Typically if you are having a skin growth removed it is because it irritates you or because the doctor cannot be sure it is not a skin cancer. The most important thing to do before your surgery is to avoid aspirin and alcohol (beer, wine, etc.) because these drugs make your blood thin.
When you arrive, the area is numbed with Xylocaine, a local anaesthetic. The procedure involves inserting a small needle into the area to be removed and then injecting the medication. It will sting when it is injected, but this is usually the worst part of the whole procedure. After the Xylocaine is injected, the doctor will typically wait fifteen to twenty minutes before starting. This allows the area to numb and also reduces bleeding.
The doctor will then remove the growth on your skin. This will be done by cutting it out with a scalpel. You should not feel any pain when the doctor is cutting. If you do, tell him right away and he will inject more Xylocaine to further numb the area. The doctor will cut an oval of skin around the growth. This leaves a longer scar, but avoids the formation of “dog ears” which are bunches of skin or folds of skin left over when a growth is cut out in a circular fashion.
Figure 1 – Cutting the growth out in a circular fashion leaves a shorter scar but one will have ugly “dogs ears.” An oval excision makes a longer scar but will not cause “dog ears.”
The tissue removed will then be sent to a pathologist for analysis. The pathologist will look at the edges to make sure the growth is all out and will also make sure there is no cancer in the removed tissue. If the pathologist finds cancer in the removed skin, the doctor will have to go back one week later and remove more tissue.
Are there any risks associated with skin surgery?
All surgery has risks. The risks of complications are quite low for skin surgery however. When surgery is performed on certain areas of the face, swelling can occur, especially around the eyes. Sometimes the eyes can nearly swell shut. Typically this edema or swelling is worse in the morning and improves as the day goes on. Most of it will resolve in one week. If your concerned about the swelling or have fever, call your doctor.
Most patients will have numbness in the area for six months, but this can last up to two years or longer. The risk of infection is low, but studies show that no matter how clean the surgery is, some wounds will get infected. If this is the case for you, the doctor will put you on an antibiotic for one week. The scar will not heal as well if your wound becomes infected. It is very important that you follow the wound care instructions given to you at the end of surgery. Sometimes a blood clot will form under the skin. If this occurs you will have a hard lump in the area for six months or longer until your body absorbs it. A blood clot is not dangerous, but it can be a real nuisance until it goes away.
Is there always a scar left after my surgery?
All patients will have a scar, regardless of the nature or scope of the surgical procedure. There is no way to remove a skin growth without leaving a scar. Often it can be hidden in your natural skin folds. You need to be patient, because the scar will not have its final appearance for six to twelve months after the surgery.
If the scar becomes red after one month or if it starts to elevate above the skin, you will need to schedule an appointment right away. This could be a sign that a thick scar or keloid is forming. If the doctor sees a keloid or hypertrophic scar forming, he can often stop or reverse it. This can be done by injecting it or by prescribing a medication to put on it. Most scars on the back, thighs, shoulders, neck and upper arms get wide, often an inch or more in width. There is nothing at this time that can prevent wide scars from forming in these areas.
What else do I need to know prior to surgery?
It’s important to follow pre-op and post-op instructions carefully to ensure a successful procedure and minimize any side effects or complications. Most procedures are quite routine so there really shouldn’t be any issues. Keep a close eye on the area in the weeks and months following surgery to make sure it’s healing and not getting worse. If it starts looking like something is not right, schedule another appointment right away and have the doctor take another look.