Which is a Better for Cosmetic Purposes for a 2mm Mole on Nose, Dermal Punch or Cutting with Knife?

We are asking this question because we have had 2 consultations with 2 different doctors. One of them prefers punching it since it is small and the other wants to cut elliptically. We are aware we can not avoid the scar and we would want to know which scars less.

Doctor Answers 9

Best Cosmetic Result for Mole Removal: Dermal Punch or Direct Excision

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You might be somewhat confused with all of the available techniques offered for mole removal. If your objective is 1. less scarring 2. faster healing 3. No disfigurement of tissue after lesion removed then I suggest the following: 1. Avoid the dermal punch or direct excision methods 2. Utilize the microscopic shave excision method.  I abandoned the direct excision method (except for questionable moles) 15 yrs ago and never looked back.  Have done approximately 6,000 radiofrequency shave removals and my patients love the results.  Choose wisely

Eau Claire Plastic Surgeon
4.7 out of 5 stars 21 reviews

Mole removal and biopsy of the nose

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There are many variables to answer this question.  I perform a lot of mole removal biopsies and would differentiate the nose moles between raised and non-raised moles, epidermal or dermal, and whether it is located on the concave or convex surface of the nose.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Mole removal

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Depending on whether the mole is raised or not a shave excision or a dermal punch can be done.  Without seeing a photo of the mole, it is difficult to really assess.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

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Removing a mole on the nose: shaving flat vs. excising with stitches.

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Mole removals can be done in a few ways. Most plastic surgeons do like to excise the mole, which means to cut it out with the deeper root, whether with a dermal punch (small cookie cutter) or a scalpel. Either way, the scar could end up very similar since both need stitches and if the dermal punch hole bunches up when stitched, a good surgeon will remove the "dog ears" of extra skin standing up and you end up with a line anyway.


Another option to strongly consider, since it doesn't actually prevent you from later going to have a full excision, is to shave the mole flat, along the contour of your nose, and just leave it at that. Sometimes the shape of the nose stays more natural that way and you haven't lost anything in terms of future options. One caution is that the center of a mole sometimes has brown pigment cells hiding, and shaving through the center of it can occasionally reveal those brown cells, giving you a flat freckle in the spot.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

Best way to remove a facial mole

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Realize that removal of a mole on the face will leave a scar no matter what technique is used.  It isn't whether it is a plastic surgeon or a dermatogist  doing the procedure it is what will give you the best long term appearance and how can the scar be minimized or hidden.   If a mole is protruding, often a simple shave results in the best cosmesis.  If the mole is deeper and a true excision and suture become necessary, the trick here is to orient and hide the scar so that it is hidden in a shadow or line on the face. 

Steven Swengel, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

Mole removal requires surgical skill

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There is no best way to remove a mole from the nose or face.  This being said, there are ways that are better than others depending on the location and size of the mole.  The best way to increase your chances to get the best possible results is to have a doctor that understands plastic surgery techniques. A board certified plastic surgeon is a physician that should be able to choose the right treatment and would have the surgical skills to apply it your unique mole.

Dev Wali, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 58 reviews

Best method for removing a small mole on the nose

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It is usually not the procedure but the skill of the doctor that will determine the final result. Punch biopsies, elliptical excisions, and shave removals can all work well to remove a mole with the least amount of scarring, depending upon its size and location. The doctor doing the procedure will know what works best based on their experience. Dermatologic surgeons typically do all of these procedures expertly and can decide which would be best for your particular mole.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Cosmetic mole removal

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I am a cosmetic dermatologist and perform all of my traditional dermatology services under the same cosmetic philosophy - minimizing as much scarring as possible. I don't use punch biopsies - they take out too much skin (you have to go wider than the lesion) and remove unnecessary amounts of tissue (they are predetermined to a certain depth). Removing with a blade allows me to get exactly off what I need to, and nothing more, thereby minimizing scarring and divets. Also, please follow post-care as that's very important too!

Cosmetic mole removal

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90% of the time we can shave remove moles and the the result is improved cosmetic appearance. Reserving excisions with sutures as a last resort makes the most sense for most moles. Excisions can have great results for certain but are more invasive than shave removals. Also be sure your dermatologist looks at the mole first to be sure it is not a skin cancer or other lesion that needs to be biopsied. If there is any question,  would recommend you have your mole sent to a lab for evaluation as there can be subtle clinical differences between some skin cancers and moles.

Shawn Allen, MD
Boulder Dermatologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.