Indent After Punch Biopsy - Will It Fill In? (photo)

Question

I had a punch biopsy on the end of my nose 10 days ago to have a mole removed. Had stitches out after 7 days and healing ok but I am upset to see that the wound is quite indented. I'm getting married in a month and worried I'll look a mess on the day that every girl wants to look their best :-( The shadows the indent casts look awful. Is this likely to fill in as it heals? What can I do to help/speed healing? Have some silicone gel and sheet but not sure if I'm doing the right thing.

Nelson Lee Novick, MD · Answer

Post-surgical indentations following punch removals do tend to fill in with time, albeit slowly (taking up to six months sometimes to do so). However, in areas under tension, such as the tip of the nose, it is likely that a small divet may remain. For these reasons, I am not much of a fan of cutting and stitching for cosmetically removing moles.

	Although removing moles by any method from the face is likely to leave a small scar, scalpel sculpting, which involves no deep cutting or stitches has, in my experience, proven quite successful for achieving gratifying aesthetic results while leaving little, or often barely perceptible, scars.

	The technique, which I have been using for thirty years, involves "scultping the mole" off from the surrounding skin in a tangential fashion (i.e. not cutting deeply into the skin). Deep cutting will inevitably result in a scar, while superficial (horizontal) removal in this fashion largely avoids this. Elliptical and fusiform simply describe the resulting shape of a wound excision after cutting them out deeply and before the placement of the sutures.

	Following scalpel sculpting, the borders of the mole can then be smoothed and blended with the surrounding normal skin by "dermaplaning," a technique by which the edge of the scalpel is used to delicately abrade the skin. Properly done, the entire procedure, performed under local anesthesia, takes no more than three to five minutes.  In most cases, the procedure is done at the time of the consultation.

Raffy Karamanoukian, MD, FACS · Answer

Mole removal begins with a comprehensive examination and consultation to determine the likelihood of a mole being worrisome. Excisional and incisional biopsies are reserved for suspicious moles. But it’s good news that most moles are not problematic and are only cosmetic, thus leading to the option of scarless or non-surgical mole removal with lasers and RF and plasma. Our office specializes in non-surgical mole removal.

Best,
Dr. Raffy Karamanoukian
Realself 100 Surgeon

Best,
Dr. Raffy Karamanoukian
Realself 100 Surgeon

Stephen Salerno, MBBS, FRACS · Answer

Hello

	You will heal well on this area, however it will still have a dint in it and it will still be red in 4 weeks time.  You should continue to massage the area and tape it to minimise the scarring.  Can massage with some silicon based cream or vitamin e oli or cream. Remember it is not the product you place on the scar but more the physcial massage which aids the scar breakdown.

	Long term it will look good.

	Stephen Salerno

Philip Young, MD · Answer

Removing it with a punch biopsy is an okay way to remove it. But if there were some proper techniques done you can get some wound spreading. The biopsy really needs to be done with a wedge fashion.

Nawarah Alarfaj, MD · Answer

It's always better to delay such procedure when ur having major event in ur life ,I think the best is to avoid sun,apply sunscreen regularly and I suggest applying a get called contractubex twice a day to the scar Plus u can apply similar skin color foundation to camouflage the color change if it's still there by the wedding time ....and congratulations

Jay S. Gottlieb, DO · Answer

If this was a benign mole then you timing was not optimal. But let's deal with what you have now. If two weeks before the big day, I would inject a small amount of Restylane and have you buy Dermablend make-up. You will be a stunning bride!

Indent After Punch Biopsy - Will It Fill In? (photo)

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