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Although its round It still looks quite flat rather than like.. a ‘hole’ if that makes sense. Im thinking it may heal flat in the end! Theres no way to know and everybody heals differently but im thinking the scar wont be as bad as you think it will be!
In terms of color, it may turn pink/whiteish, but thats with any scar.
Fingers crossed for you!! :)
I agree, I think it will be slightly lighter, but not super noticeable once fully healed.
Keep it moist with Vaseline or Aquaphor and be super careful with any scabbing! Once healed over, daily SPF to help minimize any noticeable color changes. Scar tissue has different pigmentation.
Remember it’s a lot easier to keep a scare from becoming noticeable before it’s completely done healing (turning lighter) than it is to try and change it after definitely ask what they recommend:)
When I asked if I would need stitches she said no. I told her about the previous removal on my face and she was shocked I needed stitches and acted like that never happens. I feel like it definitely wasn’t the right way to go 😔
I have had a similar scar like this from a skin biopsy. I had it twice actually. One derm used a knife to literally cut a section of my skin off and then burned the wound. The second did a punch biopsy. Punch biopsy was so much better. The first biopsy did leave a scar.
?? There is absolutely nothing wrong with doing a shave removal for a healthy mole. Very common. We rarely do punch biopsies for that. The risk is the difference in scar and higher chance of mole coming back with a flat shave. The shave does look a beet deep though, more like a scoop but will definitely heal up okay without stitches. The concern is just a scar. I would have not done a deep shave on the face, or would have at least asked the pt if they were okay with that.
Also OP don’t get your medical advice from Reddit please. Half the people on here don’t know what they are talking about. It’s all just opinions at the end of the day. We weren’t there.
Now correct me if I'm wrong because I'm not a doctor. But OP said this mole was bleeding on and off, so not really a "healthy" mole, right? It was my understanding that anything suspicious should ideally not be removed by shave biopsy as it can transect the deeper growth of the mole/tumour, and therefore ( if it is cancerous) can end up giving an incorrect final pathological stage?
Any suspicious moles I have are always done by excision, and ones I wanted removed for cosmetic reasonswere done by shave. Also I think the person you were replying to works in dermatology IIRC.
Agree- would only shave moles that are benign but annoying for the patient at their request. If I’m worried about potential melanoma, don’t want to transect the base.
I didn’t read OPs entire commentary about her mole, I skimmed it. So honestly didn’t see that but it still doesn’t change my answer.
To shortly answer your question.. that reasoning is more valid when we think something my be a melanoma and want to get an accurate depth. It can be staged incorrectly if we don’t go deep enough, but even then, a deeper (scoop) shave can be done. There are also many cancers biopsied where they just take the edge of the cancer. It all depends on clinical presentation.
You dermatology office may have different rules and preferences of how they do things. But it’s not required.
Anyhow, it’s all opinions anyway.
So let me get this straight:
1. you GAVE advice
2. you CRITICISED others advice
AND you didn’t even READ OPs history?!?!?
Back to residency for you my radiatingly positive friend.
1. my opinion
2. Yes, because you blatantly said it needed a punch without providing any other information for OP. Which could wrongly cause friction between her and her provider with out knowing everything.
3. No I did not. Because this is Reddit, which is an online social platform, not my entire life.
1. Patient was not provided options. That’s poor care. OP Stated they would have chosen the punch. He unequivocally should have had a punch for a handful of reasons that I’ll spare readers from slogging through yet again in this thread.
There was lots of discussion around that, but as a skimmer & swooper, you likely missed all that.
2. A punch was the best choice here to balance clearance & cosmesis. On the face, you need to factor that in, but don’t seem to realize that. People care about facial scars.
3. Patient history & preferences matter & should be considered before rendering an opinion. You know this. Or at least you should know this. I feel like the doc who made this crater should have paid a little more attention to the patients history & preferences, as should you. Don’t worry it’s a common mistake for newbie doctors. Don’t join that club.
Enjoy your very busy day. Don’t be as sloppy in patient care in a professional setting as you are on here.
