Basal Cell Carcinoma on the Lower Eyelid – Part 1

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Who knew you could develop basal cell carcinoma on the lower eyelid? I didn’t. I grew up in Hawai’i spending hours and hours in the sun every single day and that was before anyone wore sunscreen. We just didn’t know and it was considered wimpy to wear sunscreen. Now I certainly wish I’d worn sunscreen and sunglasses for all those years living in sunny paradise. As a result of all that sun exposure, I developed basal cell on the lower eyelid which resulted in surgery to remove it and then reconstructive ocuoplasty surgery to repair my eyelid.  In case you ever have the same experience, I want to share what I’ve learned and wish I’d known before I had my surgery.

3 pairs of sunglasses on white wood table

This has been quite some year for me. I’d never been under general anesthesia before but went under it twice in six months. The first time was for an emergency appendectomy last fall and then again this spring to remove basal cell on the lower eyelid. I’m generally a very private person. I’d rather not tell you about this experience, but I hope that this information may help someone else facing this experience. 

Let me start by stressing that I am not a physician and I have no medical expertise. I am only sharing my personal experience. You should consult with your physician for every aspect of your personal medical situation. 

My experience started around the same time as my appendectomy. Around that time, I noticed a stye on my lower eyelid (spoiler alert – it wasn’t a stye!). I get styes once in a while so I didn’t think much of it. Then I was kept busy with recovering from my appendectomy at home, so I didn’t think much about my stye.  Finally I had some unusual reactions associated with my stye that caused me to go to my family practice doctor. Two different doctors in the practice saw my stye and treated it as a “normal” stye. Finally because I’d had it for four months,  my family practice doctor referred me to the ophthalmologist. As soon as the ophthalmologist saw my stye, he suspected that it was basal cell carcinoma. The fact that I grew up in sunny Hawai’i backed up his suspicions.

Frequently Asked Questions about Basal Cell Carcinoma on Eyelid

  1. How did I get it?
  2. What does it look like?
  3. What happens?
  4. What can I expect next?

I worked as a patient advocate at a teaching hospital in a past life. I highly recommend this Medical Treatment Log to track any serious or long-term health issue. It is set up to help you manage the often overwhelming process and contains:

blue journal, pink pen, and page of colorful stickers
open journal with colorful lines and pink pen
  • Inspirational Quotes throughout
  • Diagnosis Spread
  • Treatment Option Spreads
  • Treatment Plan Spreads
  • Pre-Surgery Checklist
  • Surgery Recap
  • Medical Information
  • Medical Team Information
  • Questions for Doctor Spreads
  • Medication Log
  • Medical Result Log
  • Expense/Insurance Log
  • Support Log
  • Appointment Logs for 40 appointments
  • Lined Notes Pages

Basal Cell Carcinoma on the Lower Eyelid

These observations are mine and use layman’s terms. These do not represent medical information. 

close up of eye with small bump on lower lid with circle around it

Basal cell carcinoma often occurs on eyelids, especially the lower lid. Think about it. Even if you put sunscreen on, you don’t put it on your eyelids up to the edge. I want to show you this photo of what my basal cell carcinoma on my lower eyelid looked like so you’ll know to have your doctor check out a stye-that’s-not-a-stye if you ever have one. 

If basal cell carcinoma is suspected, they will do a biopsy.  In a way this is the worst part of the entire surgery experience because you don’t know what to expect and it’s on your eye! After going through the biopsy, you’ll know what to expect with the surgery, if it’s necessary. My biopsy was done as an outpatient procedure with local anesthesia.

I laid on my back on a table. The doctor placed a drape over my head with an opening that exposed my eye. That was disconcerting; a bit too much like a burial shroud for my liking. But the drape was helpful because then I couldn’t see what was being done on my lower eyelid. The procedure room had bright lights and that also helped prevent me from seeing what was about to happen.

The doctor gave me a numbing shot in my lower eyelid. That was the most painful part. The worst part of it was knowing that it was near my eye. If I’d had the same shot somewhere else on my body, it wouldn’t have been that big of a deal. After the local anesthesia, the rest of the process was tough psychologically, but not physiologically (I couldn’t feel anything thanks to the anesthesia). 

Let me be honest – the pain wasn’t too bad. What was difficult was the fact that needles and sharp objects are being used right by your eye. Every instinct tells you to protect your eyes and bat away whatever is coming at you. Let me stress that the pain was almost nothing. If you can focus on remaining calm, the procedure is not a big deal. Psychologically, having a stranger so close to your eye is tough, but the physical part of the procedure is bearable.

