John Louis Ratz, MD

Beauty is in the eye of the beholder. And that is a very BIG problem. What you consider beautiful may not be the same as what the doctor considers beautiful. From your photo, it appears that your left cheek is fuller than the right, and this could be improved by fat removal. But deciding really n~ds to be done in person and not from a photo. Aesthetic consultations are usually free of charge. I suggest you have several opinions from several doctors. It may help to get a better idea of what you should have done. jlr

Anything can be cut out. It could also be lasered out. There are 2 problems with removal. One is that, regardless of how it's removed, you will be left with a scar. And NOBODY can tell you what that scar may look like. The second is that you may still be left with some residual tattoo pigmentation. Another solution you can consider is having it retatooed with a more acceptable subject. So, consider your options and choose wisely. jlr

Melanoma is the most dangerous skin cancer to have. Delaying treatment is extremely dangerous. In fact, the only melanoma patients I have ever lost are those whose treatment was delayed by at least one week. Although other doctors may have differing opinions, mine is based on over 40 years of experience, most of which has been in academic centers. Why, in heaven's name, would you, risk your life? 

The mole you have is unusual in several ways and should be removed. The feeling about treating melanoma varies with each doctor. My feeling on suspicious lesions is complete removal and sending the specimen for a STAT report which is having the report ASAP, usually 48 hours. I have the patient come back as soon as the report is received. I go over the report and if it is melanoma, remove it immediately with the appropriate margin suggested by M.D, Anderson. The most important aspect regarding melanoma is its depth, which determines the extent of the wide excision.

I believe that melanoma should be removed as quickly as possible and having the tissue findings incorporated with patient factors to determine how likely the melanoma will act in that patient. I will share with you that many doctors do not operate that quickly, which I believe is foolish. I am very aggressive with melanoma and fight to win.

I hope this answers your question and wish you the best of luck.         jlr

The defect you have is called a pin cushion and/or a trap door defect. It can be readily improved with fractional CO2 laser resurfacing. Be aware, however, that the result will depend on the experience and skill of the doctor performing the procedure. Hope this helps, and good luck in your selection of a doctor.           jlr