Experience with large/medium mole removal? Post-surgical update/PIC pg 3

[poohandwendy]

My youngest DD (13) has a congenital mole on her scalp, behind the ear (between the ear and hairline). She has a consultation on Dec 12 with a dermatologist for possible removal.

When she was an infant, the pediatrician basically said "This is the type that will need removed eventually, but not anything to worry about now as they don't usually cause any problems until after puberty" I can't remember what she called it, as the subject hasn't been brought up for quite some time and I forgot to mention it on her last visit.

I decided to get this taken care of now because a) it has changed slightly since puberty (nothing major, but the color isn't as even as it used to be)
b) we are insured, no reason to put it off, c) when she gets older, since she cannot see it, she won't know if it's changed, d) she scratches it when doing her hair, e) I'd rather deal with it before it's a problem, on the chance it could become an issue.

I guess my main question is what to expect for her with a mole that isn't a simple round small area? Hers is sort of strange as it is like a thin line at one end and then sort of widens into an irregular kidney shape at the bottom. It is probably 1/8" wide at the narrowest part and 1 1/2" at the widest and 2 1/2" from one end to the other. It's one of the types where it is raised and bumpy (it almost looks like a rash, pimplie like) It's for sure not a rash, she was born with it. It is more raised now, than it was when she was a baby.

Is this the type of thing that they put you under for? Is recovery painful? Did you need skin grafts? I know none of you can tell me what will happen, LOL, I guess I am just wondering if anyone else had any experience with med/large mole removal and how it went.

TIA

 

[DawnCt1]

DS#1 had a "hairy nevi", in fact one about the size, although probably only an inch across at the widest, that your DD has and a smaller one along side of it, on his lower thigh. We had it removed when he was about 10. We too wanted it removed before puberty and before it had too much sun exposure. It was fairly non eventful. He went in for a day admission. We had a plastic surgeon do the surgery. He has a bit of a scar but it barely shows.

 

[poohandwendy]

Thanks Dawn, was this a missing school kind of thing? Did he need many stitches?

I will be curious as to whether they can just cut it out and pull the skin together or will they have to add skin there (seems like the skin is pretty tight there and the area is pretty irregular) I know, these are only things the doctor can tell me.

I also wonder if the dermatologist is going to just refer me to a plastic surgeon or do they do this? (LOl, just saw you answered this)

He has a bit of a scar but it barely shows.

The way I see it is that she already has something there, it's not like a scar would be more unslightly.

 

[MrsPete]

I had a small mole removed from my leg (I kept shaving it off, and that was painful). I want to say it was between 1/4 and 1/2 inch across. The doctor "froze" it off in his office. It was a couple years ago, but this is what I remember:

He took a small funnel and placed the small end over the mole; he pressed it down slightly into my skin so that it was like a little cup over the mole. He poured a liquid into the funnel, which sort of bubbled for about 2 minutes, then evaporated. The doctor told me that some people find this painful, and I was NOT to move -- he didn't want the liquid to run over my leg. I didn't find it overly painful. When the process was done, I think he put a bandaid over the spot, though it didn't really look different. Over the next 2-3 days, it turned black and fell off. He said that the mole COULD return and we might have to repeat the process, but that didn't happen to me.

Once the healing was done, I had no scar. Then again, it was on my leg in a spot that I can't say I really look at frequently. In fact, I can't even remember which leg it was on -- I just remember that it was below my knee. It would be different to have this done in a more visible area.

This was quick and easy, and I would not hesitate to have it done again.

 

[Serena]

I've had a few removed. The dermatologist will be able to tell you what kind of removal is neccessary. They can either "shave" it off, and it will heal and just leave a scar behind her ear. With this type, they numb the area and then shave it off. It doesn't hurt, depending on how big it is or how deep is how fast it will heal. This takes maybe 10 minutes, depending.
If it's deep they may want to cut it out. They may want a plastic surgeon, maybe not. I know they didn't knock me out, just numbed the area again. This one wasn't so easy. And the smell of burnt flesh was a little much. That one required a couple hours, but I went home shortly afterwards.

 

[luvmyboys]

I've had several removed (unfortunately, melanoma runs rampant in my family). If at all possible, I would recommend a plastic surgeon doing the procedure. The two times I had my dermatologist do the removal have left me with UGLY scars. I would bet that since it is on her head, they'll have a PS do it...

Every time it has been a localized anesthetic, and only taken a short while. There is definitely some soreness afterward, but nothing intolerable. Also, they'll usually tell you not to get the area wet for a certain amount of time.

 

[OK!]

