Why Can’t A Scar Revision Be Done On My Nose Before A Year?

Q:  I have been left with a dog ear on my face after a nose reconstruction due to skin cancer. The nasal ala was reconstructed but the end result looked like a further growth. (like a pin cushion of skin stuck on to the side of my nose) It underwent a revision about two months later. I am still not totally satisfied as I now have a further deep scar on the side of my nose and an awful obvious dog ear that looks very unsightly. I went for a follow-up and they suggested giving it a year before considering any further surgery. I am desperate to have something done but if we did operate on the dog ear, I fear it might end up worse!! How can this be and why should I live with my face like it is? What can be done now?

A: Reconstruction of the nose after cancer is one of the biggest challenges in plastic surgery. This is particularly true of the nasal ala which is a small but delicate area. Having had two surgeries and now some degree of scar contraction or dogear, it is very important to let the tissues heal and settle down. The healing must progress to the point that it is not only complete but the scar tissues have relaxed. Operating on tissues that are not soft and supple will only lead to further scar contracture problems. It is certainly frustrating to have to wait a whole year with less than an optimal result sitting on your face, but the best result from an effort at scar revision depends on good quality of tissues to manipulate.

Dr. Barry Eppley

Indianapolis, Indiana