Nasal Reconstruction After Skin Cancer Removal: How the Defect Is Assessed and Repaired

The bandage is bigger than she expected. An hour ago the spot on the side of her nose was the size of a pencil eraser, a pearly bump she had ignored through two summers. Now the surgeon is describing the hole underneath it in millimeters, sketching on a scrap of paper, and asking whether she wears glasses every day. That conversation, sitting in a paper gown with a numb face, is where nasal reconstruction after skin cancer really starts.

The nose gets more than its share of sun and, not surprisingly, more than its share of skin cancers. Removing the tumor is the medical priority. Repairing what is left is a second, separate craft, and it is one that patients rarely hear about until they are in the chair.

This article walks through how surgeons assess a nasal defect, why the same-sized wound may be repaired three different ways depending on where it sits, what the weeks afterward tend to look like, and the questions worth asking before anyone picks up a needle.

How serious is skin cancer on the nose, and why is nasal reconstruction after skin cancer planned so carefully?

Most skin cancers on the nose are basal cell carcinomas, the most common cancer in humans and one that arises in sun-exposed skin. According to MedlinePlus, basal cell carcinoma almost never spreads to distant organs, but left alone it keeps growing locally and can destroy the skin, cartilage and even bone around it. Squamous cell carcinoma, the second most common type, behaves more aggressively and carries a small but real chance of spreading, which is why the CDC lists both types as the skin cancers that most often need surgical removal.

So the honest answer to “how serious is it?” depends less on the word cancer and more on three things: the type, how deep it has grown, and where on the nose it sits. A shallow basal cell on the flat bridge is a different problem from one that has burrowed into the rim of a nostril.

The nose complicates everything. Its skin is not uniform: the tip and the nostril rims (the alae) are covered in thick, oily, sebaceous skin, while the upper sidewalls and bridge are thin and mobile. It is a three-dimensional structure made of skin, a cartilage and bone framework, and an inner lining, and it has a job to do: moving air. A repair that looks acceptable but pinches the airway or pulls a nostril upward is not a good repair.

Surgeons therefore think in aesthetic subunits, the natural zones of the nose (dorsum, tip, columella, and the paired sidewalls, alae and soft triangles) whose borders are where light and shadow already change. Scars hidden along those borders tend to disappear; scars across the middle of a subunit tend to announce themselves. Nearly every decision described below flows from that observation.

What happens during Mohs surgery on the nose, and how painful is it?

Mohs surgery is a technique in which the surgeon removes the visible tumor plus a thin rim of skin, maps it, and examines the entire edge under a microscope while the patient waits. If cancer cells remain at any point on the map, another thin layer is taken from that spot only. The cycle repeats until the margins are clear. The NHS notes that Mohs is reserved for high-risk sites such as the nose, eyelids and lips, precisely because it spares as much healthy tissue as possible in places where every millimeter matters.

The procedure is done under local anesthetic, meaning the skin is numbed with an injection and the patient stays awake. Mayo Clinic describes the day realistically: each layer takes time to process in the lab, so a session can stretch to several hours, most of it spent waiting with a temporary dressing on. Almost everyone goes home the same day.

People ask about pain more than anything else. The injections sting for a few seconds; after that the area is numb and the cutting itself is painless. Once the anesthetic wears off, most describe soreness, tightness and a dull ache rather than sharp pain. The surgical team advises on what to use for discomfort based on your other medicines and conditions; that guidance, not a general article, is the one to follow.

One detail surprises many patients: the final wound is often larger than the spot they could see. Basal cell carcinoma spreads under the surface like roots under a weed, and the microscope finds what the eye cannot. That is why the reconstructive plan is finalized only after Mohs is complete, when the true size and shape of the defect are known.

How is the nasal defect assessed after the cancer is out?

With margins confirmed clear, the surgeon studies the wound the way an architect studies a hole in a wall: what is missing, what is still standing, and what has to hold the roof up.

The first question is depth. A superficial defect involves skin and a little fat. A deeper one exposes or removes cartilage. A full-thickness defect, one that goes through the skin, the cartilage framework and the inner lining so that you could see into the nostril, needs all three layers rebuilt. Depth alone can move a repair from a simple graft to a staged operation.