The doctor place a shield over my eyeball to protect it during the biopsy procedure. It looks like the lens from a pair of glasses. It was a bit uncomfortable to have the shield in, but it gave me a great sense of psychological comfort knowing that my eyeball was protected. 

Once the biopsy was completed, I had very little bleeding and within two hours the swelling of my lower lid was gone. I never had any bruising. I was told by the doctor that bruising and swelling was possible for a couple of days after the biopsy. I guess I was lucky. By that evening, I just had a small red spot where the biopsy had been taken, it just looked like I’d scratched my eyelid. 

It took a week for the results of the biopsy to come back. Unfortunately, mine were positive for basal cell carcinoma.

Basal cell carcinoma on the lower eyelid must be removed. The good news is that basal cell cancer does not metastasize and spread, but it will continue to grow bigger and bigger, so it’s important to have it removed earlier rather than later. This is especially important on your eyelid because the less skin that has to be removed with the basal cell, the easier the reconstructive surgery will be.

Important tip. Don’t google photos. I did and wish that I hadn’t. You’ll find photos of situations much worse than yours and you’ll just add to your anxiety. Just. Don’t. Do. It. 

The next step was the actual removal of the basal cell on my eyelid and the reconstructive (plastic surgery). You can read about here – My experience with the basal cell carcinoma removal and reconstructive surgery. 

I hope you never have to experience basal cell carcinoma on the lower eyelid. Be sure to wear your sunscreen and sunglasses every single time you go outside. 

blue rectangle with red arrow and text saying "Next for page two"
3 pairs of sunglasses on white wood table

Tips to organize for medical treatment. 

open accordion file folder
2 pink journals with pens on white table

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25 Comments

  1. God Bless you my friend …Sending love & prayers your way…..I cannot even imagine how terrifying this was for you….My Mom was blind and always told me never to put anything near my eyes and even now I can hear her voice giving me that advice….At one point in time I worked at an eye care center and the doctor wanted me to teach patients how to insert contacts….Needless to say I could not do this…Every time I put that contact near my eye…(You guessed it)…I heard My Mom’s warning to me…..
    Praying all goes well for you…..Have a Blessed day…..

  2. Wow, I can’t imagine having to have that done, you are so brave! I’m glad they found it early enough and were able to treat it before it caused you bigger problems. I don’t know if I could lay there and have that done – I’m a little claustrophobic.

    1. It was tough, but had to be done. You’d have gotten through it if you had to, Brenda. I know you’re one strong woman, too.

  3. Sorry you had to go through this, and so wonderful of you to share to help others. These pop up all over, but I can only imagine how scary it is to have it on your eye!

    1. You’ve got it exactly! If it had been on my pinky toe, then no big deal. But it’s an instinct to protect your eye and it was tough having anyone so close to my eye, even if they were highly skilled doctors.

  4. Hope you are recovering well… I have just been diagnosed with the exact same… basal cell carcinoma on my lower eyelid. I am terrified, about the surgery, how it’s gonna look afterwards, and if it will come back…
    And I did the opposite of what you recommend, went and Googled it, and spent the last 2 hours crying! How did your surgery go? Are you feeling better now? Do you have any advice?

    1. Hi, Filipa. Let me jump to the end of the story. If you say me, you’d never know that I had surgery. I was terrified as well, and I’ll be honest, the toughest part was psychological. The week after the surgery was rough, but after that it really was surprisingly easy. And let me stress that my eye looks great now. Feel free to email me at iorganize31(at)gmail(dot)com if you’d like to ask more questions.

  5. Thank you soooo much for sharing your story!
    I have a basal cell on my lower eyelid and will need to go through this same process. It’s do helpful that you shared your experience so that I feel more prepared and confident with my surgery.
    Thank you thank you thank you!!!!!

    1. Lisa, please feel free to email me if you have any additional questions. I can tell you that if you say me now, you’d never know that I lost almost a third of my lower eyelid. Be sure to ask your doctor all your questions. He or she may do this procedure all the time, but this is your one and only first time going through it. And it’s YOUR eye!

