Are there stitches involved? 

Sutures are used for closure of ellipse excisions, and these need to be removed at 7-14 days, depending on the site.  Most are removed at day 7 but lower legs take longer to heal. 

Do I need to come back to have the stitches removed?

Deep sutures dissolve by themselves over an extended period of time, however if they poke out through the skin at any stage in the healing process, they are usually removed to allow the wound to close completely. 

Shave excisions do not need sutures and heal up like a graze wound with appropriate dressings and wound care. 

Melanoma Scan - Skin Cancer Clinic

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Diathermy and Curettage is a treatment using a semi sharp instrument to scrape out the cancerous tumour and uses diathermy to destroy a further margin of surrounding tissue and stop bleeding.

Flap surgery is a plastic surgical technique which is used for treatment of skin cancers where a simple elipse would not suffice.

The Melanoma Scan doctor and nurse will give you detailed instructions on how to care for your wound to reduce scarring. 

Any procedure to remove a skin cancer will cause a scar and some people will scar more than others depending on their tendency towards keloid scarring and their skin type.  Scars tend to settle to a pale mark, either a oval area after curettage and cautery or as a line from excisional skin surgery.  If there is a lot of background sun damage, this pale area can become more prominent and noticeable.  Background sun damage can include solar keratosis, freckles, pigmentation, age spots and telangiectasias (dilated small vessels on the skin surface).  All of these lesions can be treated, either as individual lesions or as part of a field treatment such as efudix, PDT, lazer, IPL or skin peels. 

Mole removal occurs it two ways, either a shave excision, which is very quick, or formal ellipse excision, which takes a little longer.  Shave excision is a technique that involves putting a small amount of local anaesthetic under the mole and then using either a straight or curved blade, which is passed through the skin directly under the mole, resulting in the mole being removed with a narrow margin of normal tissue under and around it.  Occasionally, if the mole is being removed for benign reasons (for example, it is raised and gets in the way of shaving and repeatedly traumatised) the doctor may remove the raised part of the mole and leave a small amount of mole tissue behind, in an effort to minimise any visible scar or depression left by the mole removal.  This procedure normally takes between two minutes and 5 minutes to do, using low sting local anaesthetic, which has the dual advantages of hurting less and giving almost immediate numbing to superficial lesions like a mole.  This type of mole removal can often be incorporated into a skin check or 15 minute procedure time.

Formal ellipse excision takes a little longer, because a larger area of skin needs to be numbed, and a formal excision setup needs to be done by the doctor or nurse. The mole needs to be removed as an ellipse of skin (boat shaped piece of skin removed) and the wound sutured, usually in two layers, closing both deep and superficial parts of the skin, minimising the risk of scar stretching and tram track marks being left behind from the sutures.  A typical mole removal using this technique takes about fifteen minutes to perform when assisted by a nurse, or 25 minutes without the assistance of a nurse. 

Is it a standard procedure time?

A shave excision can be done in a standard 15 minute appointment, however, an ellipse excision is usually booked into a 30 minute procedure appointment, so it depends on the technique that you have discussed with your doctor.

Melanoma Scan - Skin Cancer Clinic

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Large numbers of moles are associated with both a genetic predisposition to mole formation, and an increased sun exposure in childhood as a trigger for mole formation. 

Moles in at risk individuals, tend to cluster in areas of previous sun exposure and sun damage, including areas that have been sunburnt in the past.  In this way, large numbers of moles can act as a marker for people at increased risk of both melanoma and non melanoma skin cancer (such as BCC and SCC). 

If you have large numbers of moles, particularly if you have odd looking or asymmetric appearing moles, then a regular (at least annual) skin check with an experienced skin cancer doctor is recommended because you may be at higher risk of melanoma, particularly with advancing age, although melanoma can occur in any age group.

Melanoma Scan - Skin Cancer Clinic

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Not all moles are dangerous but sometimes the location can be annoying causing irritation. At Melanoma Scan we perform cosmetic mole removal with simple in-house surgical procedures.

Photodynamic Therapy (PDT) is a treatment based around the compound of two chemicals. Both chemicals specifically bind to premalignant or cancerous cells, and when activated by a bright light, form a reaction that kills the affected cells.

Skin cancers are managed with either destructive methods or excision.  Radiation therapy is use in limited circumstances for aggressive skin cancer or for treatment of skin cancers where surgery or curettage is inappropriate or not possible. 

Skin tags are small benign growths attached to the skin by a small thin stalk. Skin tag removal is a simple process completed by a doctor. Removing skin tags at home can be painful and often bleed heavily or become infected.

Wedge excision is a technique used to remove cancers from the edge of the lip, ear or eyelid.

The Melanoma Scan doctor and nurse will give you detailed instructions on how to care for your wound to reduce scarring. 

Shave excisions

With Shave excisions, the best results can be achieved using moist wound healing, using antibiotic ointments such as chloromycetin ointment or otocomb on high risk areas for infection, or using strataderm or stratamed silicone containing gels for areas at risk of keloid scarring.  For some areas simple moist wound dressings using Vaseline, antiseptic creams or pawpaw ointment may be a low cost and suitable alternative.  Your doctor will recommend the treatment that he believes is most suitable for your particular wound and situation.

Ellipse excisions

With ellipse excisions, taping is an important aspect of wound care to prevent a stretched up scar despite the support of the deep sutures. Equally important is abstaining where possible from exercise for up to 6 weeks following surgery.  That may not always be possible with people engaged in manual work, but often with care and getting assistance with lifting and carrying, stretching of the scar can be minimised.

Keloid scarring is a feared outcome for all excisions, however is very uncommon outside of a small group of people who appear to be prone to them.  In this group, silicone gels are utilised and the wound is reviewed 3-4 weeks after surgery to see if there is any sign of keloid formation, which can often appear after apparently normal early healing as a raised red itchy and uncomfortable scar.  Occasionally steroid injections may be used to halt keloid formation or reduce an established keloid scar, but the results are not always satisfactory in this keloid prone group of patients.

Melanoma Scan - Skin Cancer Clinic

For further information, please feel free to Contact Us or follow the link to request an appointment by clicking Book Now.

Melanoma Scan doctors are dedicated skin cancer doctors, who are focussed on giving you the best outcome of your mole removal. 

Whether it is a cosmetic shave excision, or a biopsy to diagnose or exclude melanoma, your doctor will provide you with the best experience possible under the circumstances, and the piece of mind that your mole will always be tested to exclude the possibility of melanoma or other skin cancer in the tissue.

We are dedicated to giving you the best possible cosmetic outcome as well, especially where the mole is removed from the face or body because it is raised and getting traumatised or just generally “in the way”.  In these examples, our primary focus is on achieving an excellent cosmetic outcome. 

Where melanoma is a possibility, the focus is on giving the pathologist the whole lesion to analyse, so a larger wound may be required, which of course can take longer to heal, but will ensure that the most accurate diagnosis is achieved. Your doctor will guide you through the process step by step to ensure it is pain free and minimise inconvenience.

Melanoma Scan - Skin Cancer Clinic

For further information, please feel free to Contact Us or follow the link to request an appointment by clicking Book Now.