Why Wont Plastic Surgeon or Dermatologist Remove the Mole on the Tip of my Nose? (photo)

Frequently on the tip of the nose a mole can be removed by full thickness excision and leaving the wound open to heal by itself.  It seams unlikely but frequently scarring on the tip of the nose is better when the wound is left open to heal on its own than when it is sutured.  This is a well documented method of treatment and I have used it frequently to treat skin cancers as well as cosmetic mole removal.  Shaving the lesion will simple leave a scar the size of the mole removed.  Complete excision will likely leave a smaller scar than the mole that was removed because the wound will shrink during the healing process and likely leave a inconspicuous scar.  It is always good to consult with a specialist that has experience with this method of treatment, understands your skin type as well as knows what to do if you are unhappy with the scarring.

I would highly recommend that you see a board certified facial plastic surgeon for your concern.  Typically in this area, it may be better to do what is called a shave excision.  I would also recommend that the lesion be sent to pathology as well. 

Dark bumpy moles are usually excised but since yours is on the tip of the nose, it probably will look better by punch grafting skin into where the mole was and then dermabrading it initially and again 3 months later. Another option would be to shave the dark bump flat and either use liquid nitrogen or electrofulguration to lighten up the base once or twice. Sincerely,

David Hansen,MD

There are generally two options for removal: tangential excision and excision with closure. Either method can cause scarring. Anything that you do to the skin to remove it can potentially leave scarring. I think that your best option is to talk to an experience dermatologic surgeon or plastic surgeon about your options for removing it. Since the doctors don't feel that the lesion is malignant, it is being removed for cosmetic purposes. Apparently, they don't want to create a problem that is more noticeable than your current mole, and that is something that you should remember. There is always a chance that you will be less satisfied with the final cosmetic result than the current mole on your nose. Unfortunately, that is one of the risks associated with removal on the mole. Talk to other doctors; let them examine the lesion and talk to you, and ask questions. Good luck.

Your mole should be removed by a shave excision. Dermatologic surgeons typically do this procedure expertly. A shave excision is a procedure where the mole is actually "shaved off" at a level just below the surface of the skin which should leave a minimal scar.

It is possible and easy to remove this mole. You may have a tiny mark there for a bit, but if you are happier with a skin colored mark, that would be just fine. I would suggest having it removed via a shave biopsy. Then I'd have you do a few Cutera Genesis to the site over the coming months to help alleviate redness and color differentiation. I'd suggest you try to find a local, more specialized dermatologist or dermatologic surgeon. Some dermatologists simply don't like to do as many removals, or are uncomfortable with the idea. Personally,  I am a cosmetic dermatologist with nearly 30 years of surgical removals, so this would be easy for me to do, but some dermatologists simply aren't as comfortable with cosmetic removals. Ask when you call around!