Ellipse excision is the simplest and commonest form of surgical treatment and involves cutting out a boat shaped section of skin containing the cancer, and then using sutures to bring the edges together.
The doctor will usually undermine the edges using a scalpel to free up movement, and often diathermy is used to minimise bleeding. Sutures are then placed on opposing edges to bring them together and tied using a surgeons knot. The sutures may be external or internal or a combination of both. Areas of high tension and movement such as the back and shoulders are areas when internal sutures with a long dissolving time are used to minimise stretching of the scar. Wound healing is generally rapid, but can take many weeks or months before the wound becomes sufficiently strong to resist strong forces on it without stretching or even tearing open. The sutures are removed when the wound is strong enough to withstand everyday movement, but will generally need taping and care for many weeks to give optimum scar results.
Complications are generally uncommon but can include wound dehiscence (coming apart), wound infection, bleeding, haematoma formation (a lump under the wound due to blood accumulation), keloid scarring, and incomplete excision.