What Can Be Done for Mohs Surgery Lumps?

What you have is either a hypertrophic scar as a reaction to buried sutures or the so-called 'dog ear' or standing-cone deformity after reconstructive repair after Mohs micrographic surgery. The easiest solution would be to inject very dilute amount of cortisone to the affected area. Scar massage using your pinky finger should be done 10x every 8 hours and the affected area should flatten in the next several weeks. Simple surgical scar revision can be performed as a last resort.

First of all, it really depends on what is the etiology of the "lumps." Frequently dog ears can resolve within months of surgery in some areas, such as the scalp, forehead, and trunk. Second, I would get a second opinion from another surgeon as the cause of these lumps and what can be done. Depending on the cause, the problem can likely be treated with injections at the surgery site or possibly another surgical procedure. I would recommend that you see a fellowship trained (through the American College of Mohs Surgery or ACMS) Mohs surgeon or a plastic surgeon/facial plastic surgeon who does a lot of reconstructive surgery in their practice.

The lumps after Mohs surgery have several treatment options

1. massage to soften them - this will take some time - 6 months to a year 

2. Steroid injection to soften them - this may or may not work well

3. Scar revision - a procedure to minimize the lumps

Remember that you had cancer on your nose and this was being done to rid your face of it. The most important thing is that the cancer is gone. Mohs is done to maximize the cosmetic outcome but it is not guarantee that you will "look like nothing was done". It may take additional procedures to get you cosmetically back to normal. It is important to realize that these are cosmetic concerns which your insurance company may not cover. 

Reconstruction after surgical removal of a cancer may at times result in an undesirable result. If you have an unsightly scar I would suggest you seek the opinion of a plastic surgeon to see if revising the scar would improve it's appearance. Be patient though , time is often the best solution and scars tend to minimize with time.

First of all, be sure that you are dealing with a Fellowship-trained Mohs surgeon as the Fellowship emphasizes and requires expertise in cosmetic reconstruction. If they are Fellowship-trained, you can go to www.Mohscollege.org and look up your state and find your physician will be there.
Aside from that, lumps after surgery such as dog ears are easily repaired with a small surgical excision. For deeper scar tissue lumps, an injection of Kenalog can often hasten the resolution of these lumps. Your first step is to report your concerns to your surgeon and they should be able to handle this problem (if they cannot, check the credentials of your Mohs surgeon at the website above). The next step would be to seek out a facial plastic surgeon or a general plastic surgeon, or another Fellowship trained Mohs surgeon.