How to Remove Nose Crater and Stain? (photo)

Question

I pierced my nose about 3 years ago and I've recently outgrown it. I took it out and I am left with a gray stain (which I believe may be Argyria) and a crater. It's embarrassing having both. While I know that the gray stain is irreversible, I would like to at least fade it or fill in the crater. What should I do?

Nelson Lee Novick, MD · Answer

I fully agree that photos are no substitute for an up close and personal examination and palpation of the scar to determine its stretchability, liftability, etc.

	In general terms, however, such a problem might be best approached by performing a punch-excision (following numbing with local anesthesia) of the center of the piercing and suturing it together with superfine stitches. A punch is a cookie cutter-like, extremely sharp surgical instrument. This, by itself may remove not only the scarred center, but some of the surrounding grayish discoloration. If necessary, a few weeks later, the area may be manually dermasanded or treated by medical microneedling to further improve its appearance. These procedures are quick, simple, and relatively inexpensive and involve little downtime,

	Alternatively, under local, the area may simply be lightly cauterized or electrodessicated, procedures which will promote a tighter closure, a smoother surface and improvement in the surface color, which usually is somewhat ivory-colored (a signficant improvement over dark gray). 

	An experienced dermasurgeon should be consulted when contemplating any of these procedures.

Raffy Karamanoukian, MD, FACS · Answer

This is a great question. I recently had exactly the same type of problem presented to me in my Santa Monica office.   The approach we took, with success, was percutaneous scar release followed by an appointment to a tattoo removal expert to remove the pigment from the metal piercing.

Darryl J. Blinski, MD · Answer

Best course is an IN PERSON consult with a Plastic Surgeon in your city to determine the best plan to follow. Good luck.

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