LAM FACIAL PLASTICS

Hello Dr. Lam
I am writing you on behalf of my husband who has a raised dark mole with lighter edeges on the tip of his nose that he would like to have removed.
My husband was born with this mole and over the years it has remained the same size, however, a thin layer of skin grew over the mole and camouflaged the dark color. This past August he visited a dermatologist who said he could laser the mole and probably reduce the size. He was told that surgically removing it would create a crater on his nose. The mole was burnt off or zapped by laser and it has grown back even darker and it now looks much worse as it is so prominent. I have been researching mole removal and came across your highly informative youtube video on mole removal and your question and answer forum. I spoke with your mother today and after explaining the issue and problems he has encountered she suggested that I contact you. She also mentioned that you sometimes will take on a case such as this where the client does not live in the Texas area. We live in San Francisco, but my husband would be willing to travel to Texas to work with you. We would be happy to provide photos as well. We look forward to hearing from you. Thank you so much!

hi,
unfortunately, your dermatologist is right. if you remove the mole on the tip of the nose, you will have a crater. the skin is inelastic and just won't stretch. the only way to limit the chance is to make larger cuts across the length of the nose. i have done this for a hideous large wart-like mole on the tip of the nose. i would not recommend this for a small mole because the risk far exceeds the benefit. if it is a small black dot or something to that effect, i would highly discourage surgery. lasering it again may be worth it but obviously i am sorry that it got worse so i don't know what laser you used. maybe a laser that focuses on the brown color could help. wish i could help more.
best,
s.

Thank you Dr. Lam for your response. If I could ask the following: What type of laser would you recommend for reducing the color of the mole. I believe the laser used was a "fractal" laser, it was the size of a pin head and actually burned the skin. In your video you spoke of a dermabrasion like procedure that can smooth the top layer after surgery. Would that procedure be a possibility for a mole on the nose to reduce the size and/or color of the outer layer?

no, dermabrasion in this case sounds like it should not work. i would consider a long-pulsed Nd:YAG laser or equivalent that could manage brown color, if indeed that is what the color is.
best,
sml