Next comes location by subunit. The same 1.5-centimeter wound is easy on the loose sidewall skin, harder on the immobile tip, and hardest at the alar rim, where even a small pull creates a visible notch. Surgeons often measure with a ruler and make a paper or foil template of the defect, which becomes the pattern for whatever tissue will fill it.

Skin quality matters too. Thick sebaceous skin on the tip does not match thin skin borrowed from behind the ear; the forehead is a closer match for tip and dorsum. The amount of loose skin nearby, prior surgery or radiation to the area, and the patient’s age all affect how much can be borrowed locally.

Then the person, not just the nose. Smoking, poorly controlled diabetes, blood-thinning medicines and certain immune conditions raise the risk that a graft or flap will not survive, as Cleveland Clinic notes for skin grafts generally. Whether the patient wears glasses, breathes through one side already, or can return for a second stage all enter the calculation. Assessment is finished when the surgeon can say, in plain words, which layers are missing and where replacement tissue will come from.

Nasal reconstruction after skin cancer: the options, from simple to complex

Reconstructive surgeons often describe a ladder, starting with the simplest method that will give a good result and climbing only as far as the defect demands. On the nose, the rungs look like this.

Option	Usually considered for	What it involves	Main trade-offs
Healing on its own (secondary intention)	Small, shallow wounds in concave spots such as the inner corner of the eye or alar groove	Dressings while the body fills the wound with new tissue	Longer open-wound period; can leave a pale, shiny patch
Direct closure	Small wounds on loose sidewall or dorsum skin	Edges stitched together	Can distort the tip or nostril if skin is tight
Full-thickness skin graft	Shallow wounds where cartilage is intact	Skin taken from ear area, neck or forehead and sewn in	Color and thickness may not match; graft can fail
Local flap	Small to medium wounds of tip, ala or sidewall	Nearby skin rotated in while keeping its blood supply	Extra scars; swelling; possible bulging
Forehead flap	Large or deep defects, especially of tip and ala	Forehead skin swung down on a stalk; second stage later	Two or more operations; weeks with the stalk attached

Two features of this ladder deserve emphasis. First, it is not a quality ranking. A skin graft is the right answer for many shallow sidewall wounds and the wrong answer for a deep tip defect; a forehead flap is overkill for a small dorsal wound. Second, structural work (cartilage grafts and lining) sits alongside the ladder rather than on it, because any of the skin options may need support underneath.

The NHS summarizes the same idea in a sentence: after skin cancer surgery on the face, a skin graft or flap may be needed to close the wound, and the choice depends on the size and site of what was removed. The rest of this article unpacks the rungs one at a time.

Skin graft on the nose: how long does healing take?

A skin graft is a piece of skin removed completely from one part of the body and placed on the wound, with no blood vessels of its own. For the nose, surgeons almost always use a full-thickness graft, which includes the entire depth of the skin and shrinks less than a thinner split-thickness graft. Common donor sites are the skin in front of or behind the ear and the lower neck, chosen because the color is close and the donor scar hides well.

The graft’s survival is a race. Cleveland Clinic explains that in the first day or so it lives by absorbing fluid from the wound bed, and that new blood vessels begin growing into it within roughly 36 hours. Until that connection is established, any movement, fluid collection or infection under the graft can starve it. This is why a bolster dressing, a firm pad stitched over the graft, is usually left undisturbed for the first week or so, and why patients are asked not to press, rub or bump the area.

How long does it take to heal? Cleveland Clinic gives the practical range: a skin graft generally takes a few weeks to heal, with the donor site often healing faster. The graft typically looks alarming along the way, first pale, then purple or dusky, sometimes with a crust or blister, before settling toward a pinkish color. Full color and texture blending continue long after the wound itself has closed.

The honest limitation of grafts is match. Thin ear skin on a thick sebaceous tip can look like a patch, slightly shiny and slightly sunken. That is why grafts are favored for the thinner-skinned sidewall and dorsum and used more selectively on the tip. Smoking is the single biggest modifiable threat to graft survival, and surgeons ask patients to stop before and after, a request worth taking seriously.

Local flaps: borrowing skin from next door

A flap is skin moved from one place to another while still connected to its own blood supply. Where a graft is a transplant hoping to be adopted, a flap arrives with its arteries and veins intact, which makes it more robust and lets it carry thicker, better-matched tissue.

