How Long After First Mole Excision Should I Wait Before Having Second Surgery?

There is no need to wait very long to excise the lesion as you will need more excisions to remove the actual lesion. We usually recommend repeated surgery every 4-6 weeks to give time for the wound to heal and skin to stretch. I wouldnt recommend any injections to this scar as it will be coming off completely with the lesion.

It would be a different story if there was no lesion to remove. For hypertrophic scars we try injections within 8 weeks. and would not excise before 6 months to a year.

I would wait about 1 month. Also, I would follow up with the doctor who performed your original excision for injections of mild steroid to decrease how thick the scar is. Vitamin E oil massage may also help.

There are two issues here:

1. If the mole is abnormal in any way, there should not be a lag between the first surgery and complete removal of the mole.

2. There are several reasons people heal with hypertrophic scars.

a. It could be a genetic predisposition, in which case the chances of healing with a hypertrophic scar after the second surgery remains.

b. The excision was oriented against skin tension (relaxation) lines.  If the second excision can be oriented somewhat differently, there is a chance it would heal well.

c. Your photo doesn't really show which part of the cheek the mole is on.  On certain highly mobile areas of the face, like at the jawline, scars tend to be thicker and more red than on others.

Consult with a board-certified surgical dermatologist or plastic surgeon regarding the re-excision of the mole and discuss exactly the questions you are asking here.

Do not use anything like Vitamin E on the scar as it tends to make scars worse, contrary to popular belief.

There are treatments for hypertrophic scars like Kenalog injections and laser treatments but it's best if they are instituted within 6 weeks of excision.  But it is better to have the excision done in such a way as not to need them in the first place.