When should a mole be checked?
Most moles are harmless and remain so. A mole becomes noticeable when it changes. Reasons to have it checked include:
- A mole that grows larger, or changes its shape or colour
- Blurred or ragged edges, or several shades of colour within one mole
- A mole that itches, bleeds, weeps or does not heal
- A mole that clearly stands out from all the others
- A patch of skin that fails to heal over several weeks
When in doubt, it is better to have it looked at once too early. A harmless change is quickly clarified. A malignant skin tumour is, as a rule, well treatable at an early stage — the later it is caught, the more extensive treatment becomes.
How does the assessment proceed?
The process begins with an examination of the site. If any doubt remains afterwards, the mole is removed and examined histologically — only this laboratory examination gives certainty about what it actually is. A visual assessment with the naked eye can strengthen or weaken a suspicion, but it never replaces histological examination.
If this reveals a suspicious skin lesion, Dr. Özdemir refers you to dermatology, where the site is examined under a dermatoscope and, if necessary, a biopsy is taken to confirm the diagnosis. Only once the diagnosis is confirmed can the safety margin for surgery be planned. How the resulting defect is then covered depends on its size and location.
Wound closure and defect coverage
Malignant skin tumours must be removed with a safety margin so that no residue remains. A wound can also be caused by an accident or an infection. The closure of the wound should be as cosmetically and aesthetically inconspicuous as possible. On the face in particular, defect coverage is especially demanding, as resulting scars are difficult to hide and may lead to functional problems.
In the best case, the tissue can be closed with a direct suture. If this is not feasible because of a larger tissue removal at the affected site, we have various treatment methods to close the defect and influence scar formation as favourably as possible. Most defects can be treated on an outpatient basis under local anaesthesia.
Local flap plasty
With a local flap plasty, the surrounding tissue is shifted over the open area. It is an ideal solution for closing not-too-large skin and soft-tissue defects. Numerous techniques of local flap plasty are available to us (e.g. advancement-rotation flaps, nasolabial flaps, rotation flaps). We carry out precise planning beforehand.
Skin graft
We can also carry out a skin graft from another area of the body over the wound. In the facial area, however, skin grafts can lead to aesthetically unsatisfactory results, as the structure of the skin and the colour can deviate from the facial skin.
The choice of the optimal method depends on various factors. Before the procedure, we advise you in detail on which surgical technique can achieve the best result in your individual case.
What are the risks of removal?
A scar remains. Every removal leaves one. How it turns out depends on size and location, and on how the individual's skin heals. On the face, incisions are made along the natural skin lines so that the scar is as inconspicuous as possible.
Post-operative bleeding, bruising, infection. Rare with small procedures, but possible.
Impaired wound healing. Mainly with larger defects covered with a local flap or a skin graft. A graft can fail to take in places.
Altered sensation. The skin around the scar can remain permanently numb. With larger procedures on the face, fine nerve branches can also be affected.
A further operation may be needed. If the histological examination shows that the tumour extends to the edge of the removed tissue, a second excision is needed. This is not a mistake but, with malignant findings, a normal part of the process — the safety margin depends on a diagnosis that is not known in advance.
Are there alternatives to surgery?
Watching and waiting. If a mole is unremarkable and does not change, it is enough to keep an eye on it and have it checked regularly.
If a malignant tumour is suspected, there is no sensible alternative. Laser treatment and superficial removal destroy the tissue that would need to be examined — afterwards it can no longer be established what it was or whether it was fully removed. This is why a suspicious mole is excised, not lasered.
For purely cosmetic reasons, a clearly harmless mole can be removed.