I had one removed that was on my extreme lower back several years ago. It was the type that apparently had to be cut out, and about all I remember was that the doctor should've given me 1 more anesthetic shot than he did before he started cutting. I felt nothing at first other than pressure, and then suddenly--PAIN. It felt, well, like somebody was cutting me on the butt, which isn't an experience I recommend. He hit me with another shot then, and everything was fine after that. Luckily, I didn't jerk too violently when I felt it, or he could've really sliced me a good one.

I got a few stitches, which gradually fell out or dissolved or whatever it is that they do over the course of a week, maybe? There's a scar, but it doesn't bother me because I never see it.

 

[azgal81]

I watched them remove a small mole on dr. 90210 the other day. They just numbed the area and shaved it off. It didn't appear to hurt the girl at all who was getting the procedure done. Looked pretty easy!

 

[maelstrom]

I've had two moles removed; one from my shoulder and one from my stomach. My dermatologist did it in his office. He numbed each area and sheared the moles off. It took no more than twenty minutes and barely hurt afterwards.

A more invasive procedure would be cutting/digging the mole out, where stitches would be necessary.

 

[momof3disneyholics]

I've had 2 excisions done and they were very uneventful. I got a local where the site was and then they cut it out. I had stitches and took tylenol for the pain. Nothing major. I put it off for a long time but when I had it done, I kept thinking "That was it?". I really wasn't bad at all.

 

[poohandwendy]

Thanks for all of your thoughts and experiences guys.

Honestly, if it were me I probably wouldn't even be giving it a second thought, LOL. I know it's not a major deal and will probably be a piece of cake. It's only major because it's my baby, kwim?

Also, because it has such an odd shape, I just wonder how the heck they will remove it and sew it together without bunching all of the skin up or something. I guess that is what plastic surgeons are for, LOL. Maybe I'll post a picture of later so you understand what I mean.

 

[Mouse House Mama]

My sister had a large mole removed when she was 2. She was born with it and it changed on size so they removed it. It was done by a plastic surgeon. Not a dermatologist. It was on her arm and she barely has a scar. It was very deep and she is a skinny minny! They did put her under because of her age and how deep it was. Actually they still would have put her under because of the depth of it.

 

[HARASW]

I just had a basal cell carcinoma and the birth mark next to it removed last Monday. Tomorrow, I get to have the stitches removed and see what kind of scar is left . I had a MOHs procedure done, where the doctor removes a small portion and then biopsies it immediately in the office to see if she needs to remove more or if she got all of the cancer. I had 3 stages done and had a dime sizes hole left, before the stitches. I was told that this is the best way to go, especially on the face, so as little as possible is removed at a time and the scarring is neater than what is usually done at the basic dermatologist's office. This was all done with a n umber of injections to numb the area.
Good luck!

 

[CU82]

I have had several excisions done over the last few years for melanoma type things. I have only had one that required more than 1 shot of anesthetic (sp?) and a slice off. When they had to cut deeper, my derm explained to me that what they do is to cut a larger shape around the edges of the mole/mark in a kind of tear shape, but pointed on both ends. This makes the sewing together smoother and easier. The proceedure was no big deal (except I pass out reallllly easily and had to lie down a while) and I was out of the office in 2 hours maybe. The burning flesh smell was the worst part. Stitches remained for 4 weeks maybe? Then I had them removed. I had a significant scar that has shrunk in the last 3 years and some pain, but nothing Advil could not handle. The location of mine (across the top of my breast-and I am not a small chested woman) had a lot to do with scarring. They offered to send me to a PS, but I declined. The scar would be similar no matter who did it and I was already comfortable with the derm, less scary that way.

I know it is nerve racking for you and your DD. I took my i-pod to listen to while they did it, which helped some with the jitters during. Best of luck.

 

[Snowysmom]

My younger DS had a hairy nevi removed from his forehead when he was 14. It was about 1 1/2 inches long and 1/2 inch wide. He had it done as an outpatient procedure with local anesthetic by a plastic surgeon. After the stitiches were out, the doctor recommended using mederma or vitamin E on the area. He used that for a while. He has a slight scar, but you really have to look closely to see it. We are glad we had it done then because the report came back that it was starting to change. He was only out of school for that day and did not have alot of pain afterwards. I would recommend using a plastic surgeon. I hope everything goes well for your DD.

 

[BibbidiBobbidiBOO]

I had a Nevus sebaceous removed a couple years ago as an adult. My pediatrician blew it off when my parents brought it up when I was a child. My dermatologist saw it, biopsied it, and found out what it was (and that it was benign). She wanted it out since they can have a higher chance of becoming malignant.

