Dr. Sam Lam Plastic Surgery Forum

i have a lesion on the tip of my nose that i cant define its raised so plz i'll attach my picture with this mail and u decide what the lesion is and what is the best treatment for it whether laser or electro cautery or any other preferred method...thx so much in advance

for medico-legal purposes, i cannot offer a diagnosis over the Internet. you must check with your dermatologist what it is. to remove a lesion for the tip of the nose is however very difficult. you cannot just cut it out and close it as the skin will either not close because it is too tight or it will pucker downward. the lesion must be shaved and burned conservatively. that will almost definitely leave some behind requiring further burning and removal because too aggressive a burning and removal will leave a hole. sometimes after initial burning, you have a small divot which can be softened with dermabrasion around the edges. in general, tip lesions are very hard to remove. i have removed a large tip lesion by making what is called a bilobed flap (you can google that) which is a cancer type operation because the lesion was a very large unsightly wart. i would only very rarely do that because it leaves large criss cross scars across the bridge of the nose visible for over a year. i did that because this wart was more unsightly than the incisions would have been. again, i have only needed to do that once when the "punishment fit the crime", i.e., when the situation was bad enough to justify such an extreme measure.

thx alot for your concern, but i'm still confused about its removal procedure.My dermatologist decided that its a "wart" and told me to remove it by electro-cautery, then another dermatologist told me that cosmetically wise its better to be done using laser and told me thats its a matter of opinion between dermatologist.
Thats why In the first place i asked you about your valuable opinion about its best removal method and what is the side effects. thx again

personally, i do not believe laser or electrocautery makes much difference but you would have to speak with your treating physician to ask what kind of laser, how does he use it and what advantages he thinks compared with electrocautery.
best,
sml