Nevus removal. I wish to remove my congenital nevus birthmark and I need advice on tissue expanders and price! (Photo)

I would recommend surgical excision and a full thickness skin graft to treat the large nevus to your wrist.  Staged excision could be considered if there is enough skin laxity but risk creating problems of narrowing the wrist and not being able to remove all the nevus.  Use of tissue expander is possible but very tricky to do well in this location and requires a two staged operation.  A board certified plastic surgeon with experience treating this problem would give you the expert opinion and treatment you want. This is covered by most health insurances. Good luck!

You have an epidermal nevus that can be removed one of three ways.  Serial excision, excision with flap closure or tissue expansion followed by excision and closure.  Serial excision might serve you best meaning you cut it out over a series of two or maybe three sessions.  Most often two will suffice.  More photos would make it easier to tell.  Malignancy in epidermal nevi is low but always a possibility so excision is always recommended.  There are several people here or in New York I would recommend.