SHould this be allowed to heal alone?
Hello! Thank you for your question! Without an examination, it is difficult to say. Given the size and location of your defect, I would suggest that having a flap placed in the area would give you the best result. I fear that allowing this to heal by secondary intention, just to heal by itself, will cause significant retraction of your nostril. A flap will give a better appearance than a skin graft, which often appears as a "patch" appearance. Hope that this helps! Best wishes!
Defect After Mohs
It could heal on its own but you will be left with a noticeable scar. A flap in this area -- island pedicle/cheek advancement -- is very easy to perform by any dermatologic surgeon and/or plastic surgeon. You will be happier if you do a reconstruction in my opinion. Best, Dr. Emer.
Well. I do a lot of these procedures. This one can go either way. It is in a pretty good place for a plastic surgeon to do a flap and it should look really good. If you have been happy with your plastic surgeon's results I would let that person look at it. Letting it heal on it's own is an option as well and that can also leave good results.
Mohs healing by secondary intention
When you have a site like you do on your nose, often the best thing to do is allow it to heal by secondary intention. There is not a good way to do a graft there, there is not a good way to do a flap, and there is no give in the skin to close it with sutures in a linear manner. So having it heal by secondary intention is the most common thing done for this area. Keep the site clean, well gooped up with Vaseline and/or Polysporin, and keep all crusts and dry blood away from the area.
"This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."