Mohs Skin Graft on my Nose Appears to Be Healing with a Significant Indentation/depression - Will It Improve? Doctor Answers, Tips
Mohs Surgery: Q&A
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Mohs Skin Graft on my Nose Appears to Be Healing with a Significant Indentation/depression - Will It Improve?

I had a full thickness skin graft measuring just over 1 cm wide on my nose one month ago after basal cell carcinoma removal. At first the graft appeared level with the surrounding skin but now I'm noticing a significant concaveness ( about 1 mm) in the graft site. The graft starts at the centerline of my nose and then down the right side. Is it likely to improve or level out any with time? If not, is there anything that can be done to lessen the indentation?

10 Doctor Answers | Asked by dljinok in Oklahoma
+2

Tincture of time and possibly laser can improve skin graft appearance

Full thickness skin grafts are a common method of repairing surgical defects after Mohs surgery. They definitely improve aeshetically with time, with most grafts continuing to mature for 6-24 months. However, at our center, we treat many of these grafts (and other surgical scars) with fractional resurfacing lasers. This greatly improves both the color and texture of the graft scar. Laser treatment can be initiated wihtin a month after the surgical procedure.
+2

Healing after skin grafts to the nose

Thanks for your question. Skin grafting is one of many options on the reconstructive ladder to fix defects of the nose. The best areas of the nose that heal with skin grafts are the areas with thin and less sebaceous skin. Sometimes, it is ideal to wait a 2-3 weeks for the wound to fill in from bottom up (by granulation) and then place a skin graft. This allows for better contour matches of the skin graft It is still very early to make a decision about the... more
+2

Indentation after skin graft on nose .

I agree that it is still too early in the overall healing of the graft. It is hard to say at this point whether or not the defect after the mohs surgery is deeper and still needs to fill in with the graft or whether the scar has contracted. Even if there is a portion of the graft that did not take, which is another possbility, it is best to leave the graft in place and undisturbed. Please speak with your surgeon regarding your options.

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+2

Mohs and skin graft on nose

It is still very early in your healing stages and can take 6-12 months for full results from the graft to show. I wouldn't worry at this point, nor would I try to do anything to resolve any concaveness. Some of it may fix itself, and if it is still concave after 6 months, options can be discussed at that point. Always if you have concerns, you should see the surgeon, and I'm sure you have follow-ups scheduled with him/her coming up. Never be afraid to ask questions and seek advice from the... more
+2

Depressed area to graft after skin cancer surgery #mohssurgery

I do several hundred closures a year for Mohs surgeons locally. I use grafts a lot and I also use flaps a lot. Only the surgeon can determine what is best for you. When I use a graft I will often allow the wound to heal from the bottom up for a few weeks then graft them. The problem with a graft right away is what you describe, but it is early and I have seen the tissue beneath the graft fill in with time. One month is very early so you need to give this 6-12 months. Keep communicating with... more
+2

Surgical scar healing

I agree with the other physicians who have said that you are still early in the healing process at one month. From your description, it sounds as if the graft has contracted, which is a normal part of healing. The other factor to consider is that a portion of the underside of the graft may not have survived and thus sunken down compared to the surrounding tissue. This is a limitation of skin grafts. I would discuss your concerns with your surgeon. There are... more
+2

Depressed Area to Graft after Skin Cancer Surgery

Generally, it takes 6-12 months to get the final cosmetic result after surgery so there may be some improvement with time. Grafts do well in some cases to reconstruct the surface; flaps may be preferred if the defect is deep because flaps reconstruct depth as well as surface. Your best option is to discuss your concern with the doctor who performed the repair. Sometimes scarabrasion (a.k.a dermabrasion) may improve the final appearance and make the surfaces more level. Good luck. more
+2

Mohs and Skin Graft Healing

Hi, one month is still fairly soon after the procedure. I would recommend following up with your Mohs surgeon in a few months to check in on how the healing is going. There are plenty if ways to improve the appearance of the graft down the line.
+1

STILL AMAZED byVillar

A thick split thickness skin-graft contracts better than a full thickness skin graft. The graft is sutured with a running suture biting the deep skin edge to hold the graft down on the bottom of the wound. A small puncture is made in the graft to allow drainage. The graft is now in a deep hole. A cotton ball the size of the hole is soaked in clindamycin/gentamycin solution and pushed into the hole over a small patch of xeroform gauze to keep the graft down. The... more
+1

There are often better choices for nasal Mohs surgery repair than skin grafts

Skin grafts are a good option for repairing skin removed due to cancer on the nose. In general, however, they are not the best match possible for color, texture, pore size, and tissue thickness. In almost every case, local flap repair of the nose yields a better result. Since you have already had the skin graft, continue to follow your doctor's advice and see how the final result is at 9-12 months. If you are still not satisfied, consult with a facial plastic surgeon very experienced... more
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