I was sent to a plastic surgeon and had it removed under general anesthesia in outpatient. It was a bit bigger than the size of a quarter on my scalp (half dollar size?). I had about 10 staples over stitches. My face swelled for a few days near the area (mine was close to forehead). I lost a little hair in that area from the trauma of the surgery and scar tissue BUT I have lots of hair and don't miss it.

It sounds like that is what your daughter's may be too?
http://www.emedicine.com/derm/topic296.htm I just had the singular one, not the freaky other things you read on that link!
They are pretty rare and was exciting for my plastic surgeon for some reason!

It had been pretty tender at times, and I am glad it is gone now! Yes, do use a plastic surgeon and she will probably need to take it easy a couple days.

 

[poohandwendy]

I had a Nevus sebaceous removed a couple years ago as an adult. My pediatrician blew it off when my parents brought it up when I was a child. My dermatologist saw it, biopsied it, and found out what it was (and that it was benign). She wanted it out since they can have a higher chance of becoming malignant.

I was sent to a plastic surgeon and had it removed under general anesthesia in outpatient. It was about the size of a quarter on my scalp. I had about 10 staples over stitches. My face swelled for a few days near the area (mine was close to forehead). I lost a little hair in that area from the trauma of the surgery and scar tissue BUT I have lots of hair and don't miss it.

It sounds like that is what your daughter's may be too?
http://www.emedicine.com/derm/topic296.htm I just had the singular one, not the freaky other things you read on that link!
They are pretty rare and was exciting for my plastic surgeon for some reason!

It had been pretty tender at times, and I am glad it is gone now!

OMG, that is exactly what I think it is!!! (IIRC, from what the ped thought it was and from the pictures I have seen) I have been reading about it all morning. Kinda disturbing, the idea that it can cause neurological issues. I would know if that were the case, right?

I will post a picture later, she is out with her friends...maybe you can tell me if it looks similar to what you had. Hers is just to the edge of her hair line, it is between the back of her ear and the hair line. Hers gets tender when she scratches it with a brush, and she says it gets itchy when she is hot. Other than that, it hasn't caused any problems

 

[BibbidiBobbidiBOO]

Also, because it has such an odd shape, I just wonder how the heck they will remove it and sew it together without bunching all of the skin up or something. I guess that is what plastic surgeons are for, LOL. Maybe I'll post a picture of later so you understand what I mean.

It is cut out, and somehow that skin stretches together! She may lose a little hair though.

 

[BibbidiBobbidiBOO]

OMG, that is exactly what I think it is!!! (IIRC, from what the ped thought it was and from the pictures I have seen) I have been reading about it all morning. Kinda disturbing, the idea that it can cause neurological issues. I would know if that were the case, right?

I will post a picture later, she is out with her friends...maybe you can tell me if it looks similar to what you had. Hers is just to the edge of her hair line, it is between the back of her ear and the hair line. Hers gets tender when she scratches it with a brush, and she says it gets itchy when she is hot. Other than that, it hasn't caused any problems

I feel certain that is what hers is from what you are saying. Don't worry, I am sure hers is just the one lesion and not the syndrome! That would be something you could have known about early on. I remember freaking when I read all that too! I have no such "syndrome", just had the one Nevus!

Having staples in my head was rather traumatizing, but necessary. Ice packs helped. You would never know I had this done by looking at me though (my stylist knows and can see the scar though!).

 

[poohandwendy]

I feel certain that is what hers is from what you are saying. Don't worry, I am sure hers is just the one lesion and not the syndrome! That would be something you could have known about early on. I remember freaking when I read all that too! I have no such "syndrome", just had the one Nevus!

Having staples in my head was rather traumatizing, but necessary. Ice packs helped. You would never know I had this done by looking at me though (my stylist knows and can see the scar though!).

Yeah, you gotta love the internet, it can scare you to death! I really am not freaked about it, just like to know what she has to look forward to, kwim?

Was this covered under your insurance? I am thinking that if they have to put staples in her head, I would rather her be sedated instead of just a local. She's not freaked about getting it removed, but I don't think she wants to be aware of anything like that.

As far as scarring, well...she already has something there, a scar wouldn't be much more noticeable than it anyways. She is not super self conscious about it, except when people say "eeww, what is that?" (aren't people lovely?) Not very often and she laughs it off. I think she would rather have it gone, though.

i kind of wish I had done it sooner now, just because the websites are all saying it should be done before puberty. But, obviously you had it done as an adult, so I guess it's not a huge thing. The pediatrician only brought it up twice and was more like "Oh, you should get that removed before she is an adult, but no hurry" kind of thing.