Skin Lesions

There are many types of skin lesions (cysts, masses, lipomas, skin cancers) that are typically recommended for removal. This can often be done in the office.

Skin Lesions/Masses

  • Skin lesions are very common and often referred to a surgeon for removal
  • These may be benign, precancerous, or cancerous
  • Excision is typically straightforward and often (but not always) can be done in the office
  • Some masses/lesions may be monitored without excision, if deemed safe by you and your surgeon

Types

  • The most common lesions are skin cancer, lipomas (benign fatty tumors), and cysts

Common Tests

  • Physical exam – most lesions are identified by the look and feel by your physician.

  • Ultrasound – Sometimes used to help characterize a deeper mass

  • CT/MRI – infrequently used

Surgery

  • Surgical removal of a lesion is commonly recommended for
    cancerous, or precancerous lesions, as well as for benign
    (noncancerous) lumps that cause
    discomfort/drainage/growth
  • If cancerous, the lesion is typically removed completely,
    along with normal tissue on the edge. This results in a much larger scar than the lesion itself, to ensure complete removal and allow healing in a cosmetically acceptable manner
    • This is common for skin cancers such as basal cell carcinoma, squamous cell carcinoma, or melanoma.
    • Atypical lesions may be precancerous and excised in a similar manner
  • If the mass is in the deeper tissues, such as an epidermoid cyst, or lipoma, the incision is typically about the size of the mass. The mass itself is removed and the skin is closed.
  • Most of these procedures may be done in the office under local anesthesia (numbing medication). Some require removal in the operating room; your surgeon will discuss this with you after evaluation.
  • Some skin cancers may require additional testing/surgery for staging which will be discussed in detailed with you by your surgeon

Risks

  • Bleeding, infection, recurrence

What to expect

Preparing for your surgery

  • After meeting with your surgeon to evaluate the lesion/mass, this may be recommended for removal. This may be scheduled the same day, a later day in the office, or in the operating room

Postoperatively

  • It is normal to have pain at the incision site. The numbing medication will wear off, and you ay take Tylenol/ibuprofen as needed (unless you have a medical reason not to take these medications)
  • You may return to work when you feel you are able to perform your duties without issue. This may be as soon as the following day, but varies between procedure and your responsibilities. Discuss with your surgeon.
  • Wound care
    • You may have non-absorbable sutures that will need to be removed. You will have a follow up appointment set up for you.
    • You may have absorbable (buried sutures); these will not need to be removed and will dissolve on their own, underneath your skin.
    • You may shower 24-48 hrs after your procedure.
    • If you have steri strips over your incisions. Remove bandaids in 24-48hrs after surgery. Leave white strips (steri strips) in place and shower. Let soapy water run over these and pat dry. They will begin to peel off in about 7-10 days then you may remove.
    • If you have skin glue (dermabond) over the incisions you may shower immediately. When this begins to flake off you may peel off, typically in a week.
    • If you have external sutures, you may shower after 24 hours and keep area covered for drainage only. You will be instructed when to return to the office for suture removal.
    • Do not bathe, soak incisions, go in hot tube, pool or lake/ocean for 2 weeks.
    • Your scar with heal over the next 4-6 weeks and continue to fade and soften over the next year. Use sunscreen over incisions when exposed to sun for the next year.

When to Call

  • Severe or worsening uncontrolled pain
  • A fever >101.3
  • Continuous vomiting
  • Foul smelling drainage, redness or continued bleeding from an incision sites

Patient Information & Documents