Skin tumor surgery / Mole

Skin tumors belong to the "soft tissue" category, along with muscle, fat, fibrous tissue and blood vessels. Tumors can develop in these tissues, and must be surgically removed.
Two types of tumor can be distinguished, depending on their aggressiveness: benign, harmless and harmless, or malignant (cancerous), potentially dangerous.

The main benign skin tumors (not serious)

Benign lesions may be excised (removed) when they are likely to develop into malignancies (excision is then carried out as a preventive measure). Benign lesions may also be removed if they are bothersome (causing friction and irritation due to their location) or if they are unsightly.

There are several common forms of benign skin tumours, including :

• Naevi (or moles) are benign pigmented tumors of melanocytic origin, which develop from the basal layer of the epidermis. Under the effect of several factors (repeated sun exposure, genetic factors, mechanical irritation), naevi (moles) are susceptible to carcinogenesis in the form of melanoma.
• A wart is a benign epidermal proliferation, most often of viral origin (papillomavirus). It is generally contagious to other people, or to other areas of the body on the same patient.
• Cysts are glandular proliferations whose secretions accumulate in a pocket.
• Nodules are firm, fluid-free proliferations of variable size.
• Lipomas are very common fatty tumors, also known as scalp loupes. Despite their insensitivity, they are sometimes perceived as troublesome due to their location or volume.

Malignant skin tumors

These tumors correspond to skin cancers and must be surgically removed, in most cases by excision. Exeresis is performed with a "safety margin" around the tumor to limit the risk of recurrence, obliging the surgeon to remove healthy tissue. Priority is never given to aesthetics, but to curative treatment. These may be epitheliomas, melanomas or sarcomas.

Soft tissue sarcomas are types of cancer whose diagnosis is made difficult by their wide variety and rarity. Unlike sarcomas, benign tumors are generally superficial and small (less than 5 cm). A sarcoma can be diagnosed by the appearance of a mass growing on soft tissue, more often in the limbs than in the trunk, neck or head, and sometimes with pain.

Any suspicious skin tumour should therefore be examined histologically, either by biopsy or after removal.

Dr Christelle Santini always carries out a clinical and aesthetic examination, based on your practitioner's (dermatologist's) report and microscopic examination (biopsy).

It prioritizes the benefit-risk ratio: a malignant tumor should never be given priority over aesthetic results.

On the other hand, the removal of a benign tumor such as a mole or nevus should aim for the most perfect visual result possible, especially if it is an obvious area.

Dr Santini will always give you a precise estimate and tell you whether or not your health insurance or mutual insurance company will cover the cost.

Exeresis is a general term for a surgical procedure to remove something harmful to the body (tumor, organ or foreign body).

In the case of benign tumors, skin lesions can be surgically removed for aesthetic reasons or because of functional discomfort, particularly if they are poorly placed or visible. When excision is performed for strictly aesthetic reasons, it is important to discuss with the surgeon the possible scarring that may result from the operation.

The removal of a tumour, even a benign one, demands the utmost precision, since the removal must be performed with a sufficient margin around the tumour to avoid any risk of recurrence, which is common with warts. Even so, Dr. Santini focuses on aesthetics, both in terms of technique (scalpel surgery, ablative laser, etc.) and choice of suture (fine, supple, elastic thread).

For simple excisions, the procedure is completed, if necessary, with stitches. In the case of lesions requiring deeper excision, repair of the loss of substance is necessary (flap techniques, epidermal grafting): in this case, the risk of scarring is significantly increased.

The procedure takes between 20 minutes and an hour, depending on the type of skin lesion being treated.

The procedure is generally performed under local anaesthetic on an outpatient basis.
Following the operation, the removed lesion is sent to an anatomopathology laboratory for examination to confirm that sufficient excision has been made and that the resection margins are located in healthy tissue.

The post-operative management of a benign skin tumor is generally straightforward, although you should be vigilant in the event of unusual symptoms (swelling with redness, abnormal sensitivity, onset of purulent discharge).

Post-operative histological analysis confirms that the excision is complete and benign.

Strict medical follow-up is necessary to monitor healing and any recurrences. Skin monitoring by the referring physician or dermatologist can detect early forms of tumors.
Itching is quite common during the first days of the healing phase.

As long as the scar is still dark, you should avoid prolonged exposure to the sun or use a "sun block". The scar is often red then pink for the first 6 months; it becomes fine and white between 6 and 12 months.

A delay of several months (or even a year or two) is therefore always necessary to appreciate the definitive appearance of the scar, with the possibility of reworking it to fade it.

• Outpatient procedure, usually under local anaesthetic
• A fast, aesthetically pleasing procedure.
• Histological verification of benign character.
• Scar stabilized after 6 to 12 months.