Excision for Skin Cancer

What is an excision?

To excise means to completely remove surgically with a scalpel, laser or other instrument. An excision can be any type of complete surgical removal but often refers to skin lesions and skin cancers, such as basal cell carcinoma, squamous cell carcinoma or melanoma. This type of excision is performed by a dermatologist (skin doctor). The surgery involves removing the cancerous part as well as a border of tissue surrounding it (margin). The excised tissue and surrounding lymph nodes may also be sent to the laboratory for biopsy.

What to expect from an excision procedure

Depending on the size of the lesion being removed, the procedure may require only local anesthesia (numbing of the area) so you won't feel anything. You may feel slight pressure and a scraping sensation as the doctor cuts the lesion out. For larger melanomas, however, you may need general anesthesia (you'll be asleep or heavily sedated and will not feel anything). You may also need a skin graft, which is a patch of skin from another part of your body used to help close up the wound. For procedures requiring general anesthesia, you'll be asked to not eat or drink anything for up to 12 hours beforehand. You'll also need someone to drive you home afterwards.

Risks of excision

There is always some risk of scarring after an excision. Your doctor will bandage or stitch the area to minimize the scarring. Some people develop keloid scars (raised/puffy scar), which can be treated with a steroid injection during a follow-up visit. The steroid helps the swelling go down and diminishes the appearance of the scar.

While your wound is healing, you'll also want to keep an eye out for signs of infection or bleeding. If you've had a skin graft, it is possible that your body will "reject" the graft. There may be problems with blood flow to the area, which can lead to tightness, discoloration, infection and other problems. Your doctor may prescribe anti-rejection medication to help prevent this from happening. However, if your wound is not healing well or in the expected time frame, be sure to call your doctor right away.