All Excisions Are Not Created Equal…
There is no such thing as surgery without scars, but there are good ones and bad ones. It’s your body, you want the best result, and results are entirely dependent on your surgeon. Jessie Mallalieu has everything you need in a skin surgeon: excellent training, good judgment, miles of experience, and a caring nature.At The Cosmetic & Skin Surgery Center, we don’t dabble in excisions; we excel at them.
What is an excision?
“Excision” means the surgeon uses a scalpel to remove something from the skin. Excisions are recommended for problem growths such as small cancers, atypical moles, and enlarging cysts. First, the growth is numbed with injectable anesthesia. The surgeon then excises the growth and a narrow rim of normal-appearing tissue. The excised tissue is sent to a dermatopathology lab for final diagnosis which may take 1-2 weeks.
Will I have stitches (sutures)?
The surgeon will suture the wound closed immediately following the excision. Absorbable sutures are placed underneath the skin to pull the edges together. Nonabsorbable sutures are used on the outer surface to keep the top layers together and even. The outer sutures are removed 5-14 days later depending on the body site. In some cases, the surgeon can use surface sutures that dissolve on their own.
What will the area look like after the excision?
Sutured wounds are typically lines (incisions) of different lengths depending on the size of the growth. Your incision is placed in a way that minimizes tension and improves the final cosmetic result. During the first two weeks, the incision will be very red, swollen, and sometimes sensitive. At the time of suture removal, the incision will still be red and often itchy, especially around the sutures. After suture removal, the incision gradually softens and becomes less red over the following 3-12 months.
How do I take care of the area?
Wound care instructions will be provided at the time of the surgery along with a printed handout. The care is simple and involves twice-a-day daily cleaning following by plain petroleum ointment. Most likely, you will be able to take showers and perform all your normal activities.
Are there any restrictions?
For the first two weeks, you want to pamper the area! Avoid repetitive motion and any action that might put too much tension on the incision. For example, if you have an excision on your arm, you do not want to swing golf clubs or rake your yard; however, working on the computer would be fine. Some areas, such as legs, require special care.
Will I have a scar?
All excisions leave scars, but most are subtle. The appearance of the scar will be affected by the size of the growth and the body site. Scars on the face, for example, heal with a finer line than scars on the back, where the tension is greater. The length of the scar will be 3-4 times as long as the excision was wide. This design rule prevents the scar from staying permanently puckered at the ends. For example, if you have a mole that requires a dime-sized excision, then the scar should be about three dime-sizes long to prevent puckering. Some areas of the skin are very tight and require skin grafting (lower legs) or open healing methods (scalp).
What are the other risks?
With any excision, there is always a rare chance of infection, hematoma, wound failure, prolonged bleeding, or some unforeseen reaction. Please read the “How to Prepare for Your Surgery” handout and stop any blood thinners as indicated. The surgeon will prescribe antibiotics if you are at increased risk for infection; however, this is rarely necessary. Please follow the activity restrictions in order to minimize the risk of the wound breaking open (dehiscence). Let your surgeon know about any personal or family history of bleeding or allergies. In our center, the risk of dehiscence, infection, or hematoma is less than 1%. There are other very rare risks detailed in the informed consent. Please be sure to read it thoroughly so that we may answer any questions.