Removal of facial skin lesions

You have a lesion on the skin of your face / neck that needs to be removed. This leaflet will explain:

• what will happen before your procedure

• what happens once the lesion is removed

• what the risks are to having the procedure; and

• how to look after your wound following your procedure.

If after reading this leaflet you have any questions, please ask a member of staff.

Are there alternatives?

Yes. For some patients using creams, lotions, or freezing the area helps. But you will have already discussed these options with your doctor, and decided that removal is the best treatment for you.

Will the procedure hurt?

Your doctor will remove the lesion using a local anaesthetic (you will be awake but the area is numbed). You will feel no pain.

What happens before my procedure?

• Your doctor will inject local anaesthetic into the area; it will take a few minutes for the area to go numb.

• They may use an antiseptic solution to clean the area.

• Special ink is used to mark the piece of skin to be removed.

How long does the procedure take?

This depends on the size of the area involved, but usually it takes between 40 and 60 minutes.

Is anything done after the lesion is removed?

Removal of the lesion leaves a hole in your skin. The hole can be repaired in one of three ways.

• If the hole is small, the surrounding skin can be gently pulled together with stitches. Some of these stitches may be dissolvable (they will not need to be removed), but often stitches on the skin will need to be removed after a week. This will be at your follow-up appointment. Most skin lesions are removed and repaired in this way.

• If there is not enough loose skin next to the hole to allow the edges to be stitched, then the skin near the affected area can be partly lifted and moved round to fill in the hole. This ‘flap’ is then stitched into place. Your doctor will use dissolvable and removable stitches. If it necessary to raise a flap this does leave a larger scar. Whenever possible the flap is designed so that the scar lies within your natural skin creases.

• If a large area of skin is removed we may need to repair your wound with a piece of skin from elsewhere. This graft is often taken from behind your ear or around your collarbone. We use these areas as they already have an excess of skin. The graft is then laid over the area where the facial lesion has been removed and sewn in to place. A dressing will be placed over the graft, and needs to stay in place for around 10 days.

You will discuss these options with your doctor before your procedure. Your doctor will then ask you to sign a consent form. Please use this time to ask any questions.

Why do I need to sign a consent form?

All patients must give permission before they receive any type of medical treatment, test, or examination. Consent is usually given when you sign the consent form before your treatment, but we may ask you to give it verbally.

• You must give your consent voluntarily.

• The hospital must give you all the information you need to make a decision about your treatment. This is so you can give us informed consent.  If you have not been given this information, or you have but you still have questions, please speak to a member of staff. 

• You must be capable of giving consent. This means that you understand the information given to you and can make an informed decision.

When we ask you to give consent, please use this time to ask any questions you may still have. For more information, please go to the NHS Consent for Treatment web page. Remember, you can withdraw your consent for treatment at any time.

How will I feel afterwards?

You will feel some mild pain and discomfort once the anaesthetic has worn off. You may need to take simple painkillers, such as paracetamol.

There will be some swelling and bruising for the first few days after surgery. This will usually settle within two weeks.

Can I drive after my surgery?

You should not drive on the same day as your surgery. Arrange for someone to collect you from hospital and drive you home. You may feel confused or unable to think clearly after your surgery, as the procedure was carried out on your face and you had local anaesthetic injections.

Do I need to take time off work?

This depends on the type of work you do. You may need to take the rest of the day off. Please discuss this with your doctor.

What are the risks / complications?

• Bleeding is not common. If it happens, apply pressure to the area for 10 minutes with a rolled-up handkerchief or swab.

• Infection is also unlikely. If your doctor thinks it may happen, they will give you antibiotic ointment or tablets to take home.

If you have any concerns, please speak to your GP.

Will I need a follow-up appointment?

Yes. You will need to have your dressing and stitches removed (unless they are dissolvable). An appointment for this will be arranged before you leave hospital. You must keep your dressings and stitches dry, unless you have been told otherwise.

After your procedure, skin lesions are sent off for examination; this is normal. This is to find out what the lesion was and whether it has been completely removed. This examination takes time and the results may not be available for a couple of weeks.

Further information

If you have any further questions or concerns, please speak to your doctor at the hospital.