Skin surgery - removal of lumps, bumps, moles, scars and skin cancers
Skin lumps, bumps and lesions (any abnormality of the skin) are very common and largely harmless. The commonest lesion of the skin is a mole. These are accumulations of melanin pigment-containing cells. The vast majority are harmless. However, if you are concerned about a mole, particularly if it has grown or changed in size, shape or colour or has symptoms like itching pain or bleeding, then removing the mole and sending it for laboratory analysis is advisable.
The next most common lesion of the skin is an epidermoid cyst which is a sack containing skin cells which slowly enlarges. They occur all over the body including the scalp where they are known as pilar cysts. They are harmless but can be a nuisance particularly if they are somewhere visible. They are prone to infection. They can be simply removed with surgery under a local anaesthetic.
The third most common lesion of the skin is a lipoma. This is an abnormal growth of fat under the skin. They occur all over the body. They are harmless but can be noticeable if they get enlarged and can cause pressure effects such as discomfort when lying on the affected area. Lipomas can be easily removed, usually under a local anaesthetic.
The fourth commonest lesions are skin tags and warts. These are small growths. They are harmless but can be unsightly or a nuisance if they encroach on the eye for example. They can be very simply removed under a local anaesthetic.
Lastly, if you have a new skin lesion that is growing or changing appearance in terms of shape or colour or has become raised or bleeds., then you should seek an urgent medical opinion as this may well be a skin cancer. The majority of skin cancers are basal cell carcinomas which are fortunately benign in that they do not spread to other parts of the body. This means that once they are removed that is the end of the problem. Provided these are treated early they can be simply removed under local anaesthetic. Fortunately they are slow-growing. They're quite common in the face but can occur in other areas that are exposed to sunlight such as the back. Squamous cell carcinomas are a more serious type of skin cancer that can spread to other parts of the body. Fortunately, in most cases these cancers are slow-growing and most are caught well before the risk of spread. They can usually be removed under a local anaesthetic. The last type of skin cancer is melanoma. This is a more aggressive skin cancer that can spread to other parts of the body. The key to successful treatment is to early diagnosis and treatment. Any new mole, particularly those that are dark in colour and changing in any way, warrants an urgent medical opinion. Most cases can be removed under a local anaesthetic.
If you have any of the above skin lesions, I would be very happy to see and treat you. My two main considerations in surgery are firstly to reduce the risk of recurrence of the lesion. This is achieved by taking a margin of healthy tissue around the lesion and carefully dissecting it free from surrounding structures. The second consideration is minimising the aesthetic impact of the resulting scar (unfortunately there is no way to remove a skin lesion without leaving a scar). One of the many benefits of a plastic surgery training is that we are specifically experienced in ways of concealing scars in natural lines such as creases and also in precise stitching. Sometimes it is necessary to use a skin graft or a flap of skin to close the wound if it is particularly big or a place where the skin is not stretchy enough to stitch up. If there's any chance of your skin lesion being cancerous, I will send it to the pathology lab for examination under the microscope to get an accurate diagnosis.
If you have a lesion you're concerned about I encourage you to arrange a consultation. If you wish, you can send a photograph of the lesion in advance of the consultation to my secretary at firstname.lastname@example.org. It is important not to let skin lesions go unexamined but it is also important not to worry unduly. I remove many skin lesions every year and the vast majority are entirely harmless.
On the day of surgery I will mark the lesion and inject local anaesthetic. I use a vibration device to minimise the sting of the needle and use the thinnest needle possible. I add bicarbonate to the anaesthetic so that it stings less and works faster. I cut out the lesion leaving the smallest possible scar ideally concealing it within an existing crease. I will stitch the deep and superficial parts of the wound with dissolving stitches, normally under the skin so that there are no stitches to see or remove. I use simple adhesive dressings which I will encourage you to remove at home after 5 days or so. The follow-up appointment will be a week or two after surgery at which point I will share the pathology results with you.