On the nose, local flaps borrow skin from within a centimeter or two of the defect. The bilobed flap, a two-lobed pinwheel of sidewall skin rotated into a tip or alar defect, is a workhorse for small wounds in thick skin. The nasolabial (or melolabial) flap draws on the loose skin of the cheek beside the nose and is often used for the ala, with the scar tucked into the smile line. The dorsal nasal flap slides skin down from the bridge to cover the tip. Each has a geometry the surgeon plans on the skin with a marker before the first incision.

The advantages are real: same-day completion, matching color and thickness, and healing that follows the timeline of an ordinary stitched wound rather than a graft. The costs are also real. Every flap creates additional incisions, so a small wound becomes a longer, curved scar. Flaps swell, and some develop “pincushioning,” a rounded bulge as scar tissue under the flap contracts. On the ala, pulling too hard on a flap can lift or notch the nostril rim.

Surgeons manage these risks by placing incisions along subunit borders and by choosing flap size and direction to keep tension away from the free edges of the nose. Minor revisions, such as thinning a bulky flap or smoothing an edge, are sometimes planned from the start rather than being a sign of failure.

Forehead flap nasal reconstruction: why some repairs take two stages

When a defect is large, deep or takes in most of the tip or ala, local skin runs out. The forehead flap, sometimes called the paramedian forehead flap, is the traditional answer and has been for centuries because forehead skin matches nasal skin in color and thickness better than anything else on the body.

In the first stage, the surgeon designs a strip of forehead skin using the template made from the defect, lifts it on a stalk (the pedicle) that stays attached near the inner eyebrow, and swings it down to cover the nose. The pedicle carries a named artery, so the flap stays alive while it settles into its new home. The forehead donor site is stitched closed in a vertical line; if the strip was wide, part of it may be left to heal on its own.

For the next few weeks, the patient lives with a bridge of tissue running from brow to nose. It looks strange, and honesty about that helps: it is temporary, it is visible, and it needs daily care, usually gentle cleaning and ointment as directed. Glasses often cannot sit normally during this time.

The second stage happens once the nose has grown its own blood vessels into the flap, a judgment the surgeon makes rather than a fixed date. The pedicle is divided, the flap edges are trimmed and inset, and the brow is repaired. Some surgeons add an intermediate stage to thin the flap and sculpt cartilage underneath, making it a three-operation plan.

A forehead flap sounds daunting, and it is more demanding than a graft, but for the right defect it produces a nose that moves, breathes and matches, at the price of a forehead scar that usually fades into a faint line.

Rebuilding lining and cartilage support, not just the skin

The most common mistake in thinking about nasal repair is imagining it as a skin problem. The nose is a three-layer structure, and skin placed over a hole with no framework beneath will collapse inward as scar tissue contracts, narrowing the airway and warping the outline.

Cartilage support is the middle layer. When the tumor removal has taken cartilage from the ala or tip, or when a flap is being placed over a soft area that needs stiffening, surgeons harvest a small piece of cartilage and shape it to fit. The septum inside the nose and the bowl of the ear are the usual sources; both leave scars that are essentially invisible, and neither changes the ear’s shape when done correctly. For very large reconstructions, rib cartilage may be considered. A cartilage strip placed along the nostril rim, often called an alar batten, is a common addition even for skin-only defects near the rim, because it keeps the edge from notching as it heals.

Lining is the inner layer, the moist mucosa of the nostril. In a full-thickness defect it has to be replaced first, since cartilage grafts survive only when they are wrapped in living tissue on both sides. Options include folding the end of a forehead flap inward to line the nostril, turning in a hinge of skin from the edge of the defect, or borrowing mucosa from the septum on a small flap. These are technical choices the surgeon makes based on size and blood supply, and they are one reason a full-thickness repair takes longer and carries more risk than a superficial one.

Patients rarely see any of this work; it lives beneath the surface. Yet it is the layer that determines whether the repaired nostril stays open, whether the tip holds its shape, and whether the result still looks right years later.

Who has reconstruction right away, and who is usually asked to wait?

Timing depends first on certainty about the margins. Because Mohs surgery confirms clear margins under the microscope on the day, reconstruction can often follow immediately or within a day or two, with the dermatologic surgeon closing simpler wounds and a facial plastic or reconstructive surgeon taking on complex ones. When a tumor is removed by standard excision instead, the tissue goes to a pathology lab and results take longer; surgeons may place a temporary dressing or a simple closure and wait for the report before committing to a flap.

