Hello! Thank you for your question! Without an examination, it is difficult to say. Given the size and location of your defect, I would suggest that having a flap placed in the area would give you the best result. I fear that allowing this to heal by secondary intention, just to heal by itself, will cause significant retraction of your nostril. A flap will give a better appearance than a skin graft, which often appears as a "patch" appearance. Hope that this helps! Best wishes!
It could heal on its own but you will be left with a noticeable scar. A flap in this area -- island pedicle/cheek advancement -- is very easy to perform by any dermatologic surgeon and/or plastic surgeon. You will be happier if you do a reconstruction in my opinion. Best, Dr. Emer.
Well. I do a lot of these procedures. This one can go either way. It is in a pretty good place for a plastic surgeon to do a flap and it should look really good. If you have been happy with your plastic surgeon's results I would let that person look at it. Letting it heal on it's own is an option as well and that can also leave good results.
When you have a site like you do on your nose, often the best thing to do is allow it to heal by secondary intention. There is not a good way to do a graft there, there is not a good way to do a flap, and there is no give in the skin to close it with sutures in a linear manner. So having it heal by secondary intention is the most common thing done for this area. Keep the site clean, well gooped up with Vaseline and/or Polysporin, and keep all crusts and dry blood away from the area.
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