Surgical Excision

Surgical Removal of Skin Cancer

If you have a known or suspected skin cancer, an excisional surgery might be recommended to remove the skin cancer along with a margin of healthy tissue. When Mohs micrographic surgery is not appropriate, surgical excision is typically performed to ensure complete removal of basal cell carcinoma, squamous cell carcinoma, or melanoma.

Surgical excisions are usually performed as outpatient procedures and may also be called shave excisions or excisional biopsies.

What Is Excisional Surgery Used For?

Patients with atypical or suspicious moles and melanoma or non-melanoma skin cancers may be good candidates for treatment with excisional surgery.

In addition to the removal of skin cancer, surgical excision or excisional biopsy may be performed to:

• Make a diagnosis of basal cell carcinoma, squamous cell carcinoma, or melanoma
• Relieve symptoms of a tender lesion
• Remove an infected or inflamed cyst
• Improve the cosmetic appearance of other skin lesions or lumps

Melanoma Removal

Following a melanoma diagnosis based on a skin biopsy, excisional surgery is used to remove the entire tumor and surrounding healthy tissue to help prevent a recurrence. Patients with thin, early-stage melanomas may be cured and require no additional treatment following excisional melanoma removal.

Squamous Cell Carcinoma and Basal Cell Carcinoma Removal

Excisional surgery is a good option for low-risk basal cell or squamous cell carcinoma, and additional treatment is typically not needed. High-risk basal cell and squamous cell carcinomas are more likely to recur after surgery and might require wider margins of healthy tissue to be removed, as well as additional follow-up care.

Mohs Surgery Vs Excision

Mohs surgery is a minimally invasive surgery considered the most effective surgery for basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs). It is also a good option for large lesions, for skin cancers without a defined border, and for those in areas where tissue preservation is important, such as the ears, nose, hands, and scalp.

Excisional surgery, or wide-local excision, is also used to remove BCCs and SCCs, and this type of skin cancer surgery is effective for early-stage melanomas that haven’t spread deep into the skin or to other areas.

The right treatment option for your skin cancer depends on the type of cancer you have, its stage, where it is located, and other factors. Discussing all skin cancer surgery options with your treatment provider is important.

What to Expect from Surgical Removal of Skin Cancer

The Day of Your Skin Cancer Surgery

Most surgical excisions are in-office procedures and do not require a hospital stay.

Before the excision, your provider will numb the treatment area by injecting a local anesthetic. Your doctor will then cut the tumor out, including some surrounding healthy skin. Your wound will be stitched together and you’ll receive detailed aftercare instructions before leaving.

Recovery from Excisional Surgery

The length of your recovery depends on the site treated and the extent of your skin cancer surgery.

After local anesthesia wears off, you may begin to experience mild pain. Avoid getting your excision site wet for the first day or two, and change bandages as directed by your dermatology treatment team.

Slight pinkness, tenderness, and swelling are normal. Persistent or severe pain, swelling, signs of infection, or bleeding require a call to the office.

Potential Complications of Excisional Surgery

Both excisional biopsy and excisional surgery are simple and safe procedures. However, there are some potential risks and complications to be aware of:

• Scarring
• Bleeding or swelling at the affected site
• Pain
• Hematoma (a collection of blood under the skin sometimes requiring drainage)
• Infection
• Nerve damage
• Incision opening after surgery
• Persistent cancer requiring additional treatment

What About Scarring?

Scarring is nearly certain with both excisional biopsy and excisional surgery, but our treatment team is trained and experienced to ensure your scar is as small and insignificant as possible. Whenever possible, advanced techniques are used to minimize the visibility of scars.

Your excisional biopsy or melanoma removal scar will initially be red and raised but usually reduces in size and color over 2 to 3 months. It is very important to avoid stretching the area for several weeks after the stitches are removed.

Some patients have an abnormal response to skin healing and develop keloid or hypertrophic scarring, which are scars larger and thicker than usual. If you have a history of this type of scarring, please inform your treatment team before your surgery.

Schedule Your Skin Cancer Treatment Consultation

If you have an area of concern or have been diagnosed with skin cancer and want to discuss excisional biopsy or surgical removal of skin cancer, contact us through our website or by calling one of our offices directly.