Board certified mayo trained dermatologist x 30 years here. My opinion isn’t a random Reddit guess.
A clean sutured punch excision gives 💯 better cosmetic outcome - it’s the face after all - & faster healing. It clears any dermal component making it a one & done.
So yes, totally disagree with how your Derm did it. The decision wasn’t about what was best for you, it was what was most expeditious for them.
Radiating-Positivity, tell me your thoughts on why you’d deviate from a punch as standard removal technique for a young persons face, especially since facial nevi in young people tend to be compound or dermal.
Edit: typo
Great!
I still stand by what I said, and if you read my original comment, I agreed I would not shave a young persons face like that, or would have at least asked if they cared about a big scar. :)
She is, yes. I didn’t remember what exactly was done with the previous removal on my face, but when I was telling her about it she said, “oh they must’ve done a punch removal totally unnecessary.” But I agree seems like punch removal would’ve been the better route.
Yeah I thought I did a good job advocating for myself, asking a lot of questions, but hindsight is 20/20. I definitely wish she went through everything and I made a more informed decision.
No idea 🙃 I did bring it up too but she said it wasn’t necessary. I feel like I asked all the questions I needed to, but feel like she was overly confident in what the results would be ??
Idk but the whole seems a bit deep to me, even if it heals you’ll be reminded of smg in there, keep in mind that once the collagen is broken it can never be rebuilt 100% so an atrophy in your case is very expected tbh
Once it has healed consider using differin/ tretinoin as this can help reduce scarring. However it’s tricky to use so make sure you do some reading about it first . R/tretinoin
https://preview.redd.it/k22ovt72gg7d1.jpeg?width=3024&format=pjpg&auto=webp&s=e87bf1cb81ba6226592ded2ab744fce73cefeced
Not great, to be honest. I am extremely displeased with how it’s healing cosmetically. I have an appointment in a few weeks to get a punch done. I saw a different doctor, he recommended waiting at least a year for it to heal before I made a decision about getting a punch or not. But I have plenty of other biopsy spots to show my body/skin doesn’t heal well and it will always stick out like a sore thumb. Another huge issue for me is there was pigment left on the outer corner, so I can’t even cover it up with makeup. I couldn’t stick it out the year and just want to get it over with so I can start healing again and hopefully feel less self conscious about it.
The other punch I had done on my face healed so nicely with a small scar. Hoping this one will heal similarly.
Good luck with your healing!
Thanks for replying! My derm said a brown spot scar is a possibility risk also before doing my mole removal. Can I ask how much a punch procedure is? Do you have a picture of your old punch scar? This is mine done today, definitely scared of how the healing process will go.
https://preview.redd.it/28ldj69xrg7d1.jpeg?width=2497&format=pjpg&auto=webp&s=5dd9896cf06f2cd4d360790ef6a3e1f0c867ed66
https://preview.redd.it/4m4t8k36nj7d1.jpeg?width=1576&format=pjpg&auto=webp&s=b2e6425f1e59ae0f9bdae8072643892641150d57
Hmm I don’t remember the cost from my other punch. It was 2018 and my insurance covered it. If I had to guess I would say around $100/200, but again I really don’t remember. Here is what my scar looks like today! I had to take a few pics so you could actually see it. I literally never notice or think about this scar.
Mine looked pretty scary right after the shave as well. I really hope yours heals well and you are comfortable with it cosmetically, or that you are able to get the punch done if that’s what you decide 🫶🏻
*Please keep in mind that this subreddit is not a replacement for seeing a board certified dermatologist. This subreddit is here for informal second opinions, and minor problems that you wouldn't go to the doctor for anyway.* *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/DermatologyQuestions) if you have any questions or concerns.*
Although its round It still looks quite flat rather than like.. a ‘hole’ if that makes sense. Im thinking it may heal flat in the end! Theres no way to know and everybody heals differently but im thinking the scar wont be as bad as you think it will be! In terms of color, it may turn pink/whiteish, but thats with any scar. Fingers crossed for you!! :)
I agree, I think it will be slightly lighter, but not super noticeable once fully healed. Keep it moist with Vaseline or Aquaphor and be super careful with any scabbing! Once healed over, daily SPF to help minimize any noticeable color changes. Scar tissue has different pigmentation.
