surgical excision
Excision refers to removal of a skin lesion by completely cutting it out. At Annexus Dermatology & Aesthetics, our team of surgically trained advanced practice providers, led by Board-Certified Dermatologist Dr. Neil Sandhu, MD, FAAD, are well-versed in all aspects of scar prevention, reconstructive surgery, layered closures, cosmetic units and other factors that result in an excellent surgical outcome for our patients. To schedule an appointment, book online or call the office and speak with a friendly staff member today.
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excisional surgery Q&A
What is excisional surgery?
Under local anesthesia, our specially trained providers at Annexus Dermatology & Aesthetics removes the visible cancerous tumor along with a surrounding border of presumably normal looking skin as a safety margin. The skin around the surgical site is then closed with stitches and the tissue is sent to a lab to determine whether all cancerous cells have been removed.
what does excisional surgery treat?
Many dermatologists will use excisional surgery only after less-aggressive treatments have failed. In some cases where skin cancer (such as melanoma, squamous cell carcinoma, or basal cell carcinoma) or dysplastic nevus is suspected or has been diagnosed, excisional surgery may be the first line of treatment. If the cancer is not cut out it may spread to the surrounding skin and to other parts of the body (metastasize). Excisional surgery differs from Mohs Surgery in that it will usually impact more of the surrounding healthy tissue than a Mohs procedure. Other reasons that skin lesions are excised include cosmetic appearance, to remove an inflamed lesion, or recurrent infection.
what is involved in excision of a skin lesion?
Your provider at Annexus Dermatology & Aesthetics will explain to you why the skin lesion needs excision and the procedure involved. The most common type of excision is an elliptical excision. The ellipse is designed so that the resulting scar runs parallel with existing skin creases. This ensures that the scar is as narrow and short as possible. Your provider will then cut around and under the lesion so that it is completely removed. The lesion is placed in formalin and sent to a pathology laboratory. Here, a pathologist will examine the specimen and provide your dermatologist with a report a few days later. The edges of the ellipse will then be sewn together to make a thin suture line. There may be two layers of sutures (stitches) – a layer underneath that is absorbable and a layer of sutures on the surface which will need to be removed in 7-14 days. A dressing might be applied and instructions should be given on how to care for your wound and when to get the stitches out.
will i have a scar?
It is impossible to cut the skin without scarring in some way, so you will always have some sort of scar. Your dermatologist at Aspire Dermatology & Aesthetics will try to excise the lesion in a way that will keep the scar to a minimum. Some people have an abnormal response to skin healing and these people may get larger scars than usual (keloid or hypertrophic scarring). If this occurs, your dermatologist can counsel you on treatment options.
If you’re concerned about your risk of skin cancer or have a skin lesion you would like evaluated, schedule an appointment at Annexus Dermatology & Aesthetics. Call the office and speak with a friendly staff member or book a consultation online today.
