Surgery to excise (remove) a melanoma eliminates the entire melanoma along with a margin (border) of healthy skin.
The depth of the melanoma will determine the width of the border of healthy skin removed. In addition, more tissue, typically fat and skin, is removed from under the melanoma as well.
If the excision is small, it may be closed with sutures and heal without any issues. On the other hand, excisions that are large or those located on the face, hands, or feet may need a skin graft to seal the wound after the procedure.
The size and location of the melanoma will determine the type of anesthetic necessary for the surgery. Only a local anesthetic will suffice for small and easy to reach melanomas while general anesthesia may be necessary for larger melanomas.
Texas Surgical Dermatology, led by board certified dermatologist Dr. Tri H. Nguyen, provides advanced skin care procedures to patients in Houston, Katy, Spring, The Woodlands, Texas, and surrounding locations.
Why it is Done
The most common treatment for melanoma is surgery. At times, lymph nodes may be eliminated simultaneously to evaluate them for cancer. In addition, surgery may be done to excise lymph noses that are cancerous or to eliminate tumors that may have spread to other body areas.
How Well it Works
Melanoma removal surgery typically cures melanoma if it is detected early. It may also cure melanoma if the cancer is only in the surrounding lymph nodes.
Surgery may also be used in the treatment of metastatic melanoma. This cures cancer only in a few cases. However, surgery offers the most effective and sustainable relief of symptoms.
How is elliptical excision performed?
The most common way to excise a tumor is elliptical excision. In this procedure, the dermatologist will draw a margin around the tumor. This margin may be as narrow as 4 millimeters (mm) for a low-risk melanoma skin cancer.
However, in the case of a thick melanoma, the margin may be as wide as two cm. For patients undergoing excisional biopsies, the doctor will mark the margins from the biopsy scar.
The dermatologist will cut an elliptical, or football shape around the margin. This type of cut helps remove more skin relative to a circular cut, and also results in a better-looking scar. After the procedure, the doctor will seal the incision with sutures. The scar will appear as a thin, flat line.
How are tumors excised from complex areas?
It can be tricky to excise tumors on certain areas of the body such as the face, scalp, ear, foot sole, toes, and fingers.
Once tumors are excises from these regions, it may not be possible to stretch the skin over the area to seal it. The patient may require surgical repairs. Repair procedures may include skin grafts or flaps. In these areas, margins may be smaller.
Excision for High-Risk Non-Melanoma Skin Cancer
Excision is a treatment option for high-risk BCC or SCC as well. High-risk BCC is more likely to recur while high-risk SCC is more likely to recur or spread.
For this reason, the doctor will use wider margins to excise these cancers. In addition, a pathologist may evaluate the excised tumor while the patient is still in surgery. The surgeon will not seal the incisions until they get clear margins.
The recovery after a procedure to remove melanoma will depend on the site and extent of the procedure. The healing may be more extended if the patient undergoes reconstructive techniques such as skin grafts.
Board certified dermatologist Dr. Tri H. Nguyen receives patients from Houston, Katy, Spring, The Woodlands, Texas, and nearby areas for skin treatments.
For more information on procedures and treatments offered at Texas Surgical Dermatology PA please call 832.663.6566 or click here to contact our dermatologists. Helping patients in Houston, The Woodlands, Springs, Katy and other surrounding areas of Texas.