Nose scar from previous mole removal - is excision a good option for me? (photos)

Question

I had a 1mm mole excision on my nose more than 6 months ago by a GP, dissolvable stitches were used which left an indent and hyperpigmentation. I am skin of colour and have been skeptical of laser treatment to treat scar. I had subcision done on my nose 9 weeks ago, which has helped lift the scar however my concern is the stitch marks. I have seen people have excision of scar on nose removed and I wonder if this is a good option for me?

Nelson Lee Novick, MD · Answer

Areas under dynamic or static tension, such as the nose, are very prone to the development of stretch scars and tram track stitch marks following excisions or revisions. Going forward, should the need ever arise again you would do well to explore Scalpel Sculpting, for removing moles, particularly in locations subject to motion or static tension. Subcision, however, was an excellent choice for elevating and smoothing the scar that did develop, and I have been personally using this simple and inexpensive technique for elevating and smoothing indented scars from all causes since 1995. Once the scar has been sufficiently elevated, as is the case here, professionally performed manual Dermastamp microneedling (no need for the expense and risks of the addition of RF to the microneedling), would be a very appropriate "polishing" step for smoothing the stitch tracks and blending the treated area better with the surrounding normal skin. You would be wise to make sure to consult with a board certified cosmetic dermatologist and best of luck.

Randal Haworth, MD, FACS · Answer

If you are concerned about the appearance of the stitch marks from your mole excision, you may want to consider a scar revision procedure. Scar revision is a surgical technique that can help to improve the appearance of a scar by removing the existing scar tissue and repositioning the skin in a way that creates a more aesthetically pleasing result.

The technique used for scar revision will depend on the location and severity of the scar, as well as other individual factors such as skin type and the extent of scarring. In some cases, excision of the scar may be the most appropriate option, particularly if the scar is deep or the surrounding tissue has been significantly affected.

However, it is important to keep in mind that any surgical procedure carries risks, and it is important to carefully consider the potential benefits and drawbacks of any treatment before making a decision. It is also important to seek the advice of a board-certified plastic surgeon who can evaluate your individual case and recommend the best course of action for you.

In addition to surgical options, there are also non-surgical treatments available for scar revision, including laser therapy and injectable fillers. These treatments may be particularly helpful for individuals with skin of color, as they can be tailored to the unique needs of darker skin tones. It is important to discuss all available treatment options with your surgeon to determine the best approach for your specific needs and concerns.

Best of luck !

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

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