Mohs Surgery: Q&A
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Mohs Surgery Scar on Nose
I had Mohs Surgery when I was 27 (8 years ago) to remove a large basal cell carcinoma from the tip of my nose. My scar runs along the length of my nose and is discolored, raised/depressed and my nose has a somewhat lopsided/chewed up appearance now. After surgery, I had one session of dermaplaning with some improvement to texture. What are the best scar treatment options for me and would I get better results from a plastic surgeon or laser surgeon? Thanks
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13 Doctor Answers |
Asked by
Chicago3869
in Chicago
+2
Mohs surgery basal cell carcinoma nose 27 year old
Before anyone discusses revision of a scar for cosmetic reasons, please note that your photograph preoperatively shows a whitish flat spot. This type of basal cell skin cancer is usually an infiltrative type of pattern of growth so it doesn't look clinically typical and may spread for a wide area. It grows with little strands in different directions underneath the epidermis. In your current photograph, there again, is a white area which may represent scar from some tissue...
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+2
Nasal scar
Thank you for the pictures. The scar can likely best be fixed/helped appear better by ablating the surface that is uneven to heal in smoother. This can be accomished by either, dermaplaning the scar down or using a laser to smoothe the scar down. An experienced derm surgeon would be able to do this for you.
+1
Scar Revision
I would agree with some of the other physicians that I would talk with your dermatologist before undergoing any scar revision to ensure that you do not have a recurrence of the skin cancer. If that is not a concern, I would suggest speaking with a facial plastic surgeon. Laser resurfacing can be useful but it may be that you need several kinds of lasers - one for texture and one for color. If you have significant texture irregularities, fillers or reexcision may be more appropriate....
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Scar following mohs
Fractional C02 resurfacing can help smooth the texture although it wont be as smooth as before surgery.
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Scar revision after Mohs micrographic surgery
While most scars after Mohs micrographic surgery is a worthwhile trade off in place of an insidious skin cancer such as basal cell carcinoma, it is reasonable to desire scar revision afterwards. Before resorting to additional surgical scar revision where the resulting scar may not be superior than the original scar, it may be helpful to undergo Fractional CO2 laser resurfacing as the texture of the scar can be improved and overall risk of getting another skin cancer in the area that...
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Options for scar improvement after skin cancer surgery
The options depend on what degree of improvement do you want and what amount of downtime or healing are you willing to tolerate. Topical silicone sheets or additional dermabrasion might improve the final cosmetic results, but that tends to work best in the first year after surgery. The second option would entail excision of the scar and scar revision. This should be addressed by a doctor with a significant amount of training in nasal reconstruction, either a fellowship-trained Mohs...
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Nasal scar revision options
As mentioned, the options include something simple like dermabrasion or something more formal like a scar revision (actually excising the old scar and more carefully re-approximating it).
Without examining you, it is hard to tell what those possibilities could be, but...if the scarring has caused the skin to be very tight, believe it or not, performing skin stretching exercises can loosen this and usually can make enough laxity to allow it to be revised with an improvement in the ap
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Demabrasion and/or CO2 laser best for nasal scars
Your scar is typical of a post Mohs scar on the nose of a male patient... while linear scars often heal best on the nose, they can sometimes have a "bumpy" quality due to the numerous oil glands that complicate nasal healing. I treat many scars such as yours and find that wire-brush dermabrasion would work best to re-contour and smooth the raised portion. After dermabrasion, I would consider fractional CO2 resurfacing to improve the scar even further if dermabrasion doesn't accomplish as much as
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Baton Rouge Dermatologist
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Mohs Scar
As said before, anytime that you have surgery, you are going to get a scar. I agree with Dr. Prendiville that dermabrasion would be a reasonable thing to try for this. It looks to me like there was a slight step-off deformity (i.e. the two sides did not align exactly after closure). I think dermabrasion could help that, but as said before, there is always the risk of making things worse.
Frisco Dermatologic Surgeon
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Nasal scar revision
There isn't any significant extra skin on your nose to use in a revision so just excising it will make it tighter and this isn't usually going to improve a scar. You don't look bad enough IMO to go to the nasal reconstruction flaps like a forehead flap but that is an option if you really hate the current state. Look these up for examples.
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Mohs Scar
Obviously, it is impossible to have a skin cancer removed without some form of scar. However, the scar is somewhat depressed and wide on you nasal tip and may benefit from scar revision followed by Dermabrasion. As was previously mentioned, any subsequent procedures always carry the risk of making the scar worse.
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Scar after Mohs surgery on the nose
At this point, eight years following surgery, your best bet is to get an opinion from a plastic surgeon. Keep in mind any time you pursue a scar revision you also risk making it worse.
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Mohs Surgery Scar on Nose
You appear to have some textural changes that are wider than the original incision which is by itself a reasonable scar.
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