Plastic surgeons routinely remove moles, which are common skin growths made of pigment-producing cells called melanocytes. While most moles are non-cancerous, removal is often sought for cosmetic reasons or due to irritation from clothing or shaving. A plastic surgeon is frequently chosen when the aesthetic outcome is a high priority. This specialized approach ensures that lesion removal is combined with meticulous attention to minimizing the resulting scar.
Why Choose a Plastic Surgeon for Removal
Patients frequently select a plastic surgeon over a general practitioner or dermatologist when a mole is located on a highly visible area, such as the face or neck. Plastic surgeons undergo specialized training focused on the reconstruction and aesthetic management of soft tissues. This training allows them to employ techniques specifically designed to minimize the appearance of a scar.
The primary advantage is their expertise in wound closure and managing skin tension. A plastic surgeon often orientates the incision along the body’s natural skin tension lines (creases and folds where skin naturally relaxes). Closing the wound parallel to these lines reduces the mechanical pull on the healing tissue, which is a major factor in how noticeable a scar becomes.
This approach is beneficial for larger moles or those requiring full surgical excision. The goal is not simply to remove the lesion but to restore the area with the least visible evidence of the procedure.
Surgical Methods Used for Mole Removal
Plastic surgeons utilize two principal techniques for mole removal, chosen based on the mole’s depth and whether malignancy is suspected. The first method is shave excision, reserved for moles that are raised above the skin surface but do not penetrate deeply. A fine scalpel blade is used to shave the mole flush with the surrounding skin.
Shave excision is a quick, minimally invasive option that generally does not require sutures, healing much like a scrape. For moles that are deeper or have irregular characteristics, a full excision is necessary to ensure the entire lesion is removed. This technique involves cutting through the full thickness of the skin, removing the mole in an elliptical shape, and then closing the resulting wound.
To minimize scarring after a full excision, plastic surgeons use a meticulous layered closure technique. This involves placing dissolvable sutures deep beneath the surface of the skin to bear the majority of the wound tension. Closing the deeper layers first allows the surface skin edges to come together gently, which is essential for achieving a fine, less noticeable linear scar.
Pre-Surgical Evaluation and Biopsy
Before any mole is removed, a thorough pre-surgical evaluation assesses the lesion’s potential for malignancy. Clinicians use the established ABCDE criteria to examine the mole for signs of melanoma. This involves checking for Asymmetry, an irregular Border, multiple Colors, a Diameter larger than 6 millimeters, and Evolving or changing characteristics.
If a mole displays suspicious features, a biopsy is performed to obtain a definitive diagnosis. A biopsy involves sending the removed tissue sample to a pathologist for microscopic examination. If cancer cells are detected after an initial shave or small punch biopsy, the plastic surgeon will proceed with a wider, definitive excision.
For lesions confirmed to be cancerous, the surgeon performs a wider excision to remove a margin of healthy tissue surrounding the mole. This ensures that all cancerous cells are cleared. The medical necessity of this margin takes precedence over purely cosmetic concerns, though the plastic surgeon’s skill aids in subsequent reconstruction and closure.
Recovery and Scar Minimization
Immediate post-operative care focuses on keeping the wound protected and moist. Patients are instructed to clean the site gently and apply a topical ointment, such as petroleum jelly, to prevent scab formation and promote optimal healing. For excisions closed with sutures, stitches are usually removed within one to two weeks, depending on the wound location and skin tension.
Long-term scar management involves protection from sun exposure to ensure the scar fades properly. Ultraviolet radiation can cause a healing scar to become darker and more noticeable, a process called hyperpigmentation. Application of a broad-spectrum sunscreen with an SPF of 30 or higher is recommended for at least a year.
Once the surface wound has fully closed, patients are advised to begin using topical treatments like silicone sheets or gels. These products hydrate the outer layer of the scar and regulate collagen production within the tissue. Consistent use of silicone for several months helps to soften, flatten, and lighten the appearance of the maturing scar.