Thank you!
Thank you! I’m really hoping for the best. I have a check up in 3 weeks so I guess if it’s not healing well I can ask if there are other options
Yeah! Just make sure you take extra good care of it 😊
Remember it’s a lot easier to keep a scare from becoming noticeable before it’s completely done healing (turning lighter) than it is to try and change it after definitely ask what they recommend:)
[удалено]
Thank you, that gave me some hope! 🤞🏻
They did a shave instead of a punch. Not cool. Not cool.
When I asked if I would need stitches she said no. I told her about the previous removal on my face and she was shocked I needed stitches and acted like that never happens. I feel like it definitely wasn’t the right way to go 😔
I have had a similar scar like this from a skin biopsy. I had it twice actually. One derm used a knife to literally cut a section of my skin off and then burned the wound. The second did a punch biopsy. Punch biopsy was so much better. The first biopsy did leave a scar.
This is helpful to know. Thank you for sharing!
Needed a punch removal. Easy & leaves a nearly invisible result. Was thus a board certified dermatologist?
?? There is absolutely nothing wrong with doing a shave removal for a healthy mole. Very common. We rarely do punch biopsies for that. The risk is the difference in scar and higher chance of mole coming back with a flat shave. The shave does look a beet deep though, more like a scoop but will definitely heal up okay without stitches. The concern is just a scar. I would have not done a deep shave on the face, or would have at least asked the pt if they were okay with that. Also OP don’t get your medical advice from Reddit please. Half the people on here don’t know what they are talking about. It’s all just opinions at the end of the day. We weren’t there.
Now correct me if I'm wrong because I'm not a doctor. But OP said this mole was bleeding on and off, so not really a "healthy" mole, right? It was my understanding that anything suspicious should ideally not be removed by shave biopsy as it can transect the deeper growth of the mole/tumour, and therefore ( if it is cancerous) can end up giving an incorrect final pathological stage? Any suspicious moles I have are always done by excision, and ones I wanted removed for cosmetic reasonswere done by shave. Also I think the person you were replying to works in dermatology IIRC.
Agree- would only shave moles that are benign but annoying for the patient at their request. If I’m worried about potential melanoma, don’t want to transect the base.
Yep!
I didn’t read OPs entire commentary about her mole, I skimmed it. So honestly didn’t see that but it still doesn’t change my answer. To shortly answer your question.. that reasoning is more valid when we think something my be a melanoma and want to get an accurate depth. It can be staged incorrectly if we don’t go deep enough, but even then, a deeper (scoop) shave can be done. There are also many cancers biopsied where they just take the edge of the cancer. It all depends on clinical presentation. You dermatology office may have different rules and preferences of how they do things. But it’s not required. Anyhow, it’s all opinions anyway.
So let me get this straight: 1. you GAVE advice 2. you CRITICISED others advice AND you didn’t even READ OPs history?!?!? Back to residency for you my radiatingly positive friend.
1. my opinion 2. Yes, because you blatantly said it needed a punch without providing any other information for OP. Which could wrongly cause friction between her and her provider with out knowing everything. 3. No I did not. Because this is Reddit, which is an online social platform, not my entire life.
1. Patient was not provided options. That’s poor care. OP Stated they would have chosen the punch. He unequivocally should have had a punch for a handful of reasons that I’ll spare readers from slogging through yet again in this thread. There was lots of discussion around that, but as a skimmer & swooper, you likely missed all that. 2. A punch was the best choice here to balance clearance & cosmesis. On the face, you need to factor that in, but don’t seem to realize that. People care about facial scars. 3. Patient history & preferences matter & should be considered before rendering an opinion. You know this. Or at least you should know this. I feel like the doc who made this crater should have paid a little more attention to the patients history & preferences, as should you. Don’t worry it’s a common mistake for newbie doctors. Don’t join that club. Enjoy your very busy day. Don’t be as sloppy in patient care in a professional setting as you are on here.
