Can You Have Revision Rhinoplasty After MOHS?

Question

I am a 26 year old female and I am 3 months post op rhinoplasty. I am so very disappointed with my results. I have already looked into revision options. My only concern is that now I have a spot on my nose that may be basil cell carcinoma. I have an appointment to get it biopsied in a week. My question is if I have to have MOHS surgery performed, how long do I have to wait to be able to get revision rhinoplasty?

Houtan Chaboki, MD · Answer

A complicated question that only a comprehensive evaluation be a rhinoplasty surgeon can answer. Hopefully, the biopsy is not skin cancer, but MOHS surgery is good option to treat skin cancer of the nose. Some dermatologists may close the open wound immediately after MOHS, while some dermatologists will refer to a plastic surgeon for wound closure. At that point, the plastic surgeon may consider a revision rhinoplasty at the same time as MOHS wound closure, if appropriate.

	Generally, most plastic surgeons do not recommend revision rhinoplasty for at least several months or a year from the first surgery. Speak with your plastic surgeon. Only after a comprehensive evaluation can he/she provide appropriate options for you.

	Best,

	Dr. Chaboki

Stephen Weber MD, FACS · Answer

Yes you can have revision rhinoplasty following Mohs excision. Depending upon the size of the defect you would need to wait 6-12 months. With that said, most Facial Plastic Surgeons will recommend waiting another 9 months (full year following rhinoplasty) before pursuing a revision procedure. This would also depend upon where the skin lesion is located and what portion of your nose you would like addressed with the rhinoplasty revision. If the lesion is on the nasal tip and you want the bridge lowered, you would have to wait a shorter period of time. The first step is to get your nasal lesion biopsied. If that is a basal cell carcinoma you'll want to pursue Mohs. An ignored skin cancer just gets bigger which will jeopardize more of your nasal skin. I hope this information is helpful.

	Stephen Weber MD, FACS

	Weber Facial Plastic Surgery

William Portuese, MD · Answer

To make sure full healing has taken place from the rhinoplasty and a Mohs micrographic surgery, it is probably best to wait at least a year for a electing to undergo revision rhinoplasty.

Shervin Naderi, MD, FACS · Answer

Hi

	Sorry to hear about your disappointment.  But more importantly sorry to hear you may have a skin cancer at such a young age!  Make sure you see a great MOHS surgeon.  That is much more important than the revision rhinoplasty.  With cancer removal, MOHS or traditional, you have to close the resultant hole.  You need skin.  So I would suggest seeing a Rhinoplasty Specialist and have him coordinate with your MOHS surgeon.  If the hole is small enough perhaps you can get a revision at the same time as closure because elevating the skin during a revision will free it up and allow better closure of the cancer defect.  But if the cancer defect is large enough then you should wait on any revision rhinoplasty at this point.

Samir Shureih, MD · Answer

You need to put revision rhinoplasty on the back burner for the time till you had taken care of the basal cell carcinoma on the nose. Once the basal cell carcinoma is removed either by Moh's chemosurgery or by Frozen section and the defect is reconstructed then one can tell you if the revision rhinoplasty is safe.

Jay M. Pensler, MD - Account Suspended · Answer

You can certainly have a revision rhinoplasty after Moh's surgery on your nose. The first thing to note is Moh's deals only with the excision of the malignancy. The area of the excision will need to be closed after the tumor resection or allowed to heal by secondary intention. The extent of the resection and the type of closure will determine the timeline for recovery and potential revision of your rhinoplasty.

David Alessi, MD - Account Suspended · Answer

It depends on where the possible cancer is located. First, get a biopsy to confirm the diagnosis. Second, get the MOHs if it is indeed cancer. If it is basal cell, the rhinoplasty may even be done at the same time as the post MOHs reconstruction if the defect is in a very favorable area. If the defect is not in a favorable area, then you will have to wait probably 6 months. If the lesion is squamous cell, I would wait a year after the MOHs to do anything. Best wishes

Can You Have Revision Rhinoplasty After MOHS?

Answers (7)

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