Mr Morritt regularly undertakes mole removal for cosmetic purposes in Sheffield. He uses Plastic Surgery techniques to minimise scarring and places scars in areas where they will be less conspicuous. Scarless wound healing is not yet achievable (it is possible in the foetus). Having said that the vast majority of wounds following cosmetic mole removal heal very well and in some patients may be very difficult to see.
Mole removal – Procedures
Mole removal is generally performed under local anaesthetic as a day case procedure. Moles are removed using ‘shave excision’ , ‘punch biopsy’ or ‘excision biopsy’.
The mole is shaved down slightly into the skin to remove it’s roots. A dressing is placed on the shaved area after the surgery to encourage the wound to form a scab. The wound then heals and the scab ultimately falls off. Different people heal at different speeds (young people tend to heal more quickly than the elderly). For moles with shallow roots, full healing may occur within 5-7 days. Moles with deeper roots may take slightly longer to heal. Scars tend to be very difficult to see once fully mature but it is sometimes possible to see a slight dent where the mole was removed from. As the full thickness of the skin is not removed with shave excision, the chance of the mole growing back following the surgery is slightly greater than with punch or excision biopsy.
A small punch (which looks a bit like a metal straw but with a very sharp end) is used to remove the mole and a tiny area of surrounding normal looking skin. In contrast to shave excision where some of the skin under the mole is not removed, punch biopsy removes the full thickness of the skin under the mole. The wound is stitched with a tiny stitch that is removed 5 days following surgery. This technique is generally suitable for smaller moles. Because the full thickness of the skin is removed with the mole, the chance of the mole growing back is less than with shave excision. The wound generally heals with a thin fine scar once the scarring has fully matured.
The mole and a tiny area of surrounding normal skin are removed in one piece. The full thickness of the skin under the mole is removed which reduces the chance of the mole growing back. The wound is stitched with a tiny stitch that is removed 5 days following surgery on the face (stitches will be left in for longer on other body parts). This technique is generally used for larger moles. Excision biopsy generally heals with a thin fine scar once the scarring has fully matured.
Mole analysis after surgery (histopathology)
As the vast majority of moles removed for cosmetic purposes are benign and this is apparent from their appearance we do not routinely send the moles off for histological analysis after they are removed. Moles can of course be sent off for analysis if patients desire (this usually incurs an additional fee). In the event that there is any concern regarding the appearance of a mole or if a patient has a personal or family history of skin cancer, Mr Morritt may recommend that the mole is sent off for histopathological analysis.
Risks of mole removal surgery
Poor scarring – the vast majority of wounds heal with thin, pale, flat scars. Rarely scars can become raised, red and painful. Wounds that take longer than normal to heal may heal with a slightly different skin tone to the normal surrounding skin.
Regrowth of the mole – more common with shave excision than with punch or excision biopsy. In the event that a mole grows back, the treatment can be repeated or an alternative treatment performed.
Numbness – this can occur around any surgical scar but is usually limited to the area immediately around the scar.
Contour defect – there can sometimes be a visible slight indentation following shave excision.
Wound infection – this is rare following mole removal but usually responds to a short course of tablet antibiotics.
‘Dog ear’ formation – this term is used by doctors to describe a bulge that sometimes forms at either side of a surgical scar. This usually happens because doctors try and limit the size of the scar at the time of surgery to make scars less conspicuous. Many ‘dog ears’ following surgery settle with time as swelling from the surgery wears off and the skin itself contracts. For those ‘dog ears’ which do not improve with time and that trouble the patient, it is possible to remove the dog ears by performing a small operation to lengthen the scar slightly.