Questions About Types of Mole Incision? (photo)

I have a large mole below my right nostril & want it removed. I don't know whether to see a dermatologist, dermatologist surgeon or facial surgeon. What are names & type of incisions better to remove the mole & leave less scar? I've looked online & there are incisions made vertical or horizontal. Which 1 of these is best for my case? What is fusiform & elliptical excision? What questions do you recommend for me to ask the doctor. I'm nervous about the procedure & would appreciate your help.

Doctor Answers 5

Scalpel Sculpting and Dermaplaning Work Well For Removing Facial Moles (Beauty Marks, Birth Marks)

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Although removing larger moles by any method from the face is likely to leave a small scar, scalpel sculpting, which involves no deep cutting or stitches has, in my experience, proven quite successful for achieving gratifying aesthetic results while leaving little, or often barely perceptible, scars.

The technique, which I have been using for thirty years, involves "scultping the mole" off from the surrounding skin in a tangential fashion (i.e. not cutting deeply into the skin). Deep cutting will inevitably result in a scar, while superficial (horizontal) removal in this fashion largely avoids this. Elliptical and fusiform simply describe the resulting shape of a wound excision after cutting them out deeply and before the placement of the sutures. 

Following scalpel sculpting, the borders of the mole can then be smoothed and blended with the surrounding normal skin by "dermaplaning," a technique by which the edge of the scalpel is used to delicately abrade the skin. Properly done, the entire procedure, performed under local anesthesia, takes no more than three to five minutes. Perfectly flat moles (beauty marks, birth marks) can be elevated a tad with the local anesthetic and then more easily scalpel sculpted away and shaped to the contour of the surrounding skin.

Minimal Scarring for Mole Removal

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Shave excision with vaporization with either laser or ellman radiofrequency device has yielded consistant results. Linear scars seen with excision and suture closure are seen by the eyes of an observer much more rapidly and are detected as unnatural in appearance.  A circular defect even though pigment irregularity may be seen by the observer as a natural pox, acne, or blemish scar is usually dismissed. Avoid UV exposure for over 6 weeks after your procedure. M.Lyons,md

Michael B. Lyons, MD, FACS
Mobile Facial Plastic Surgeon

Best methods for mole removal

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Depending on its size and location, facial moles can be easily removed by either a shave excision or a standard elliptical shaped excision with sutures. Either method, done properly, should result in a minimal scar.  I would recommend being evaluated by a board certified dermatologic surgeon to decide which would be best for your particular mole as plastic surgeons rarely do shave excisions.

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Mole Removal Techniques

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There are a number of ways to remove moles from the skin. One technique that is used frequently is a shave excision. In this procedure, the physician will literally 'shave' the mole off so it is flush with the skin. A special solution, electric needle or laser can then be used to stop bleeding and blend the scar in with the surrounding skin (kind of like airbrushing). This leaves minimal scarring after the procedure, but may leave a slightly hypopigmented or whiter area of skin where the mole was located.This technique is extremely affective for superficial moles that do not have deep roots, and provides excellent cosmetic results.

In another technique, the doctor actually cuts the skin to remove the mole and then closes the skin with stitches. Round moles are cut out in round circles. However, when you try to close a circle side to side, you get puckers or pleats that stick up from the skin. In order, to make the scar less noticeable and lie flat, the 'circle' is turned into an ellipse/fusiform or football shape so the skin closes better. With this technique, a very fine line scar can be left behind that often fades with time.

Both of these procedures can be performed under local anesthetic without putting you to sleep. Unfortunately, there is no way to cut the skin without causing some scar or mark. However, skilled physicians are trained in these techniques and have ways of minimizing any scarring that might result. Often scars are hidden in natural folds in the skin.

It is hard to make a recommendation based on your picture. Your doctor should be able to evaluate your lesion and suggest the best treatment for you. Make sure you discuss all of your concerns before your treatment.

Adam J. Mamelak, MD
Austin Dermatologic Surgeon

Mole removal under the nose should turn out very nice.

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Excising the mole under the nose should turn out very nice and have a good cosmetic result. It would be done under local anesthesia and a slight swiggly curvature to the incision with overlying superficial dermabrasion to help camaflouge it and fine buried sutures. Good Luck, David Hansen,MD

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.