Surgery for moles, lumps and bumps is not minor surgery. Moles, lumps and bumps are often in highly visible locations such as the upper lip or the cheek. An unfavorable result may be difficult or impossible to correct. Because it is often called minor, patients think nothing of having surgery done by a non-board-certified plastic surgeon or even a non-surgeon. Patients have high expectations because they think it is a simple procedure and they are disappointed if they don’t get a blemish-free result. A board-certified plastic surgeon with rigorous surgical training and an understanding of natural skin crease lines and underlying anatomy, is essential. Badly planned and executed surgery may result in a scar that is as visible or worse than the original problem and distort facial features such as the lip, eyelid, cheek or eyebrow. If the resultant scar is near a joint, such as the shoulder or the web space between the fingers, there may be a restriction of range of motion or webbing across the concavity of a joint or the webspace.
Excision: Mole removal is usually a short procedure, depending on the number and size of the moles. A mole can be removed under local anesthesia, in the office. Usually, once it has been removed, it will not re-occur, although this is a potential risk. The full depth of the mole is removed, and the wound is stitched. The ‘specimen’ is sent for histopathological examination. The scar that results from excision may be a thin line, though it can sometimes be more noticeable. The coarse hair which sometimes grows in a mole is only eradicated with excision of the entire mole, including its base in the fat, under the skin. Dermatologists often perform a shave biopsy. This results in a round depressed scar which is often unsightly and difficult to correct. An osteoma or bony bump arising from the skull of the forehead can often be removed through a remote scalp incision using an endoscope, so that there is no visible scar.
After removal of the mole, the wound is closed in multiple layers with deep absorbable stitches. A skin stitch is often placed just beneath the skin and along the entire length of the incision, to avoid stitch marks or railroad-tracks. If stitches are placed in the skin then they must be removed within a few days, sometimes as soon as 48 hours, to avoid stitch marks.
All moles, lumps and bumps should be removed completely so that they do not grow back. If pieces are left behind, they will reoccur and need another surgery. Although lipomas are made of fat, they should not be removed with liposuction. This results in an incomplete removal and the likelihood of a recurrence.
Dr. Kirwan’s book entitled ‘My Mole Book’ is available at Amazon.com
My Mole Book Paperback – Illustrated, 15 Apr 2009
by Laurence Kirwan (Author), Peter Fasolino (Illustrator\
