Skin growth removal

picture of male skin surgeon

Skin growth removal

Skin growth removal, or excision, can be used for both benign skin growths & cancers

Which growths can be removed with excision?

Pretty much any growth, whether benign or cancer, can be excised, but there may be other better
treatments available for your particular growth. This is because excision leaves a scar, and
depending on what growth you have and where it is, excision might not be best

How is skin growth removal performed?

Often the skin growth can be removed under local anaesthetic (ie with you awake), but sometimes a
general anaesthetic is needed.

The surgeon will mark out the growth and the planned margins needed, and when numb will cut the
growth out. Depending on the type of skin growth, it may be taken with a small amount of
underlying fat, a thick cuff of fat, or even deeper tissue. The growth is usually then sent to a
laboratory for testing, which can take a few days to weeks.
Any bleeding areas are sealed using an electric device called diathermy or cautery, and the wound
then closed.

What scar will I have after skin growth removal?

This depends on a number of factors, including the size of the growth, what type of growth it is,
where the growth is, how the wound is closed, and whether you tend to form good scars or not.
If the wound can be stitched closed as a straight line, then usually the line will be 2-3 times as long
as the growth itself. This is because the surgeon will cut the growth out in an elliptical shape (think
of a stretched ‘lemon shape’), to help the scar settle as flat as possible. If the surgeon cuts the
growth out as a rounded shape, then when it gets stitched up the ends will poke upwards.
Scars in different areas of the body can differ too. Those on the chest or shoulders can be prone to
forming raised, red itchy scars, called hypertrophic or keloid scars. Scars on the back can sometimes
stretch, leaving a pale, shiny, widened scar appearance.

How does the type of skin growth affect my scars?

Skin growths that are completely benign can usually be cut out by keeping quite close to their
margins, and so keeping the scar relatively short
Skin cancers need wider margins taken from their edges though, so the scars will be longer. Basal
cell carcinomas often need at least 3-4mm margins to be taken around them, squamous cell
carcinomas 4-6mm, and melanomas can sometimes need 3cm margins, depending on the melanoma
thickness. With larger excisions, the wound may not be able to be closed as a line, and other forms
of reconstruction may be needed such as skin grafts

Are dissolving stitches used to close the wound?

Dissolving stitches are often used for the deep layers of the skin, but often non-dissolving stitches
are used for the top layer. These are taken out after a few days, but the exact timing of stitch
removal depends on the location of the wound

What are the risks of skin growth removal?

Scarring – as described above, scarring can be variable and can potentially form hypertrophic or
keloid scars. Occasionally scar improvement techniques can be used
Infection – this is relatively uncommon, but if the area becomes red and sore then antibiotics might
be needed

Bleeding – it is normal to get a little bit of bleeding after skin growth removal, but if there is a lot of
bleeding then you may need to return to have the area checked and any bleeding stopped

Recurrence – even if the skin growth is thought to be completely removed, they can occasionally
return and may need further treatment

Incomplete excision – even though a wide margin may have been taken, occasionally the lab checks
say that the growth is not completely removed. Depending on the type of skin growth further
surgery may be needed

Numbness – the area around the surgery may be numb for a short while, especially for an hour or
two after surgery while the anaesthetic wears off. The numbness can be long-term though,
especially if a larger growth has been removed

Pain – this is usually not too bad after smaller growth removal, and can be dealt with by simple
painkillers. For larger growths, stronger painkillers may be needed

Bruising/swelling – this is usually fairly uncommon, although areas of the face can be prone to
bruising and swelling, especially around the eye. This usually settles after a week or so

Cosmetic appearances – usually the scar will start off being a dark ping colour, but will tend to fade
after a few months to leave a pale scar, although occasionally this redness persists. The surgeon will
usually aim to get a fairly flat scar, but there can be noticeable dips and bumps in the scar. Again
these tend to improve in time but can be long-term

This information is for general information only. If you have any concerns about your health or are considering any treatments, you should seek advice from a healthcare specialist

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