Several situations commonly lead a team to advise waiting. If the pathology raises the possibility of a more aggressive tumor, such as a poorly differentiated squamous cell carcinoma or a melanoma, further treatment or wider excision may be needed first, and a flap should not be moved over an area that might have to be re-opened. If radiation therapy is planned, the sequence is coordinated so that grafts and flaps are not placed into freshly irradiated tissue.

Personal health plays a part. Surgeons often ask people who smoke to stop for a period before and after a graft or flap, because nicotine constricts the small vessels the repair depends on. Blood-thinning medicines are managed by the prescribing clinician, who weighs bleeding against clot risk; patients should never stop these on their own. Uncontrolled diabetes or active infection may also prompt a delay.

Finally, some people choose to wait or to choose a simpler rung. An older adult with a shallow sidewall wound may prefer to let it heal on its own rather than undergo a forehead flap, and that is a legitimate choice when the team agrees it is safe. The right plan matches the defect, the person and their priorities, and it is made together.

What the first days and weeks usually look like

The first night is mostly about position and patience. Sleeping with the head raised on extra pillows limits swelling; bending, lifting and straining are discouraged because they raise pressure in the small vessels of the face and can start bleeding. A little oozing onto the dressing is expected; firm, steady pressure with a clean gauze for several minutes stops most of it, and the team gives written instructions for anything more.

Bruising around the eyes and cheek is common even when the wound is on the tip, because blood tracks downhill under loose facial skin. The repaired area will be swollen, tight and often numb. Numbness can persist for months as small skin nerves regrow; it is not a sign of damage.

Dressings differ by repair. A graft keeps its bolster until the first follow-up, and the wound should stay dry until the team says otherwise. Flaps and direct closures usually involve a thin layer of ointment and a light dressing, with gentle cleansing once permitted. Stitch removal on the face is typically scheduled within the first week or two; the exact day is the surgeon’s call, based on tension and healing.

Glasses deserve their own note. Frames resting on a fresh graft or flap can press on tissue that has almost no blood supply yet. Many people tape the frames to the forehead, use a lightweight pair, or go without for a while.

By a few weeks, Cleveland Clinic’s general timeline for grafts and stitched wounds applies: the surface has closed, though the scar is still red, firm and raised. From there the work is sun protection. New scars darken permanently if they burn, and the same UV exposure that started the problem raises the risk of another. The CDC’s basic advice, shade, a brimmed hat and broad-spectrum sunscreen, matters more on a healing nose than almost anywhere else.

Risks and complications, in plain language

Any surgery on the face carries risks, and honest counseling names them without inflating them. Bleeding is the most common early problem, usually minor and controlled with pressure, occasionally needing a return visit. Infection is uncommon in the well-supplied skin of the face but can occur, showing as spreading redness, warmth, increasing pain and pus.

The complication specific to grafts and flaps is failure of blood supply. A graft that does not take turns black and hard and eventually separates, leaving a wound that must heal on its own or be re-grafted. A flap in trouble looks pale or, more often, dark purple and congested at its far end; partial loss of the tip of a flap is more common than total loss. Cleveland Clinic lists smoking, diabetes, poor circulation and infection among the factors that raise the chance of graft failure, and the same logic applies to flaps.

Later problems are about shape and function. The nostril rim can retract upward or develop a notch. The airway can narrow if lining or cartilage support was insufficient or if scar contracted. Flaps can bulge (pincushioning), grafts can sink or stay lighter than surrounding skin, and scars can thicken, especially in people prone to raised scars. Asymmetry between the two sides of the nose is common to some degree and noticeable to the patient more than to others.

Revision surgery, small procedures to thin, smooth or reposition tissue, is a normal part of complex nasal reconstruction rather than an admission of failure, and surgeons often mention it up front.

Finally, the cancer itself. Even after clear margins, skin cancer can recur at the same site or appear elsewhere; MedlinePlus notes that people who have had one basal cell carcinoma are at higher risk of another. Lifelong skin checks with a clinician are part of the plan.

What people often get wrong about nasal reconstruction

“They will just take the spot off.” The visible lesion is the tip of the iceberg. Mohs frequently reveals tumor extending well beyond the edge you could see, and the defect is planned around what the microscope finds, not what the mirror showed.

