There are a number of potential reasons to remove a mole. Sometimes a patient simply doesn’t like the way it looks, whileatothertimesthemoleitselfmaybesensitiveorpronetoinflammation. Yetanotherreasonisthatsometimes your dermatologist will recommend that a mole be removed because it looks suspicious. It’s important for patients to understand is 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:
Theadvantage ofthisprocedureisthatittypicallyprovidesthebestcosmeticresult. You’llseeintheexplanationsof the other two removal methods that if we make it our goal to remove absolutely every last bit of the mole, a more noticeablescarwillbemade. Withthisprocedure,theendresultisthattheareawhereyouoncehadthemolewould 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 residualportioncouldgrowinthecomingyears,givingtheimpressionthatthemoleis‘growingback’. Also,ifthelab 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:
And 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 removedaspossible. Performinga‘deep’shaveremovalalsomakesitveryunlikelythatthemolewouldevergrow back. Thedisadvantageofthisprocedureisthatitresultsinamuchmorenoticeablescar. Thescarsfromthistypeof removal are often depressed, like a ‘divot’, and may also be hypopigmented (lighter in color than the surrounding skin).
Thethirdkindofmoleremovaliscalled‘excision’. Thisinvolvescutting‘around’themole,throughtheentirethickness 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 initsentirety. Thisisparticularlyimportantwhenitcomestomoleswhichareshowing‘pre-cancerous’oreven ‘melanoma’ changes within.
There are a few disadvantages to excision. First, it’s a surgical procedure that typically can’t be performed wi thout planning and preparation. In other words, such a procedure normally needs to be scheduled ahead of time on a ‘surgery day’. Second,becauseitgoesdeeper,morerisksareinvolved,suchasinfection,bleeding,orevennervedamage. Third, excisioncreateswhatmostthinkofasatraditional‘surgical’scar. Inotherwords,itwillhealinaline-likescar,andyou 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.