Are there lasers that can help minimize the appearance of a hole from mole removal on the nose? (photo)

Question

I had a couple moles removed by a facial plastic surgeon in Boston. I did my research and thought I’d be in good hands. I was totally wrong. Now I have a large hole. He wants to cut it out and place stitches. Are there any lasers to improve the appearance of this hole ? He did erbium laser twice and it did not help.

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

Nelson Lee Novick, MD · Answer

First, let me say that I am really sorry that this has happened to you. But, unfortunately, as any of my regular readers would attest, none of what you describe is at all surprising. First, simple 'Scalpel Sculpting" for aesthetically removing moles is particularly effective even for perfectly flat ones from areas, such as the nose, that are subject to a great deal of static tension with very little chance of scarring (and since no  deep cutting or stitches are used) there is no chance for the subsequent development of stretch scar formation or tram track stitch marks. Moreover, my regular followers would also tell you that much of the marketing hype surrounding lasers is backed up by a real paucity of hard science to support their use. So no surprises at your disappointment there, as well. My concern about cutting the current scar out with the placement of stitches is as described above, i.e the subsequent development of an unsightly stretch scar and stitch tracks. Make sure to consult an experienced, board certified cosmetic dermatologist. Best of luck. And let this be a cautionary tale for other readers considering aesthetic mole removals to first check out minimally invasive "Scalpel Sculpting" before agreeing to surgical removal of moles, especially in areas subject to a good deal of muscular movement or static skin tension. It's also a lot less expensive than excisions.

Jeffrey H. Spiegel, MD · Answer

Depressions on the nasal skin are very challenging.  Even when you revise the scar, the depression can occur.  Often the only/best solution is a combination of skin stimulation techniques. These can include subcision, biostimulator fillers, and radiofrequency and/or standard microneedling.  It should get better over time, but can be very frustrating for you (and the doctor) in the interim.

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