My rule of thumb is, if the lab says to remove the rest of something, I do it. You don't want to mess around with moles that are doing funny things- melanoma can kill you! Now, it's probably not melanoma, but best to get rid of it because of "unusual features." Traditionally, a rim of normal tissue is removed along with the lesion. The amount of normal tissue depends on the findings from the biopsy. You would have a scar, but with plastic surgical techniques, the scars that result from facial reconstruction can be very satisfactory. Good luck!
Moles and the periodic examination of suspicious moles are very important. I would definitely listen to your dermatologist if the pathologist recommended more removal. Ignoring a mole that is atypical will only create a larger problem later on. Please return to your treating dermatologist for discussion and re-excision if necessary.
If the lab really said "some unusual features" when describing a mole then they are not giving the doctor and the patient enough information. And if the lab recommends taking the rest of the mole out, that still doesn't mean that surgery is necessary. It's up to your doctor to interpret these results in the clinical context and treat the patient, not the lab report. I would never remove a mole simply because the lab report said I should. It is very important to make sure your biopsy was read by a dermatopathologist, a doctor who specializes in skin biopsies. Moles with abnormal cells are called
atypical nevi. Your doctor needs to find out just how "atypical" these cells
were. Saying they have "unusual features" is not enough information. In our
office, we will do an excision with suture closure to get clear margins for all
moles that have moderate to severe atypical cells. For a mildly atypical mole
we will observe the area and, if any pigmentation recurs in the biopsy site in
the future, a very small excision is done (often with a small punch biopsy
tool) for a minimal scar. We also follow all of our "atypical mole"
patients by doing full skin examinations at least every six months.