I get a lot of “curbside consults” from my patients, showing me skin lesions (“moles”) that they “should really get removed someday” and ask if I can do it for them.
The answer is, “Yes, I absolutely can,” and “Yes, I am a plastic surgeon and I can give you the best scar possible,” but that doesn’t mean that the lesion should always necessarily be excised. The two main deciding factors are:
1) Is it “suspicious” for being malignant (cancer), or becoming malignant?
Is it dark in color?
Is it wider than six millimeters?
Are the borders irregular?
Is the color non-uniform (darker in some places, kind of “speckled”)?
Has it changed at all over time?
Do you have a history of a lot of sun exposure?
Even if you’ve had something “forever” and it has never changed, you should still have it routinely evaluated by a dermatologist, especially if you have fair skin, light eyes, and have had significant sun exposure over your lifetime. I can remove anything from your skin, but only a dermatologist can determine by looking at it if it needs to be removed.
So why is it important to try to figure this out first—why not just “take it off”?
2) Depends on where is it located
This is important, because different areas of the body scar very differently. If you have a mole on your face that you don’t like, taking it off is almost always a good choice. Anything on the face usually heals very well. The skin is thin and—the older we are—the more elasticity we lose and, counter-intuitively, the less scarring we get. The neck is usually a good bet as well.
But have you ever noticed that orthopedic scars—the ones from shoulder and knee surgeries, for example—almost always heal stretched-out and/or thick? This is because of all of the tension and movement in these areas that stretch the wound apart as it heals. Another danger zone is the upper chest area, where not only is the scar pulled by arm movement, but by gravity pulling on the breasts. So there are instances where—unless a mole should be removed because it is “suspicious,” it should be left alone because removing it might cause a scar as big and wide—and possibly worse—than the mole itself.
So unless something is obviously suspicious, you might reconsider before you have it removed, and a board-certified dermatologist is the best person to make thisdetermination. If you live in the Beverly Hills area, my recommendation for your yearly “mole checks” is Dr. Don Mehrabi, who I think might be the last board-certified cosmetic dermatologist in Beverly Hills who actually takes insurance. He has always taken excellent care of my patients, is in network with most PPO insurances, and he also offers multiple laser and cosmetic skin care treatments for the total Beverly Hills experience.
If you need a “mole check”, check out Dr. Don Mehrabi at www.bhskin.com.