Should a nose flap after Mohs surgery look fairly normal after 7 weeks? (Photo)

Question

I had a basal cell taken from the right tip of my nose and the dermatological surgeon who performed it did a local flap taken from the nose itself. Its been 7 weeks and the end of my nose appears to have a foldover effect where the flat is not really joined with the rest of the nose correctly in my opinion. Should I have a plastic surgeon look at it?

Larry S. Nichter, MD, MS, FACS · Answer

This is a normal appearance at this stage and is secondary to contraction along the edges and edema - both expected at this period. With time this will diminish. Occasionally laser and/or steroid injections may be helpful.

Mary Alice Mina, MD · Answer

You appear to be healing well, however the flap is a little thick with some pin cushioning. This can be fixed easily with a steroid injection or dermabrasion. I would follow up with whomever did your Mohs surgery/reconstruction to show them and possible treatment.

Robert Paul, MD · Answer

This is a typical appearance of a flap on the nose.  The skin on the nose is very thin and when other tissues are moved into the area there often discrepancies in the thickness, skin type, etc.  This is what we call "pin cushioning"  as it has the appearance of pin cushion.  You are early on in the reconstructive healing process and the area will continue to remodel overtime.  The remodeling process continues for up to about a year.  You can approve the appearance but rubbing the area several times a day with enough pressure just to feel it.  This will soften it a little.  However, the often times revisions are needed to help these appearances.  Things like flap thinning and or laser resurfacing/dermabrasion can provide the final contouring needed to give you the best result.  These procedures can be performed at anytime and are only needed if you wish to continue sculpting the flap otherwise you appear to be healed from the surgery do not require any further procedures if you choose.  Good luck and I hope this helps with your care.

Brandon L. Miner, DO · Answer

I do a lot of these flaps and it takes time.   The first 3 months the transferred tissue will always be bulky.  It will take a full year for the scar to mature.   Don't push for any alteration until after that time frame.

Should a nose flap after Mohs surgery look fairly normal after 7 weeks? (Photo)

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