Mole Removal for Slightly Raised Facial Mole?

Moles, often called "beauty marks" or "birth marks," are pigmented skin growths that may be completely flat or project above the skin surface. Typically, they may range in color through the entire spectrum of browns, from fawn-colored to extremely dark brown. Ocassionally, they may even be blue or nearly black. Removing them for cosmetic purposes, particularly from the face and neck, is a routine, simple, in-office procedure that takes less than five minutes to perform.

Scalpel Sculpting is my favorite method of removal since this technique does not require deep cutting into the skin nor sutures (stitches) to close the wound. The procedure is quite simple. The area directly under the mole is anesthetized locally with a tiny drop of lidocaine and then the surface of the mole is "sculpted" with a scalpel horizontally flush with the skin surface to leave a completely smooth area. The removed tissue is then sent to the laboratory to confirm that it is entirely benign and the "scratch"-like wound is left to heal by itself.

I strongly advise against any removal techniques, such as lasers, cautery, freezing or acids that simply destroy the tissue and do not permit laboratory confirmation that the mole is entirely benign and contains no evidence of malignant melanoma (mole cancer).

Following scalpel sculpting, the normal skin surrounding the wound supplies new cells to cover the surface of the wound, which heals by itself completely in about seven to ten days. During this time, little care is required, except for covering the wound with some ointment and a Bandaid.

Hairs growing out of moles will not be treated by this method, since the cutting is so superficial and the roots of the hairs are so deeply situated within the skin. However, these may be treated by electrolysis of laser hair removal at a later date.

Since scalpel sculpting requires no deep cutting nor the placement of sutures, there is little chance of any scarring and no chance of leaving stitch tracks. Because most moles have some sort of root that is located below the surface, there is a small chance of a recurrence, which can easily be treated in only a matter of moments. Most people are extremely gratified with both the simplicity of the procedure and the cosmetic results.

Mole removal begins with a comprehensive examination and consultation to determine the likelihood of a mole being worrisome. Excisional and incisional biopsies are reserved for suspicious moles. But it’s good news that most moles are not problematic and are only cosmetic, thus leading to the option of scarless or non-surgical mole removal with lasers and RF and plasma. Our office specializes in non-surgical mole removal.

Best,
Dr. Raffy Karamanoukian
Realself 100 Surgeon

Usually I will perform a shave excision followed by low energy cautery. This typically results in no scarring, with a small chance of recurrence. Any time the skin is incised there is a small risk if getting a bad scar. The risks in your particular case would be assessed by your doctor.

The mole can be removed using plastic surgery techniques and likely get good results.  I have removed a number of moles like this.  Below is link to a patient review posted on realself with a similar mole to yours.

This mole can either be completely surgically excised or a shave excision can be done.  Either way, it should be sent to pathology for evaluation.  

From your picture this is a benign probably intradermal nevus. A "shave" excision as some dermatologists sometimes do will leave a "crater" or small contour deformity type scar...also the nevus has a decent change of coming back. I do quite a number of these and excise them precisely in the direction of the skin lines (Langer's lines) and send them for pathology just to be sure it is not something malignant or worrisome. Then I close the incision precisely with very small sutures and they heal great with a small "linear" (line-type) incision that once completely healed is usually imperceptible.
Hope this helps!

Unfortunately, it's really hard to tell from a picture how I would go about removing your mole. The first question is, how much does it bother you? When you are requesting the removal of a mole on your face, neck, chest or very visible location, I always ask my patients, "on a scale of 1-10, how much does this bother you?" If the answer is 8 or more, then trading a mole for a tiny scar is worth it. I typically will use a shave technique which means that you will be left with a small indent, where the mole was removed. this will heal in over time and eventually will become less noticeable. It is very important that you keep the area covered and once healed, use excellent sun protection to avoid hyper-pigmentation. 
Good luck and I hope this answer has been helpful.
Best regards,
Sheetal Sapra, MD

My preferred technique for most facial moles other than the most superficial/raised and small ones is to excise them and suture the incision. This ensures the entire base of the mole is removed to eliminate the chance of recurrence and also refines the scar or blemish that might form. Shaving can work very well for moles that are very raised and superficial almost looking like they're stuck onto the skin surface, especially if quite small. I find shaving larger moles too unpredictable in terms of the healing results.

It is called Waterlase. It is a laser commonly used in dentistry but approved for skin treatment as well. The best part is that no anesthesia is needed.It uses a combination of water and air to keep the laser-tissue interface cool allowing moles and many other skin lesions to be shaved down to the "root" of the mole or pigmented spot with little to no damage to the adjacent dermis. The treated area will heal completely in 3 to 5 days. About 10 to 20% of the time a second touch-up treatment is needed if the lesion appears as if it is not completely eradicated after everything has healed following the initial treatment. Pigmented or non-pigmented lesions that have been present for one or more years, and have not changed in size, shape or color over that period are reasonable to treat with this laser because of the extremely low chance of malignancy. The typical mole that grows hair is particularly unlikely to be a cancerous lesion. No injections of local anesthesia are required and no sutures are needed because the wound is too superficial to require closure. This makes the treatment simple and cost-effective. But the real advantage of this laser over all others is that it is so gentle to the surrounding tissue that the treated tissue regrows new skin to cover the superficial wound without any visible scar where the mole had once been. Check out the youtube video below for more information.

From the single photo you posted, I would likely recommend the mole be excised and the base gently sculpted.  This is done in my office surgical suite and takes about 30 minutes. You should be able to have an excellent result.  I remove moles like this from people's faces routinely.  Many doctors perform mole removals, but this mole is in a key spot on your face. Be sure to pick an expert with specific training in this specific type of facial cosmetic surgery.  I would recommend an in-person consultation with a board-certified, fellowship-trained Oculofacial Plastic Surgeon with extensive experience in face mole removals. Ask to see before and after photographs or reviews from prior patients. You can peruse my website for an extensive gallery of before and after mole removal photos -- all unretouched! Good luck to you!
Damon B. Chandler, MD
Harvard-Penn Trained Oculofacial Plastic Surgeon