Dermabrasion 6 Months After Nasal Flap Repair - Too Late?

Question

I had Mohs surgery to remove BCC 8 weeks ago, on the nasal ala. It was repaired with a rhomboid flap which is still elevated by the crease. Will this improve over time? Or would dermabrasion improve this, and can it be effective if done 6 months from the original mohs surgery date?

P. Daniel Ward, MD · Answer

Dermabrasion 6 months after repair is not too late!!!  The flap will improve with time, but dermabrasion may help improve more quickly.  You may also want to ask your surgeon about steroid injections.  Sometimes, however, neither dermabrasion nor steroids will help the swollen area and the only thing that will help is flap contouring, which will require an incision to "debulk" the flap.

Ron Shelton, MD · Answer

No it's not too late to do a dermabrasion IF it's warranted.  It appears from this frontal view that the flap is only slighlty elevated and your surgeon did a very good job, but of course we can't examine you.  If there is a slight elevation, which does increase because of "pincushioning" or if the flap stays the same, dermabrasion may not be indicated as it would thin out the good skin of the flap when in reality you wouldn't want the surface changed but the infrastructure of the flap.  If the edge of the flap, or the incision, is slightly depressed as a groove then dermabrasion can help improve, but not eliminate, the line.  There are other treatments including Fraxel laser than can help the incision scar.  The thickness or elevation of the flap can be addressed at times with injections and surgical revision to thin out the flap.  All treatments have risks so discuss them carefully with your surgeon.

Andrew Kaufman, MD · Answer

No, eight weeks is not too late. Generally, you want to dermabrade a wound that is young and still actively producing and modifying collagen, but not too young that the trauma of dermabrasion causes problems to the incision line. So most studies suggest the optimal time would be around 8-12 weeks after surgery. But the question is whether you need dermabrasion. Dermabrasion works best for softening the transition from scar to the surrounding skin. It's hard to tell from the photograph, but if the flap is elevated. A better option might be massage and intralesional steroids. Sometimes flaps like the rhombic flap may develop trapdoor scarring, which is basically scarring that is contracting beneath the flap and causing a bulge. This is especially a possibility over concave areas such as the alar crease. So go back to the doctor that did the reconstruction and see what your best option is.

Jeffrey Ellis, MD · Answer

After surgery, it is important to give a wound time to heal before you consider alternatives to improve it.  You may want to wait 6-9 months before a Dermabrasion to see how the wound settles.  Remember that after the surgery there is a certain degree of swelling and inflammation - and as wound heal they often contract.

	In addition, you may want to ask your doctor about cortisone injections to help soften the puffy area as this may be a potential treatment for a puffy flap.

Steven Hacker, MD · Answer

There are many alternatives to correct an unsightly scar resulting after Mohs surgery.

	Treatment options include dermabrasion, steroid injection, and surgical scar revision. Keep in mind that any attempt to correct an unsightly scar carries a risk of making said scar worse.

Dermabrasion 6 Months After Nasal Flap Repair - Too Late?

Answers (5)

Answer: Wounds need time to heal

Answer: Wounds need time to heal

Answer: Unsightly scar after Mohs surgery

Answer: Unsightly scar after Mohs surgery

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Everything you need to know about Mohs Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

Dermabrasion 6 Months After Nasal Flap Repair - Too Late?

Answers (5)

Answer: Wounds need time to heal

Answer: Wounds need time to heal

Answer: Unsightly scar after Mohs surgery

Answer: Unsightly scar after Mohs surgery

Browse related questions

Recommended reading

Everything you need to know about Mohs Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.