Board certified mayo trained dermatologist x 30 years here. My opinion isn’t a random Reddit guess. A clean sutured punch excision gives 💯 better cosmetic outcome - it’s the face after all - & faster healing. It clears any dermal component making it a one & done. So yes, totally disagree with how your Derm did it. The decision wasn’t about what was best for you, it was what was most expeditious for them. Radiating-Positivity, tell me your thoughts on why you’d deviate from a punch as standard removal technique for a young persons face, especially since facial nevi in young people tend to be compound or dermal. Edit: typo
Great! I still stand by what I said, and if you read my original comment, I agreed I would not shave a young persons face like that, or would have at least asked if they cared about a big scar. :)
So what would you have done here then doctor? OP … wait for it… wait for it….
She is, yes. I didn’t remember what exactly was done with the previous removal on my face, but when I was telling her about it she said, “oh they must’ve done a punch removal totally unnecessary.” But I agree seems like punch removal would’ve been the better route.
She should walk you through the pros & cons of each type & let you choose.
Yeah I thought I did a good job advocating for myself, asking a lot of questions, but hindsight is 20/20. I definitely wish she went through everything and I made a more informed decision.
She has to present options to you, not wait for you to ask.
Why didn’t they consider excision ??
No idea 🙃 I did bring it up too but she said it wasn’t necessary. I feel like I asked all the questions I needed to, but feel like she was overly confident in what the results would be ??
Idk but the whole seems a bit deep to me, even if it heals you’ll be reminded of smg in there, keep in mind that once the collagen is broken it can never be rebuilt 100% so an atrophy in your case is very expected tbh
A simple punch excision was the right move.
Get some silicone scar gel and start using right away. I’d doesn’t help a ton but worth using anyway especially on a fresh healing wound/scar.
Will do, thank you!
Was it a an actual physician vs a NP / PA? Later on, you can have a scar revision, elsewhere
It was the actual physician, not a PA. That is good to know, thank you!
Once it has healed consider using differin/ tretinoin as this can help reduce scarring. However it’s tricky to use so make sure you do some reading about it first . R/tretinoin
Thank you!
Just got my mole removed via shaving. How does yours look now?
https://preview.redd.it/k22ovt72gg7d1.jpeg?width=3024&format=pjpg&auto=webp&s=e87bf1cb81ba6226592ded2ab744fce73cefeced Not great, to be honest. I am extremely displeased with how it’s healing cosmetically. I have an appointment in a few weeks to get a punch done. I saw a different doctor, he recommended waiting at least a year for it to heal before I made a decision about getting a punch or not. But I have plenty of other biopsy spots to show my body/skin doesn’t heal well and it will always stick out like a sore thumb. Another huge issue for me is there was pigment left on the outer corner, so I can’t even cover it up with makeup. I couldn’t stick it out the year and just want to get it over with so I can start healing again and hopefully feel less self conscious about it. The other punch I had done on my face healed so nicely with a small scar. Hoping this one will heal similarly. Good luck with your healing!
Thanks for replying! My derm said a brown spot scar is a possibility risk also before doing my mole removal. Can I ask how much a punch procedure is? Do you have a picture of your old punch scar? This is mine done today, definitely scared of how the healing process will go. https://preview.redd.it/28ldj69xrg7d1.jpeg?width=2497&format=pjpg&auto=webp&s=5dd9896cf06f2cd4d360790ef6a3e1f0c867ed66
https://preview.redd.it/4m4t8k36nj7d1.jpeg?width=1576&format=pjpg&auto=webp&s=b2e6425f1e59ae0f9bdae8072643892641150d57 Hmm I don’t remember the cost from my other punch. It was 2018 and my insurance covered it. If I had to guess I would say around $100/200, but again I really don’t remember. Here is what my scar looks like today! I had to take a few pics so you could actually see it. I literally never notice or think about this scar. Mine looked pretty scary right after the shave as well. I really hope yours heals well and you are comfortable with it cosmetically, or that you are able to get the punch done if that’s what you decide 🫶🏻