There are a number of potential reasons to remove a mole. Sometimes a patient simply doesn’t like the way it looks, while at other times the mole itself may be sensitive or prone to inflammation. Yet another reason is that sometimes your dermatologist will recommend that a mole be removed because it looks suspicious. It’s important for patients to understand that there are different ways to ‘remove’ a mole – with each having its advantages and disadvantages.
Superficial Shave Removal
In this procedure, only the ‘raised’ portion of the mole is removed. Because all moles have some degree of ‘under-the-skin’ component, some of the mole will remain after it’s healed.
The advantage of this procedure is that it typically provides the best cosmetic result. You’ll see in the explanations of the other two removal methods that if we make it our goal to remove absolutely every last bit of the mole, a more noticeable scar will be made. With this procedure, the end result is that the area where you once had the mole would now be flat. If the mole had some color in it, then it’s likely that there will be some color left behind, but at least it will be flat and ‘freckle-like’ rather than raised and ‘mole-like.’ However, if the mole was flesh-colored in the first place, then it would likely heal both flat and roughly the same color as the surrounding skin (an ideal cosmetic result).
The disadvantage of this procedure is that, because some of the mole is left behind in the skin, it’s possible that the residual portion could grow in the coming years, giving the impression that the mole is ‘growing back.’ Also,if the lab were to evaluate the removed part of the mole and determine that there are abnormal (or even cancerous) cells within it, then complete removal (such as that described in either procedure below) would still need to be performed.
Deep Shave Removal
This procedure is fairly similar to that previously described, except as the name implies, this removal goes deeper. Because the removal goes deeper, it leaves a ‘depressed’ scar that will probably never completely fill in.
The advantage to this procedure is that if a mole appears to be harmful, you would want to have as much of the mole removed as possible. Performing a ‘deep’ shave removal also makes it very unlikely that the mole would ever grow back. The disadvantage of this procedure is that it results in a much more noticeable scar. The scars from this type of removal are often depressed, like a ‘divot,’ and may also be hypopigmented (lighter in color than the surrounding skin).
The third kind of mole removal is called ‘excision.’ This involves cutting ‘around’ the mole, through the entire thickness of skin. Because the entire thickness of skin is removed, an ‘open’ wound is created which must be closed with stitches.
The advantage of excision is that it provides the highest degree of certainty that the mole has been completely removed in its entirety. This is particularly important when it comes to moles which are showing ‘pre-cancerous’ or even ‘melanoma’ changes within.
There are a few disadvantages to excision. First, it’s a surgical procedure that typically can’t be performed without planning and preparation. In other words, such a procedure normally needs to be scheduled ahead of time on a ‘surgery day.’ Second, because it goes deeper, more risks are involved, such as infection, bleeding, or even nerve damage. Third, excision creates what most think of as a traditional ‘surgical’ scar. In other words, it will heal in a line-like scar, and you may also see marks where the sutures were placed.
Because of these issues, excision is typically reserved for moles that need to be removed for safety reasons. Your dermatologist will be happy to answer any additional questions you may have regarding mole removal.