How Painful is Mole Removal by Electrocautery Without Any Anesthesia?

Mole removal via electrocautery without anesthesia sounds like something used in a Medieval torture chamber, not a treatment done in a Surgeon's office. It is a bad idea from an oncologic standpoint as mentioned (margins cannot be determined) and a bad idea from an analgesia standpoint (Lidocaine works very well and is very inexpensive).

We generally do not advise mole removal by the electrocaustery method. One of the reasons for mole removal is to evaluate for the presence of disease (benign or malignant). Electrcautery destroys the lesion completely and does not provide for a specimen. Secondly, the mole typically extends to the dermis and electrocautery at the dermal level can produce scarring.

I see red flags. If the lesion us near the eye, anesthesic agents should be used. I know of no plastic surgeon who charges for local anesthesia. I would not perform a procedure without appropriate anesthetics and you should inquire why your physician believes that it is appropriate to do so and, if you aren't satisfied with the response, seek another opinion. Electrocautery does not provide a specimen for pathological evaluation which is importan to rule out skin cancer. There should also be concern as to the secondary healing from cauterization and the scarring which can result.

I would suggest getting a second opinion. There is no place around the eye where a mole grows that I would not inject anesthesia. I would also agree that electrocautery would destroy the mole and preclude sending for a pathologic evaluation. In the end, I think a second opinion with a facial plastic surgeon, dermatologist, or plastic surgeon is in order.

Several things in your question raise alarm bells.
1. Saving less than 1 dollar in local anesthesia cost. Being cut or burned hurts. Being cut or burned on the face hurts more. You should not have to endure and "bear" a painful procedure and I have a real problem with any physician who would put you through this.
2. I agree with Dr. Placik. As important as removing a mole is making sure that it was not cancerous OR if it is a cancer what kind it was, was all of it removed and how deep was it.
3. Lastly, burning (as you are about to have) or freezing a mole damages the wound edges and does NOT leave a nice scar. A MUCH nicer, less visible scar is obtained by cutting it out with a scalpel and properly closing the wound with stitches.
Dr. P. Aldea