Just two days ago I had three moles removed. I had seen a dermatologist who advised me they looked benign. The size ranges from 6mm to the largest being 13mm. As they were considered benign removal not covered health plan. I therefore went to a skin clinic and was offered an excision. I figured this meant total removal but in fact was a shave excision. This was a shave and sent for pathology. If report is bad can something still be done or did having the shave excision mess this up?
Shave Excision for Moles. Risk?
Doctor Answers (3)
It is common for lesions to be biopsied first and confirmed by pathology to be either benign or not prior to a complete surgical excision.
Risk of a shave excision for moles
In the technique of doing a shave excision, the mole is actually "shaved off" at a very superficial level just below the surface of the skin. This method is quite effective to remove moles and leaves a minimal scar. The procedure typically takes less than a minute, and is fairly painless. There is no increased risk in this method because if the mole is found to be cancerous or precancerous it can always be excised at a later date to ensure its complete removal.
Shave Removal for Moles
Something can always be done. The problem with shaving is only if the lesion is a melanoma and only if the shave transects the melanoma. In that case it makes it more difficult to say how thick the melanoma is, and thickness is the most important prognostic factor in melanoma. Shaving through a melanoma does not negatively impact a patient's prognosis (i.e. doesn't cause the melanoma to spread).
Shave removal is done frequently for benign appearing pigmented lesions. If the lesion is suspicious for melanoma, an excision of the lesion is performed or an incisional (sampling) biopsy is performed.
Usually, I don't perform shave excisions on flat moles because it might leave a depressed scar. In those cases I would frequently remove the lesion and suture it closed. One potential downside to shave removal is that sometimes if not all of the nevus cells (cells which make up the mole) are removed you can get some recurrent pigmentation developing.
Again the best decision should be made after a discussion between the patient and their physician. Good luck.