“A graft will look like normal skin in a week.” It will not. Grafts pass through pale, purple and crusted phases before settling, and blending of color and texture continues for many months. Judging the result early leads to needless worry.

“Reconstruction is cosmetic surgery.” Restoring the shape and airway of a nose after cancer removal is reconstructive surgery, a distinction that matters medically and, in many systems, administratively. Function comes first; appearance follows from restoring the right structure.

“One operation fixes everything.” Forehead flaps are staged by design, and planned revisions are common in complex cases. Knowing this beforehand turns a second visit to the operating room from a disappointment into an expected step.

“Photos of other people’s results show what mine will look like.” Before-and-after images show one person’s defect, skin and healing. They cannot predict yours, and no reputable surgeon presents them as a promise.

“Letting it heal on its own is giving up.” For small, shallow wounds in the right locations, healing by secondary intention gives results comparable to surgery with fewer scars, and surgeons choose it deliberately.

“Older people should not have flaps.” Age alone is not a barrier; overall health, circulation and the person’s goals determine the plan.

“A visible scar means something went wrong.” Every incision leaves a scar. The aim is to place scars where the face already has lines and shadows so that, in time, the eye slides past them.

Questions to ask your care team, including the insurance question

A short list, written down before the appointment, tends to get better answers than a rush of questions in the chair. These are the ones experienced patients wish they had asked.

• What layers of my nose are missing: skin only, cartilage, or lining as well?
• Which repair are you recommending, and what made you choose it over the next simpler option?
• Where will the graft or flap come from, and what will that donor site look like afterward?
• Is this a one-stage or multi-stage plan, and roughly how far apart are the stages?
• What will the area look like at one week, one month and later, so I know what is normal?
• How should I handle my glasses, sleeping and washing my face?
• Which of my regular medicines need attention before surgery, and who decides that?
• What signs should make me call you, and how do I reach someone after hours?
• How often will my skin be checked for new cancers, and by whom?

Then the question almost everyone types into a search engine and few ask out loud: will insurance, including Medicare, pay for plastic surgery after skin cancer removal? The reliable answer is procedural rather than numerical. Repair of a wound created by cancer removal is generally classified as reconstructive rather than cosmetic surgery, and most health plans treat those categories differently. Coverage rules, prior authorization requirements and what counts as medically necessary vary by plan, by region and sometimes by the specific procedure code. The people who can answer for your situation are your plan’s member services line and the hospital or practice’s financial counselor, ideally before the reconstructive stage is scheduled. Ask them directly, ask for the answer in writing, and bring any letter of medical necessity your surgeon offers.

When to call your doctor

Healing noses look worse before they look better, and the team expects a certain amount of swelling, bruising and crusting. Some signs, though, need a same-day call, and a few need urgent care.

Call the surgical team promptly if bleeding soaks through the dressing and does not stop after fifteen minutes of firm, continuous pressure; if the graft turns black or the far end of a flap becomes dark purple, cold or pale and stays that way; if redness spreads outward from the wound, the area becomes hot or increasingly painful after the first day or two, or thick yellow or green drainage appears; if you develop a fever; if the wound edges pull apart or stitches come out early; or if the pedicle of a forehead flap is kinked, twisted or bleeding.

Seek urgent or emergency care if bleeding is heavy and uncontrolled, if you have difficulty breathing that is not explained by expected nasal swelling, if you develop facial swelling spreading toward the eye with vision changes, or if you feel faint, confused or unwell in a way that worries you. Chest pain, sudden shortness of breath or a swollen, painful calf in the weeks after any operation should also be treated as emergencies.

After the wound has healed, call for a routine appointment if you notice a new pearly bump, a sore that bleeds and does not heal, a scaly patch, or a change in the scar such as a firm lump or a new ulcer. These can be scar irregularities, but they are also how recurrent or new skin cancers present, and only an examination, sometimes with a small biopsy, can tell the difference. Your treating team knows your repair and your history; when in doubt, they are the people to contact.

Frequently asked questions

How serious is skin cancer on your nose?

