Sculpting Away Moles, Growths, & Age Spots Without Stitches
Article by Nelson L. Novick, MD
New York Dermatologic Surgeon
As you age, your skin can become host to a wide variety of cosmetically displeasing, flesh-colored or pigmented bumps and lumps. Which ones develop, when they do, how quickly they appear, and how extensively they cover the canvass of your skin are determined by a combination of your genes and how much sun exposure you have gotten over the years. Often, these often unsightly and unwanted lesions are moles. Lesions is doctor lingo for any spot or lump in the skin that causes concern or differs from normal skin. Moles, or nevi, are dark, oval-shaped “beauty marks” or “birth marks.” Other types of cosmetically troublesome growths include “overgrown oil glands,” little orange-yellow bumps known as sebaceous hyperplasia, warty-looking, skin-toned or brownish age spots called seborrheic keratoses, and skin tags, fleshy growths that hang from tiny, narrow stalks.
If you’ve always wanted to have these things removed, but hesitated because of the fear of stitches, scarring, or the expense of surgery, the quick and simple, minimially invasive, no-stitches-required techniques described below may be just right for you.
Scalpel Sculpting is an excellent method for removing growths elevated above the skin surface. Immediately following the administration of a small amount of local anesthetic just beneath the spot, the doctor uses a scalpel to remove it with a horizontal, back and forth, “sawing” motion of the scalpel blade that essentially “sculpts” the undesirable area away from the surrounding normal skin. The wound underneath is left to heal by itself. Since the cut is so superficial, no sutures (stitches) are needed, and there is little risk of scarring. The cosmetic result is generally excellent, and the whole procedure takes literally under five minutes.
Scissor Excision or scissor removal is essentially a variation of Scalpel Sculpting, except that instead of a scalpel, a very delicate surgical scissors is used to cut away the growth. It is particularly useful for removing skin tags, which can be snipped off right at the base of the stalk. Here again, no stitches are required and the results quite gratifying.
Curettage is another no-stitches sculpting technique. It is a kind of skin scraping performed with a special instrument called a curet, hence the name curettage. A curet is a cutting instrument with a round or oval, loop-shaped cutting edge and a handle, and is available in varying sizes. Largeer curets are used for removing larger growths. Curets are used to “scoop” out or off an unwanted area. If the site to be removed is small, anesthetic may not even be required.
Wire Loop Removal is still another variation. This procedure is once again similar to the other three methods described, except that here a wand with a wire loop at its tip is used to encircle the lesion. A radiosurgical device supplies the radiowave energy necessary for the loop to “melt” through the base of the growth and free it up from the underlying normal tissue and sculpt it away. Radiowaves are the energy source that runs your AM/FM radio.
The accompanying before and after figures illustrate the results of this technique for removal of a mole from the upper eyelid.
Sculpting procedures generally run between $150-$300 for each area, depending upon the size, the exact method used, and the location of the lesion.
Q. Describe the usual healing phase after sculpting procedures.
A. A scab usually forms within the first 48 to 72 hours that eventually falls off sometime between days 14 and 21. Although the wound site is entirely healed by this time, there is usually a pinkish/purplish discoloration that remains temporarily, eventually fading sometime between four weeks and twelve weeks afterward. During this period, the site will ordinarily pass through a series of additional color changes that range from dark brown to fawn colored before returning to normal flesh color.
Q. Can numerous growths be removed in one session?
A. Yes, in an otherwise healthy person there is no reason not to. I have, in fact, removed as many as seventeen moles from a young woman’s face at one time in about half an hour. However, when that many are done at once, it is important to warn the patient that immediately afterward, and until the wound sites completely heal, they will appear as though they had an outbreak of acne.
For this reason, many people who have numerous unsightly facial growths opt to have them removed over a period of several sessions. When only three or four are done at once, it is easier to adequately mask them with coverup cosmetics until all the color changes of the healing phase are gone.