Eyebrow mole removal concerns. Should I see a dermatologist or a plastic surgeon?

Question

Hi Dr. I'm about to turn 21 very soon and have made the decision to have my mole removed. I've had my mole since I was seven. It is located right in between my eyebrows, and is a bit smaller than a pencil's eraser. Because of its location, I am extremely nervous about having it removed, but I feel as though it is now or never. How can I go about finding the right doctor? Should it be a dermatologist or a plastic surgeon? Any important questions I should ask a doctor? Please help!

Nelson Lee Novick, MD · Answer

If you&rsquo;ve always wanted to have a mole (beauty mark, birth mark) removed, but hesitated because of the fear of stitches, scarring, or the expense of surgery, the quick and simple, minimially invasive, no-stitches-required techniques described below may be just right for you.

	Scalpel Sculpting is an excellent method, especially for removing growths elevated above the skin surface. Immediately following the administration of a small amount of local anesthetic just beneath the spot, the doctor uses a scalpel to remove it with a horizontal, back and forth, &ldquo;sawing&rdquo; motion of the scalpel blade that essentially &ldquo;sculpts&rdquo; the undesirable area away from the surrounding normal skin. The wound underneath is left to heal by itself. Since the cut is so superficial, no sutures (stitches) are needed, and there is little risk of scarring. The cosmetic result is generally excellent, and the whole procedure takes literally under five minutes.

	Scissor Excision or scissor removal is essentially a variation of Scalpel Sculpting, except that instead of a scalpel, a very delicate surgical scissors is used to cut away the growth. It is particularly useful for removing skin tags, which can be snipped off right at the base of the stalk. Here again, no stitches are required and the results quite gratifying.

	Sculpting procedures generally run between $150-$350 for each area, depending upon the size, the exact method used, and the location of the lesion.

Dev Wali, MD · Answer

Using plastic surgery techniques there are ways to minimize the appearance of scars. Often times a plastic surgeon can plan the incision to fit into existing skin creases or anatomic shadows. It is also important to understand what makes a scar visible and understand which surgical maneuvers can minimize these problems.

Sam Naficy, MD, FACS · Answer

There are a few options to consider. Would you be better off with a shave excision or a complete surgical excision? For either options, I recommend that you see a plastic surgeon or an experienced dermatologist.

Thomas A. Lamperti, MD · Answer

A Facial Plastic surgeon, Plastic Surgeon or Dermatologist can all have the training to perform a facial mole removal. You want someone with extensive experience with doing this, especially on the face. Whether or not it is removed via a shave technique (and left to heal without sutures) or excision and suture closure depends on its location and how deep within the skin it extends. No matter the technique used, there will be a scar. The hope is that you trade a pigmented mole for a fine, faint scar.

William Ting, MD · Answer

Not all moles are created equal. If the mole is pigmented and if the goal is aesthetic removal, simple excision is the way to go by either a board-certified plastic surgeon or dermatologic surgeon. Completely flesh-colored moles however, may benefit from shave excision by an experienced dermatologist where there will no stitch mark and if you are not completely happy with the cosmetic outcome, simple excision is always an option. But if you cut it out and repair it surgically, there is no going back.

Sanusi Umar, MD · Answer

Both a dermatologist and/or a plastic surgeon can get remove the mole for you successfully. Some questions you may want to ask is, "What type of procedure will he be doing? What kind of scar would it leave? What is the plan for the excision for the mole? How large of a wound will it create? What is the downtime for this type of procedure?" All of these types of questions will keep you well informed and allow you to feel safe and comfortable with the procedure.

Anil R. Shah, MD · Answer

Dermatologist, Plastic Surgeon, Facial Plastic Surgeon can all be excellent options for mole removal depending on the location and the physician's experience in mole removal. Key is determining the right procedure for your mole and technique.

Raffy Karamanoukian, MD, FACS · Answer

A mole can be removed effectively by both a plastic surgeon or dermatologist familiar with cosmetic surgical techniques. I am biased toward a plastic surgeon since I am board certified by the American Board of Plastic Surgery, but I have seen very good work by dermatologists as well. We all work together to acheive common goals. Good luck

Curtis Wong, MD · Answer

will alway risk a scar. My colleagues have elaborated on this and if you have already pursued it, I hope it has turned out to your satisfaction. My philosophy when approaching moles is to start simple and save the more complex procedures to salvage unsatisfactory situations. If a patient presented to me with the same problem as yours, ablation or excision would be discussed. Ablation would be recommended unless the mole was hairy, in which case the follicles have to removed by excison or lasered at a later time. If my patient did not like the resultant scar, then an excision would be pursued with the simplest closure which is the purse-string. In my experience, this technique has always produced a satisfactory result. And if it didn't, the the more traditional plastic surgery techniques of complex closures and flaps would have to be considered. The lesson is not to burn any bridges. Best wishes!

Andrew Kaufman, MD · Answer

The best thing you can do is discuss with the doctor how they plan to remove your "mole." If it is skin colored, they might consider shaving it off. If it is pigmented, they'll have to remove and suture it. An experienced dermatologist or plastic surgeon should be able to remove the lesion with the minimal amount of scarring. As our office is in Thousand Oaks, I know that there are many good dermatologists and plastic surgeons in your area quite capable of performing your procedure.

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