It depends on the type and depth more than the location itself. Basal cell carcinoma, by far the most common type on the nose, rarely spreads elsewhere but continues to grow into skin and cartilage, so it needs complete removal. Squamous cell carcinoma carries a small risk of spreading and is treated more urgently. Melanoma on the nose is uncommon but managed differently. Your treating team stages the cancer from the biopsy and examination and explains what it means for you.

How long does it take for a skin graft on the nose to heal?

Cleveland Clinic describes skin grafts as taking a few weeks to heal, with new blood vessels growing into the graft within roughly 36 hours and the bolster dressing typically staying on for about the first week. The surface then closes over the following weeks, while color and texture continue to blend for many months. Timelines vary with graft size, location and health factors such as smoking, so your surgeon’s estimate for your graft is the one to rely on.

Does Medicare pay for plastic surgery after skin cancer removal?

Repair of a wound created by removing skin cancer is generally considered reconstructive rather than cosmetic surgery, and health plans, including public programs, usually treat those categories differently. Exact coverage, prior authorization rules and definitions of medical necessity vary by plan, region and procedure. The dependable route is to ask your plan’s member services and the practice’s financial counselor before the reconstruction is scheduled, and to request the answer in writing along with any letter your surgeon provides.

How painful is Mohs surgery on the nose?

The procedure is done under local anesthetic, so the main discomfort is the initial numbing injection, which stings briefly. Removing tissue is painless once the area is numb, and the long part of the day is waiting for the lab. Afterward, most people describe soreness, tightness and a dull ache rather than sharp pain, usually manageable with what the surgical team recommends for your situation. Increasing pain after the first day or two is a reason to call.

Will my nose look normal again after nasal reconstruction?

The goal is a nose that breathes well and looks unremarkable at conversational distance, and skilled reconstruction often achieves that, but every repair leaves scars and some degree of asymmetry. Grafts may stay slightly lighter or flatter; flaps may need thinning. Results keep changing for months as scars soften and redness fades. No surgeon can promise a specific appearance, and before-and-after photos of other people do not predict your outcome. Ask your team what is realistic for your defect.

What is forehead flap nasal reconstruction, and why does it take two operations?

A forehead flap moves a strip of forehead skin down to the nose while keeping it attached by a stalk that carries its blood supply. Because the flap cannot survive on the nose alone at first, the stalk stays connected for several weeks while new vessels grow in from the surrounding nasal tissue. A second operation then divides the stalk, trims the flap and repairs the brow. Some plans include a middle stage to thin the flap and shape cartilage beneath it.

Can I wear glasses after nasal reconstruction?

Usually not on the repaired area during the early weeks, because frames press on tissue whose blood supply is still fragile. Patients often tape frames to the forehead, use a lightweight pair, rely on contact lenses if they already have them, or go without for a while. During a forehead flap, the stalk itself may block the frames. Your surgeon will tell you when it is safe to rest glasses on the nose again.

Why not just let the wound heal on its own?

For small, shallow wounds in concave areas such as the inner corner of the eye or the groove beside the nostril, healing by secondary intention is a deliberate and often excellent choice, with no extra scars. For larger or deeper wounds, especially on the tip or nostril rim, open healing tends to contract, pulling the rim upward, narrowing the airway and leaving a shiny, sunken patch. The surgeon weighs size, depth and location before recommending either path.

Who performs nasal reconstruction after skin cancer, a dermatologist or a plastic surgeon?

Both, depending on the wound. Dermatologic surgeons trained in Mohs surgery routinely close small and moderate defects with direct closure, grafts and local flaps on the same day. Larger, deeper or full-thickness defects, and staged forehead flap reconstructions, are commonly referred to facial plastic, plastic or otolaryngology (ear, nose and throat) surgeons. Many centers coordinate so the tumor removal and repair happen in sequence. Ask who will do your repair and what their usual approach is.

How soon after Mohs surgery is the nose reconstructed?

Often the same day or within a day or two, because Mohs confirms clear margins under the microscope before the patient leaves. When a tumor is removed by standard excision, surgeons may wait for the pathology report before committing to a flap, using a temporary dressing meanwhile. Reconstruction may be delayed further if the cancer proves more aggressive than expected, if radiation is planned, or if health factors such as smoking or uncontrolled diabetes need attention first.

References

• MedlinePlus: Basal cell skin cancer
• Cleveland Clinic: Skin graft
• NHS: Non-melanoma skin cancer, treatment
• CDC: About skin cancer

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.