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

Hi I have this mole/birthmark its a completely flat brown nevus on my arm probably 1 cm wide and I have always felt insecure about it and finally at 20 ive decided im going to get it removed. I went to a laser clinic and they told me that because its very deep, I would need electrocautery laser to remove it. However, thats going to leave white scarring and and its going to cost 500$. Do you think I should go with electrocautery or have it removed surgically? And what would be the less scarring?

Doctor Answers 6

Dark Brown or Black Pigmented Birthmark removal

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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.

Mole removal

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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.  

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Nevus removal

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Surgical excision is recommended as this will produce a specimen for pathologic analysis and completely remove the lesion. The lesion will be replaced by a linear scar and a board certified plastic surgeon can use closure techniques to create the best possible scar. Full excision is covered by most insurance plans.

Surgery is preferred method for removing nevus (mole)

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Surgery is definitely the preferred method to remove a mole (nevus) for two reasons.

One:  it works better cosmetically and Two: any mole removed should be sent for pathology to exlude cancer. 

A one centimeter mole is larger than usual and warrants pathologic exam - this should be covered by insurance.

Electrosurgical destruction will probably not completely remove it and will generate heat, causing longer healing and usually a less desirable scar.  

I have removed thousands of moles and am well versed in all removal techniques. 

Robert Strimling, MD
Las Vegas Dermatologist
4.3 out of 5 stars 9 reviews

Surgery vs electrocauterization for birthmarks

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The vast majority of moles/birthmarks tend to be benign.  A small portion may be malignant (ie, melanoma) or pre-malignant (ie, dysplastic nevus).  Although you would be trading your mole for a surgical scar, the major advantage would be complete excision of the birthmark so that there is no chance of developing a malignant, albeit rare, complication.  Also, you would be obtaining a firm diagnosis which offers peace of mind.  Depending on the source, there is approximately 1-10% risk of developing melanoma or other skin cancer in a given birthmark over a lifetime.  This can be a substantial risk for some individuals, who may wish to eliminate the worry from their lives.  Electrocautery would destroy the lesion but there are several disadvantages: 1) it may not destroy all microscopic elements of the birthmark, especially the deeper cells located along the hair follicles in the fat layer; 2) it will likely still leave a scar or indentation in the skin; and 3) you will not be able to get a diagnosis if the birthmark looks worrisome.  For these reasons, I routinely recommend surgical excision which more reliably addresses the problem and gives us a diagnosis.  It also allows the complete elimination of even the deeper parts of the birthmark that are located in the fat layer of skin and can be frequently missed by lasers or electrocautery.

Andre Panossian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 4 reviews

Mole should be removed surgically

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Thank you for your question.  There are various ways to remove birthmarks, depending on its etiology.  For example, a birthmark caused due to a vascular problem needs a completely different treatment than a birthmark such as a mole.  More often than not, vascular birthmarks need to have some form of laser treatment.  They can require more, but a laser is generally a minimum.  Other birthmarks such as a mole, can be excised in the office with relative ease.  The size and location will determine the final outcome.  A photograph always helps but there is no substitute for and in person physical examination.  Make sure you visit with a board certified plastic surgeon for the best outcomes.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.