Tight and Lopsided Skin Flap Reconstruction Results

I appreciate your concern and worry regarding the pulled appearance after Mohs surgery. You should rest assured that it is not uncommon for nearby anatomical structures (lips, nose, ear, eyes) to look a bit pulled after reconstruction. Such effects generally settle out within 90 days or so. If it is persisting beyond 90 days, you should return to your surgeon for a re-evaluation.

Asymmetry after reconstruction can be a temporary or permanent situation. When a flap is created it is basically borrowing tissue from one area to move it to another area that lacks adequate tissue (i.e. the surgical defect). It is very important that the person designing and executing this repair be an individual with training and experience in facial reconstruction. If the design and execution are performed correctly then the problem will likely improve over time (although perhaps not completely since again there is limited loose tissue from which to borrow on the nose). It takes 6-12 months to get the final cosmetic result following reconstructive surgery. Follow up with the plastic surgeon who performed the repair, and if you're not comfortable and satisfied with the care of that doctor, see another doctor, perhaps a fellowship-trained Mohs surgeon, for a second opinion.