I have huge nevus on my buttock, so look like weird, I want to remove it - is it possible? (Photos)

Question

Huge dark brown spread to whole my right side buttock, i am worried about that,

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Alexander M. Sailon, MD · Answer

Hi there,
Based on the photographs provided, you appear to have a giant congenital hairy nevus. There is about a 5-10% lifetime risk that this nevus will convert into a malignant tumor, melanoma. I would recommend consulting with both a plastic surgeon and a dermatologist. The simplest solution would be to excise the entire thing and place a skin graft, but this would leave you with a significant deformity. Otherwise annual surveillance is a good option with a low threshold to biopsy any concerning areas. Best of luck!

Thornwell H. Parker, III, MD · Answer

This nevus or birthmark is typically referred to as a "giant hairy nevus" or "bathing trunk nevus" or "giant congenital melanocytic nevus."  An important reason to consider removal is that these nevi are thought to carry a significant risk of developing melanoma overtime.  Many scientific papers have been written trying to determine what the risk of melanoma is, but there is no consensus...anywhere from 2% to 42%.  During my training years, we most often cited a risk of around 7 to 14%
Surgical removal is possible, and typically the best option, but complicated by the large size, necessitating advanced reconstructive procedures.  Plastic surgeons most often perform these reconstructive procedures.  The most common techniques involve either tissue expansion, serial excisions, and/or skin grafting.  Each of these techniques has advantages and disadvantages, and each would likely be a difficult and long process.  However, with the significant risk of melanoma, the benefits of removal may far outweigh downsides.  I would recommend seeing a skin specialist (dermatologist or plastic surgeon) to have you nevus inspected and begin discussions regarding surgical removal.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Hard to remove, surgical over laser, many sessions needed. Not advisable for the morbidity. The main thing is cancer surveillance for melanoma risk 2-6% in the literature. Overall lifetime risk, not annual. You do need to see a dermatologist for photography and check ups in your best interest. Dr Davin Lim

I have huge nevus on my buttock, so look like weird, I want to remove it - is it possible? (Photos)

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