How Can The Dent In My Nose Be Fixed After Skin Cancer Removal?

Q: Dr. Eppley, I have one vertical scar on forehead and one atrophic scar (dent; ) on top of nose which has broken my profile line. Forehead scar from a cyst and nose scar from a biopsy caused by sunburn incident..which caused skin cancer. Can you fix the scars and how can my profile be fixed. I feel really bad that I no longer have a smooth profile line. Also, I avoid photos because my dent catches the light which emphasizes it. Lasers? Surgery? Cost? I am not interested in fillers but would prefer a permanent fix.

A: The nasal indentation is obviously caused by the excision of skin from the biopsy. While putting back skin would be the logical anatomic approach I don’t think an obvious patch of skin whose color does not match the surrounding skin would create a favorable aesthetic improvement. Thus the approach would be to build up the structure of the nose beneath it to push the indented area…much like any nasal profile depression. This requires a cartilage graft to do so, probably harvested from the septum or the ear. I don’t know how flexible the skin in the depressed area is but I will assume for now that is has enough stretch to be able to be pushed out. Whether that is best done from an intranasal approach or reopening the external scar line is yet to be determined.

The vertical scar in the forehead is in a good location and is not that wide but its white color and straight line make it more visible. I would do a irregular broken line scar revision on it to make it less visible.

Dr. Barry Eppley