror, how it would ever look normal after that level of cutting. After cutting the cancer out, Dr. Khorasani would have to move his skin over to cover up the hole.
"Once he started doing the work it was interesting — it was amazing to see just how the progression would happen. He was very communicative. It was just amazing," said O'Connor.
Mohs surgery can be overwhelming for many patients because it really looks like a gaping hole in the affected area after the cancer is eradicated. But Dr. Khorasani's method involves reconstruction right after the cancer is fully removed- the same day. On top of that, because he serves as the Mohs surgeon, oncologist, and cosmetic surgeon, he plans his closure of the defect in advance, which ultimately provides you with the best scar possible. This can be extremely important for many patients, especially when the cancer is as prominent as right on your face.
That's exactly how it was for O'Connor. The cancer had invaded a 4 inch area from the right nostril to the entire right upper lip and parts of the right cheek. In order to repair this large defect, Dr. Khorasani had to design a flap with 3 distinct lobes (called a tri-lobe transposition flap). One lobe of the flaps was transferred from his cheek to the lip, another to cover the cheek donor site from the jawline, and a third from behind the ear to cover the jawline donor site. According to O'Connor, Dr. Khorasani told him this was one of the more rare cases of Mohs surgery he had ever performed. In fact, he said it was in the top 10 most extreme cases he’d ever encountered.
"I was pretty sure I was going to come out of this thing looking the best I could come out with. He was really good. I can't say it enough," said O'Connor.
Once the flap was healed work had to be done on the aesthetic component of the scar, which is one of Dr. Khorasani’s other specialties. He used a “thinning” procedure to match the thickness of the flap with the thickness of O’Connor’s lip. This was a quick, in office surgical procedure followed by a few additional injections to reduce the volume of the flap. To account for the scar surface irregularity, Dr. Khorasani proceeded with dermabrasion of the entire scar. Finally, in order to remodel the scar, Dr. Khorasani used a fractional co2 resurfacing laser. Needless to say, Dr. Khorasani’s work did not stop after the tumor removal and reconstruction.
The recovery for O'Connor was a little uncomfortable, but his inspiring attitude pushed him to see the bright side of things. "I got used to it pretty quickly," he said. "It's nice to see the healing. Still now I'm shocked."
O'Connor was lucky in many ways: to have a wife who pushed him to go to the doctor, for having an attitude that allowed him to throw himself all in as quickly as he had to, and to have been referred to the office of Dr. Khorasani.
You have to wonder if O'Connor has had a change of heart when it comes to routine doctor's visits.
Admittedly, he has not been back to the doctor. But he was adamant that if he ever had to go back to the doctor again, he would, without a doubt, choose Dr. Khorasani.
"This guy is my hero," he said. "Without a doubt I wish every other doctor was more like him. He's confident. I didn't dread the whole process. In fact, I may need to go back for liposuction because of [all the comfort food during] COVID," he joked. Then added, more seriously, "I would tell anyone I know who had something similar, to see him."
If you suspect an irregular mole or area of skin, please contact Dr. Hooman Khorsani for a consultation. To expedite a consultation, message us, or call our Manhattan office at: 212-210-2127. Visit our Mohs Micrographic Surgery page and our SkinCancer Surveillance page to learn more.
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