The biopsy is a diagnostic procedure, and not a treatment for skin cancer. While some pathologists will comment on the type of basal cell seen, regardless of the type, further treatment with Mohs surgery is important to make sure that the deep and peripheral margins are clear of tumor. While it may seem like the site is healing well and the cancer is gone, it is impossible to know for sure without further work. Fortunately Mohs surgery can evaluate the margins microscopically, give you the highest cure rate and smallest scar possible.
You appear to be healing well, however the flap is a little thick with some pin cushioning. This can be fixed easily with a steroid injection or dermabrasion. I would follow up with whomever did your Mohs surgery/reconstruction to show them and possible treatment.
I tell my patients that anytime we cut the skin, it will leave a scar. Whether that scar is noticeable to most people will depend on the type of biopsy taken (shave vs punch biopsy) and how deep the biopsy needs to be. Lesions concerning for skin cancers such as melanoma will need to be deeper than other biopsies and may leave a more noticeable scar.
Skin flaps are very common on the nose given the relatively tight skin here, even with small defects. Looser skin on the cheek or in between the eyebrows/upper nose will often be used as a flap to close defects on the nose. While initially it may appear to be quite a long or funny looking scar, these flaps heal very well. A fellowship-trained Mohs surgeon or Plastic Surgeon will be very familiar with these common flaps, and this will likely yield a more favorable cosmetic result compared to leaving it open to heal.Best of luck.Dr. Mina
Wound healing after Mohs surgery can be quite variable depending on the location, size of the defect, and type of repair. Typically, my younger patients are anxious to return to their jobs the next day which is appropriate in most cases; however, I let them know that they will have a fair amount of swelling/bruising and will need to wear a bandage for at least a week. The majority of swelling does subside significantly within the first week after surgery. A pre-operative consult with your Mohs surgeon can give you a better idea of the type of recovery, scar and healing you can expect for your individual skin cancer and treatment.
