An excision is a surgical procedure to remove abnormal growths or lesions from the skin. The primary aim of a skin lump excision is to determine the lump's nature (benign or malignant) and remove it simultaneously. This could be because of symptoms such as pain, irritation, or cosmetic concerns.
The excised tissue is often sent for histopathological examination to confirm the diagnosis, plan further treatment, or alleviate your concerns. There are two primary skin lump excision methods—an elliptical excision and a shave excision.
An elliptical excision involves making an elliptical incision around the lump to be removed, with a small margin of healthy tissue at the ends. This surgical technique is indicated for lumps that extend deeper than the papillary dermis or if complete removal is required to minimise the risk of recurrence.
Examples of lumps suitable for excision biopsies include:
The elliptical shape then allows for the closure of the defect in a linear fashion with minimal puckering at the ends, leading to a cosmetically pleasing outcome. Depending on the depth of the defect created, we stitch in multiple layers to help strengthen the wound and minimise the spreading of the scar that often takes place a few months later.
The usual method, which creates a scar three times the size of the lump being removed, will leave a longer scar. However, in most cases, this scar can be made smaller. We can use special techniques, like S-shaped cuts or removing the lump in stages, to reduce and hide the final scar.
At Lumine Dermatology & Laser Clinic, we believe in intervening early to set your scar recovery on the right track. Therefore, our range of lasers for scarring and injectables can help fade scars quickly.
A shave excision involves using a small blade to remove the elevated portion of a superficial lesion. This suits superficial benign lesions. Examples of lumps suitable for shave excisions include large skin tags, viral warts, seborrhoeic keratoses, epidermal nevi, fibrous papules of the nose, and benign intradermal moles.
Instead of closing the wound with stitches like in excision biopsies, all that is needed in shave excisions is cautery or a chemical is applied to the base of the wound to stop bleeding. This typically leads to minimal scarring, keeping the wound confined to just the site of the original skin lump.
| Elliptical Excision | Shave Excision |
| Removal of deeper lesions | Removal of superficial lesions |
| Stitches required | No stitches required |
| Lower chance of recurrence | Higher chance of recurrence |
At Lumine Dermatology & Laser Clinic, we take a personalised approach to epidermal cysts. Factors such as the cyst's size and location, your medical history, any previous inflammation or surgeries, and your expectations—like the length of the scar, the recovery time, and how the procedure fits into your lifestyle—are crucial in determining the most effective treatment approach.
Cyst removal can be conducted via the following methods:
A traditional elliptical excision may not be required for a lipoma. Instead, an incision can be made over the lipoma, and the body of the lipoma can be enucleated from the incision. This leads to minimal skin loss and a smaller scar with a quicker recovery time.
This condition is where multiple sebum-filled cysts are found primarily on the torso, upper arms, and occasionally the face. These lumps are typically harmless, but occasionally, one or two may become inflamed and painful. In this case, removal may be necessary.
Some of these lumps can also be removed for cosmetic indications. For steatocystoma multiplex, a small stab incision can be made over the lump, and the cyst sac can be removed via the small incision. Stitches are often optional if this is done.
Skin lump excision can be employed to treat various conditions, including:
Once you arrive at Lumine Dermatology & Laser Clinic, our dermatologist will thoroughly evaluate the lump's characteristics and take a detailed medical history.
Before any skin surgical procedures, the area is typically numbed using a local anaesthetic to ensure comfort. One may experience a stinging sensation when the numbing medication is injected. However, once the anaesthetic starts to work, the procedure will be painless. A numbing cream can be applied beforehand for our younger patients or those particularly sensitive to pain.
The dermatologist then makes a precise incision around the lump to ensure minimal scarring. Once the lump is carefully removed, the excised tissue may be sent for pathological analysis to determine whether it is benign or malignant.
Following the removal, we will clean the wound to lower infection risks. The method of closing the incision will depend on various factors, including the wound size and location, to ensure the best cosmetic outcome.
Typically, oral antibiotics or painkillers are not needed post-surgery. We'll provide topical antibiotics and recommend antiseptic washes for home care. If non-dissolvable stitches are used, we'll schedule a follow-up for removal within 1-2 weeks. Should the excision reveal a more serious condition, we will be here to discuss and navigate through the next steps and treatment options with you.
Most skin surgery procedures are completed on the same day in the clinic, allowing you to return to your routine with minimal interruption. We also offer assistance with insurance claims to ease your journey to recovery.
How do I know if my skin lump needs to be excised?
What are the benefits of a skin lump excision?
How long does it take to recover after a skin lump excision?
This typically takes 1-2 weeks. Following postoperative care instructions and attending follow-up appointments can minimise the recovery time and ensure optimal healing. We will monitor your recovery closely to address concerns and guide you through the healing process.
Is skin lump excision painful?
The procedure is performed under local anaesthesia to ensure minimal discomfort during the excision. One may experience a stinging sensation when the numbing medication is injected. Once the local anaesthetic kicks in, this is a painless procedure. For children or pain-sensitive individuals, we can apply numbing cream to the treatment site prior to infiltrating the anaesthetic.
Are there risks of scarring after skin lump excision?
We make a small cut whenever we remove a lump; your body heals this by forming a scar. How big or noticeable this scar is can depend on a few things, like the depth of the scar, the lump's size, where it is on your body, and how your skin heals.
We use special techniques to make the scar as tiny and light as possible. We will also give you tips on how to care for the wound to help it heal better. We might suggest treatments, like laser therapy or polynucleotide injections, to help your scar look better after it’s healed.
Keep the healing scar out of the sun as much as possible and follow postoperative instructions closely. You may also need to delay your return to the gym so that your scar has time to recover.
How long does skin lump excision take?
An elliptical excision biopsy takes about 20-30 minutes, while a shave excision biopsy takes about 10-15 minutes.
