American Society of Plastic Surgeons
For Medical Professionals
 
NicDoV
4 years ago
Answered

Mole Removal?

My dermatologist recommended I have a moderately dysplastic nevus removed from my scalp and has referred me to a plastic surgeon. The mole is slightly larger than a pencil eraser and is located quite close to my hairline, 2 inches above my ear. Given the sensitive location, how are moles like this normally removed? I'm worried. Thank you for your time.

Procedure: Tattoo Removal
Location: Worcester, MA

Replies 3

Barry Citron
ASPS Surgeon

This is a very common request. Don’t worry. A pencil eraser is 6mm in diameter. Let’s say your mole is 8mm. A good rule of thumb is to remove 2mm on each side of the mole, which we call a margin. So a 1.2 cm diameter circle (about one half inch) might be necessary to remove your approximately 8 mm mole with 2 mm margins. In order to close that defect, the circle is converted into an ellipse which can be closed as a straight line that lies flat. Estimated length of scar is 3x the diameter of the circle, 3.6 cm or about an inch and a half. Local anesthetic is all that is required. Best wishes

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Gregory Dowbak
ASPS Surgeon

There is good reason your dermatologist referred you to a plastic surgeon. A famous mathematician non-surgeon demonstrated a long time ago that closing wounds on a curved surface such as the scalp can be problematic. Many physicians have discovered much to their chagrin that after excising a significant mole on the scalp they could not close it. Typical mathematical formulations frequently do not work on the scalp and other curved surfaces. He designed a flap that has his name, the Limberg Flap. It is composed of multiple rhomboid flaps which are re-arranged and makes for easy closure without tension. Used many times today. There are other flaps for “tissue rearrangement.” While our wounds are typically beautiful, go to a member of this society because we know how to stay out of trouble and do it right.

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Nelson Castillo

Thank you for sharing your excellent question. In general the dysplastic nevus is excised sharply and the resultant wound closed with staples to minimize scarring and hair loss. Hope this helps.

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