Which removal technique is best for a mole on on vermillion border and what are the chances of scarring or damage? (photos)

Mole removal begins with a comprehensive examination and consultation to determine the likelihood of a mole being worrisome. Excisional and incisional biopsies are reserved for suspicious moles. But it’s good news that most moles are not problematic and are only cosmetic, thus leading to the option of scarless or non-surgical mole removal with lasers and RF and plasma. Our office specializes in non-surgical mole removal.

Best,
Dr. Raffy Karamanoukian
Realself 100 Surgeon

Yes you will definitely have a little scar where that ugly mole is but any scar is better than the ugly mole. Surgical excision under local and 1-2 superficial dermabrasion to the edges will probably give the best results possible. Cost is roughly $1000 for the initial excision and so worth it.

Removing a mole on the vermillion border (the line separating the lip from the surrounding skin) requires careful consideration due to the aesthetic and functional importance of this area. The best removal technique and the potential for scarring or damage will depend on several factors, including the size, shape, and depth of the mole, as well as the patient's skin type and healing tendencies.

Common Techniques for Mole Removal on the Vermillion Border:

1. **Shave Excision:**
- **Procedure:** The mole is shaved off with a scalpel or a razor blade. This technique is generally used for raised moles.
- **Advantages:** Minimally invasive, quick, and with minimal downtime.
- **Disadvantages:** May not remove the entire mole if it is deeper, and there is a risk of recurrence.

2. **Surgical Excision:**
- **Procedure:** The mole is cut out along with a small margin of normal tissue. The wound is then closed with sutures.
- **Advantages:** Complete removal of the mole and lower risk of recurrence.
- **Disadvantages:** Higher likelihood of scarring due to the need for sutures and a more invasive approach.

3. **Laser Removal:**
- **Procedure:** A laser is used to break down the pigment cells of the mole.
- **Advantages:** Minimally invasive, less risk of scarring compared to surgical excision.
- **Disadvantages:** Multiple sessions may be required, and it might not be suitable for all mole types (especially deeper or atypical moles).

4. **Electrosurgery:**
- **Procedure:** The mole is removed using an electric current that cuts and cauterizes the tissue.
- **Advantages:** Quick procedure with minimal bleeding.
- **Disadvantages:** Risk of scarring and it may not be suitable for larger or deeper moles.

Considerations for the Vermillion Border:

- **Aesthetic Impact:** The vermillion border is a prominent and aesthetically significant area. Any scarring or irregularity can be highly noticeable.
- **Functional Impact:** Damage to the lip line can affect lip function and symmetry.

Potential for Scarring or Damage:

- **Shave Excision:** Lower risk of deep scarring but may leave a noticeable mark or pigment change.
- **Surgical Excision:** Higher risk of noticeable scarring due to sutures and the need to remove a margin of normal tissue.
- **Laser Removal:** Generally lower risk of scarring, but may not be effective for deeper moles.
- **Electrosurgery:** Moderate risk of scarring and pigment changes.

Recommendations:

1. **Consultation with a Dermatologist or Plastic Surgeon:** It's crucial to have a detailed consultation with a specialist who has experience in cosmetic and functional outcomes of mole removal, particularly in sensitive areas like the vermillion border.

2. **Consideration of Non-Surgical Options:** For smaller or less concerning moles, non-surgical options like laser removal might be preferable due to the lower risk of scarring.

3. **Post-Procedure Care:** Proper wound care and possibly the use of silicone gel sheets or other scar-reducing treatments can significantly improve healing and minimize scarring.

4. **Realistic Expectations:** Discuss with your physician the potential outcomes and understand that while techniques aim to minimize scarring, the unique nature of your skin and healing process will play a significant role.

The best technique depends on the mole's characteristics and your specific situation. Consulting with a specialist who can assess the mole in person and discuss your aesthetic and functional concerns will provide the best chance for a favorable outcome.

For this raised mole on the vermillion boarder, my recommendation would be to start with shave removal. When careful shave removal is performed, the raised aspect of the mole is removed and the normal anatomy is preserved. Pigment from the mole may sometimes recur and if that happens and bothers you and excision may be needed to remove the rest of the mole causing the regimentation. This is complicated in this particular location because it will leave a little line scar across the boarder of the lip which may always be somewhat visible.