What Happens to Mohs Surgery Scar when Healed by Itself?

It's amazing how well the skin can heal on its own (called healing by secondary intent).  It may possibly be depressed after healing or heal over too much (become a raised bump).  If it heals too much, that can easily be repaired.  A depression is more difficult to repair but can be done possibly be dermal implant or filler.  If you're not happy with how it looks you can always opt to have more surgery later.

Secondary intention healing is an excellent choice for certain defects that result after a Mohs surgery. Generally speaking concave areas of the face, ideally, perialar areas (around the nostrils) that are concave, heal excellent by secondary intention.

Although I agree with other posts which state that healing by secondary intention of a Moh's defect is sometimes appropriate, it is generally in the minority of situations. The reason for this is that nasal skin is thicker and more sebaceous than other area of the face. In addition, it is supported by relatively flexible underlying cartilaginous structures. Healing via secondary intention on the nose relies on wound contraction which can lead to distortion of varies nasal subunits, and a... more

The wound (defect) created after Mohs surgery will need some sort of approach to yield the best result. This can involve primary stitching or more involved movement of neighboring skin (flap) or skin from another site (graft). In some cases the final result from allowing a wound to heal on its own is comparable (or even better) than a surgical reconstruction. This is primarily dependent on the size of the wound and the location on the face. An experienced Mohs surgeon or plastic surgeon... more

If the Mohs surgery location on your nose is in the concave part on the side just above your nostril, this is an excellent location for healing by itself (also known as healing by secondary intention, or granulation). Your Mohs surgeon or plastic surgeon should evaluate whether letting the wound heal this way might cause collapse of the nostril when you try to breathe in through your nose. If there is no risk of collapse, and you don't feel like more surgery, I think allowing it to... more

You seemed to have answered your own question. If you feel you are too old for a nasal flap or worried about the skin grafts appearance, than by all means allow the wound to heal by secondary intention. Than you can decide if the appearance of the scar is acceptable to you. If you are not happy you can always have surgery. Regards from Miami

 Moh's excisions were originally intended to heal by the wound shrinking and scarring over (secondary intention).  Sometimes this works well and in some areas it draws the tissues together into a distortion of the facial features.

Healing by secondary intention may be appropriate for concave areas such as the temple, or the inside aspect of a ear (such as the scaphoid area of the ear). However, unless the defect is quite small, it may not offer the best cosmetic outcome on the nose as there will be some contraction leading to a likely depressed scar and some subtle or not so subtle distortion of the nasal contour, e.g. asymmetric flare of nostrils. Flap repair such as bilobed or rotational flap repair may be more... more

Some parts of the nose heal well without surgery of any kind (healing by secondary intention). Others heal poorly since the scarring process pulls and distorts the adjacent tissues. We often recommend the simplest procedure that would do the job and this is especially true in older patients in whom we are concerned of the risk of surgery or injections of epinephrine (adrenaline) commonly used to reduce bleeding and prolong the effect of anesthesia. A skin graft WILL look like a patch the... more

Skin cancer surgical defects in certain locations on the nose can heal with a nice cosmetic result. These locations include smaller defects of the tip of the nose, the ala or "wing" of the nose and in some cases, the nasal sidewall. If a reconstruction is required, I usually will elect to go with a flap rather than a graft, to achieve better skin matching. Although it can take up to several weeks to heal in, a wound that is left to heal by "secondary intention" often looks better than you... more