Mole Removal FAQs – (Mole Removal Frequently Asked Questions).
- Will my mole removal be covered by my insurance?
Dr. Lam does not accept insurance of any kind.
- I have a mole on my body. Will Dr. Lam help me with this mole removal?
Most oftentimes, Dr. Lam will refer you to a body plastic surgeon to have your mole removed from your body, since Dr. Lam’s specialty is the face and neck. However, one warning should be offered. Oftentimes, benign-appearing moles are removed from the central chest purely for cosmetic reasons but the result is a very enlarged hypertrophic scar or keloid. Oftentimes no matter how good the surgeon is in removing a mole from the central chest, this area is prone to bad scarring. Dr. Lam generally recommends not having a mole removed from this area simply for cosmetic reasons.
- How does Dr. Lam remove my mole?
A mole, or more properly a nevus (the scientific term), should be entirely excised rather than shaved off. A mole generally has depth, i.e., extends deeper into the skin than a shave or burning off technique can capture (as illustrated), meaning that these shallower methods of removal almost always lead to a recurrence. Dr. Lam also does not believe that liquid nitrogen is a good treatment option for two reasons. First and foremost, the uncontrolled thermal injury that liquid nitrogen imparts can lead to an undesirable blanching or whitening of the skin color. Second, the depth of injury of liquid nitrogen is imprecise leading to a high failure rate in many cases. Instead, in most circumstances, Dr. Lam prefers an excisional removal of a mole. Unfortunately, excisional removal of a mole requires a physical skin incision and one that extends beyond the borders of the mole in a fusiform shape (see illustration). A fusiform incision is mandatory to permit the incision to heal flat and not bunch up, which would make the result more obvious instead of less so. Remember that you are trading off the unsightly presence of a mole for a fine and (if done right) imperceptible line in most cases.
Another very important principle of proper mole removal is following the so-called relaxed skin-tension lines (RSTLNs) that represent the way that collagen bundles are arranged on your face. By following the RSTLNs, the incision closure has very little tension and follows lines of skin tension so that the incision heals well instead of poorly. For example, if a mole is on the chin, the common thinking is to make a horizontal incision to hide the incision along the jawline. However, making an incision along this directional line will lead to a very bad scar. Understanding the RSTLNs is a prerequisite in a seamless removal of a mole.
Dr. Lam’s method of mole removal is based on sound and meticulous plastic surgical principles. That is why you would elect to have Dr. Lam perform your procedure owing to his attention to detail, excellent plastic surgical technique, and follow-up care. During the procedure, Dr. Lam ensures that the incision closes without any tension so that your incision line will become barely perceptible. He also closes the incision in two layers so that there is almost no tension on the skin to make the incision heal even better. Using sutures to evert (or roll the wound edges outward), the incision should heal flatter and become truly imperceptible over time. In addition, care instructions and a care kit will be given to you so you know how to take care of the area for the week following the procedure. Dr. Lam offers and encourages careful follow up to make sure that your incision heals perfectly. There is no extra cost for this follow-up care. At times, injection of certain medications are important to make sure that the area heals as beautifully as possible. Also, mechanical dermabrasion to smooth out any edges is offered at 6 weeks postoperatively to ensure that the area appears the best that it can. Dr. Lam will send out what he removes for pathologic inspection to make certain of the diagnosis of what was removed. These subtleties are what make Dr. Lam’s removal of your mole truly the best care and quality of the result that you can find.
- How does Dr. Lam remove freckles?
Dr. Lam uses a specialized KTP laser that eliminates freckles that arise from sun exposure. However, freckles must be distinguished from other types of benign brown discolorations like melasma, which are larger and deeper areas of brown discoloration. Oftentimes, the KTP laser may be inadequate to address melasma. Instead, the PIXEL in combination with a directed photofacial and/or KTP and/or bleaching products may all be necessary to manage melasma. Also, remember that freckles, melasma, skin tags, etc. all can “come back” over time in that your body will create new areas with aging, sun exposure, and hormonal changes. Sun block and sun avoidance are integral to extending the longevity of your result.
- How do I know that what I have is not a skin cancer?
Although the only way that you would be certain is a formal consultation with a board-certified dermatologist and oftentimes with a biopsy (i.e., removal of some tissue for inspection), there are certain guidelines that can help you decide the likelihood if something you see on your skin is a skin cancer. Remember that these are only guidelines and should never replace a formal consultation and evaluation with a board-certified dermatologist. A simple mnemonic can be helpful: ABCD. These letters refer to the nature of the skin lesion that may indicate a cancerous lesion. A stands for asymmetry in that the shape of the skin lesion is not purely round or symmetrical on all sides. B refers to the border of the lesion being partly or completely ill defined or irregular in nature. C stands for the color being very light or very dark or having undergone a change in color to become lighter or darker. D refers to the dimensions of the lesion being increasing in size over time. Other helpful clues relate to any bleeding or other changes that you may have noticed over the past few months or longer period of time.
- How does Dr. Lam remove skin tags?
Skin tags are little outcropping of skin that can be easily snipped off at the base after a little anesthesia is administered to the area in question. Although removal of these tags can be very satisfying, your body continues to manufacture these lesions and more will arise over time. Removal of these new skin tags that may crop up after months to years will be charged separately.
- Does Dr. Lam remove warts?
No. He will send you to a respected dermatologist to help you with this matter.
- Does Mederma (onion extract), Strivectin, or Vitamin E oil work to help improve the appearance of my incision?
Dr. Lam does not believe that any of these remedies work to help a scar mature well. In fact, rigorous scientific studies that have involved blinded, prospective, randomized, split scar analysis (in other words, good and controlled scientific research) have indicated that these treatments provide no improvement at all in an incision or scar. In fact, Vitamin E oil has been shown actually to worsen wound healing in some cases. In the past, Dr. Lam used Vitamin E oil to help with wound healing. However, with recent evidence to the contrary, he no longer believes that any of these topical ointments do any good to help with scar healing.
If you have additional mole removal questions not answered on this mole removal FAQ page, please Ask Dr. Lam in our Mole Removal Forum.