  6. Dear Susan,

    I finally had an itchy patch on my lower eyelid checked, out and it turns out to be Basal Cell Carcinoma on the Lower Eyelid. It’s a small patch more towards the nose than yours but about the same size. I have light skin and I thought I was very careful to use sun screen and sunglasses, but a little patch about the size of a pinhead grew to about 1/10 inch diameter a year later. Guess I waited to lOng to have it checked. I’m going to have a biopsy done and I’m sure it will be basal cell carcinoma. I guess it will have to be excized, but will it also required plastic reconstructive surgery? I use the VA hospital and just wonder it they will have the expertise.

  7. Thank you SO much for sharing your story. Just received my diagnosis yesterday. The DR said I may have my eye sewn shut for 3-4 weeks. I’m freaking out and visions of Frankenstein are going through my mind. I won’t look at pictures per your comments. I can’t imagine 3-4 weeks. OMG

    1. Do they tell you that it needs to be done right away? I work at a school and since I don’t want to freak out the kids, I would love to wait until June (4-5 months)

      1. I think it may depend on how large the carcinoma is. I had to wait 5 weeks because of scheduling issues. I’d explain your situation and ask the doctor’s opinion.

        1. Thanks. Mine looks similar to yours. How long until you looked presentable? I feel like all the pictures on the internet are directly after the removal before they are stitched up. I remember getting freaked out before a MOHS surgery on my face and it ended up not being too terrible.

          1. My eye was sewn shut for one week. The minute they reopened my eye, I looked 100% normal with just a little bruising (you can see a picture of what I looked like in part two of this series).

  8. This is a helpful post for anyone facing this type of surgery and experience. Thanks for including the link to my story as well. I hope it helps others!

  9. Hi,

    Thank you so much for sharing your story it has really helped my anxieties over my upcoming, lower lid surgery. I was just wondering, how long did you have the wee little bump before you had it looked at? I’ve had mine for about 7 years, and 3 doctors told me it was nothing and not to worry about it. However, one very enlightened doctor told me we need to biopsy that, and lucky she did, because of course it came back as being Basil Carcinoma.

    1. I had my bump, that I thought was a stye, for about 6 months. I had additional related issues that finally caused my primary care doctor to refer me to an ophthalmologist. But my primary care doctor didn’t realize that it was cancerous.

    2. 7 years! I’m so sorry you had that experience. I’ve been going to a highly rated dermatology practice for the past 15 years for an annual skin cancer check, but not once in that time have they checked my eyelids. About 18 months ago, I thought I was getting a stye on the center of my lower right eyelid, but the bump never turned into a stye. It didn’t hurt and never bled or oozed, but it did grow. I forgot to mention it when I went in for my annual check in December, but when it didn’t resolve, I went in 2 months later, in February, specifically for the bump, saying I wondered if it might be skin cancer. I was told it was not skin cancer, although they didn’t do a biopsy. I was sent me home with instructions to use warm compresses to make it go away. Needless to say, warm compresses have no effect on BCC. I went back in August demanding they check it again, and this time they said it was almost certainly a BCC and referred me to an oculoplastic surgeon. My ophthalmologist, whom I see every 6 months, didn’t notice it either.

      1. I’m so sorry, Judith. Apparently, doctors are not as familiar with bcc on the eyelid and often miss diagnosing it. I’m so glad that you took care of advocating for yourself.

  10. Susan, I want to thank you for taking the time to write and post this. I’ve just been diagnosed (FINALLY) with BCC of the lower eyelid, and your post is one of the most helpful articles I’ve found anywhere about this. I’ve been referred to an oculoplastic surgeon. He has terrific credentials and I like him, but he wants to do a wedge resection rather than Mohs surgery, so I’m trying to figure out whether I should have Mohs and then go to the oculoplastic surgeon for reconstruction or whether I should just let him do the wedge resection to remove the tumor. From everything I’ve read, I’m leaning toward Mohs, but I haven’t made up my mind. I’m apprehensive about all of it, but your post really has helped me, so thanks again.

    1. I’m glad that you found this information helpful, Judith. It made the process a bit easier for me somehow hoping that sharing my experience might help someone else. Could you see a dermatologist familiar with basal cell on the eyelid for a 2nd opinion? As a former patient advocate, I’m a big believer in advocating for yourself. The tough part is that ultimately you have to trust and “jump” at some point. There’s never enough time to go to med school and through a residency before we have to make our decisions on how to proceed. I’ll keep you in my prayers, and please let me know how it goes for you.

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