Facial plast Surg 2013; 29(04): 327-330
DOI: 10.1055/s-0033-1349359
Letter to the Editor
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Depletion of the Nasal Reserve after a Mole Excision

Silvia Scevola1, Giovanni Nicoletti2, Claudio Albizzati3, Angela Faga2
  • 1TAMeRiCI Research Center, University of Pavia, Pavia, Italy
  • 2Department of Plastic Surgery, University of Pavia, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy
  • 3Department of ENT, Multimedica Group Research and Care Institute, Sesto San Giovanni (MI), Italy
Further Information

Publication History

Publication Date:
24 July 2013 (online)


The authors present an original case report to warn of a possible severe functional complication that might follow a simple facial skin procedure. A 55-year-old woman underwent excision of a mole along the alar-facial groove, which seemingly healed without immediate complications. Ultimately the patient reported an ipsilateral nasal obstruction 2 months postoperatively. Intranasal inspection and a computed tomography scan revealed a severe septum deviation that had been previously clinically unapparent. The authors argue that the skin-scarring process progressively counterbalanced the action of the levator labii superioris alaeque nasi muscle fascicle to the nostril. Such an action had been compensating for a subtotally compromised nasal air flow from a preexisting severe septal deviation. In this context, skin scarring was enough to impair a minimal residual nasal respiratory reserve. The authors therefore advise performing an internal nasal inspection at all times prior to any sort of skin surgery around the alar-facial groove. This will allow detection of any subclinical functionally compensated preexisting septal deviation or any other intranasal obstruction that could manifest at a later stage.