Q: Dr. Eppley, four months ago I had two moles removed on my cheeks. The plastic surgeon removed them by circular excision to achieve a short scar. She didn’t mention the dreaded dog ear deformities that I have now been left with. I now have four white hardish protuding lumps at either end of where my moles were. So I have no moles but four lumps instead. Was this a bad method of mole removal? The plastic surgeon is still hoping that they will flatten in time but my cheeks are quite fat and I am seeing no improvement or flattening out so far. How long shall I wait to hope that they will dissapear or do you think four months without any improvement means that they won’t. Would much appreciate your advice as I really don’t know what to do for the best result. I have very little in the way of scar where the mole was but if I now have to have the lumps excised what can I expect in the way of scarring?
A: Removing the smallest amount of normal skin when removing a skin lesion, particularly on the face, is a desired approach. In many ways, you have had a ‘punch excision’ but without using that specific instrument. The trade-off for a circular excision is that there may residual skin (dog ears) as you now have. After four months, most likely what you see if what you will have. Improvement will only come from a scar revision (elliptical excision) now. While there are scar concerns, your recent experience shows that you seem to scar fairly well in this facial area. You will have to decide whether a flatter scar or these bumps are better aesthetically. That is as much as I can say without seeing pictures of these areas.
Dr. Barry Eppley