Skin Lesions

The steep increase in skin cancer is directly related to the exposure to a number of environmental factors – primarily sun exposure. Your dermatologist should determine the etiology of a skin lesion and recommend removal of suspicious ones. The excision is performed in the office under local anesthesia using sterile instruments. The length of the scar is determined by the width, orientation and the nature of the skin lesion or subcutaneous tumor. The direction of the scar is usually made according to the resting skin tension lines so that it matches as much as possible normal body wrinkles. The resulting wound is closed primarily in anatomical layers. Sutures are removed after one to three weeks, depending on the location of the incision. The exception to the above is when the incision is, in selected cases, left to heal on its own, or when its location and size dictate treatment in the operating room. The pathology report will determine if further office or operating room re-excision or any other adjuvant treatment will be needed. In such cases, multidisciplinary treatments might be required. A scar resulting from removal of a skin lesion or subcutaneous mass is permanent and may change overtime due to the lesser tensile strength of repaired tissues, genetic predisposition or just its location. Plastic surgery techniques are applied to optimize scar healing. In addition, modified activity level is needed for about 3 weeks following mole removal or scar revision. Following suture removal, in order to minimize scaring and optimize the outcome, scar gels or therapies can also be considered.

Subcutaneous soft tissue massed usually represent benign soft tissue fatty tumors that depending on their size, depth and location are removed in the office. Alternatively, they may require removal in the operating room, especially if clinical findings suggest a non-fat type of tumor or if the mass is too deep for removal in the office. Recurrence is possible, although very rare.

If scars following surgery or trauma persist and cause contractures, pain or create functional and aesthetic concerns to the patient, surgical excision and scar revision might be indicated. Although recurrence following scar excision cannot be excluded, most patients do benefit from revisions.