Mole/birthmark Removal, Should I Do It Surgically or with Electrocautery?

Dark Brown or Black Pigmented Birthmark removal
The best way to remove this would be direct excision with closure in such a way to leave a minimal scar. . Lasers are generally not used and it is customary to send what was removed to a pathologist for analysis to make sure it is not worrisome.

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

Complete surgical excision is recommended in this case.  It is advised to send the specimen to pathology for complete analysis to confirm whether it is benign or malignant.  With this procedure, you will be replacing the lesion with a linear scar.