Will my nose ever look normal again 6 weeks after Mohs? (Photos)

Question

Mohs surgery and flap was done on one side of nose. This is 6 weeks out and though it's a lot better my main concern is the flatness and unevenness of the nostril.

Raffy Karamanoukian, MD, FACS · Answer

Moh’s surgery on the face often requires surgical repair and reconstruction to reapproximate the skin edges. Flaps or direct closure techniques are used. It is important that you optimize scar healing during this phase in order to reduce longterm scars. For red scars, we use Vbeam laser, followed by fractional laser for scar topography and contour. We recommend Plato’s Scar Serum twice daily for the immediate postoperative period. Fractional laser is safe for scar laser therapy. 
There are treatments for swelling and edema of the scars. If there is residual sutures or edema, we advise you to follow a scar treatment protocol that can minimize the time to recovery. Our office specializes in scar revisions for Moh’s surgery. 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Amy Y. Paul, DO, FAAD · Answer

So far your nose looks great in the photos.  It is too early to tell what the final outcome will be, but most Mohs surgeons that are fellowship trained do fantastic work and I have many patients that I can't even see the Mohs scars on.  I would recommend you keep your follow up appointments with your surgeon and discuss your concerns with him or her.  They will be the most familiar with your case and can recommend techniques to minimize scarring.  Best of luck!

John Louis Ratz, MD · Answer

Without seeing what your nose looked like before or the defect created by the surgery, I would say this looks like an excellent result. Healing won't be complete until approximately 6 months after the surgery and mother nature will be doing some remodeling in the meantime. It is sometimes difficult to impossible to fully restore appearance on the outside and function on the inside. Because, as a patient, you and the surgeon can easily see the outside, restoration is done to primarily make the nose appear normal at the cost of disturbed function inside, such as difficulty breathing. You, like most people, probably never noticed that your nostrils were not symmetric before the surgery, but every patient notices the asymmetry after. While you still may have functional problems moving forward, don't forget that skin cancer replaced normal tissue on your nose, and your doctor appears to have done a great job in concealing that fact from the casual observer. Best of luck to you.                    jlr

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