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May 4, 2010

Mole removal

Dear Dr. Perry, mole

I am 22 years old and one of your avid readers. My problem which is really bothering me most is the mole on my upper left lip. Although it doesn't change its color, it is growing and has some hair in it.

My dermatologist advised me that only a "competent surgeon" can do a good job of mole removal that's why I wrote you for some advice.

Doctor, how much will this procedure cost? Will the scar be big or small? How will the procedure be? Plesae help me.

Thank you in advance. I'm hoping for your reply and for your continued success.

—Name Witheld

Dr. Perry replies:

The size of the mole will determine the particular procedure that will be utilized to remove your mole.

If the mole is small, a surgical excision with primary closure can be done. Unsightly scar formation can be avoided by making the incisions fall on the natural skin lines. This way, the resultant scar will not be under tension and formation of hypertrophic scar may br avoided.

Smaller moles, especially if they are multiple, may be fulgurized by electro-cauterization. These are superficially located lesions that will not leave scars after the procedure.

For bigger moles, removal may be done either in series by serial excision, or in one sitting by excision with skin grafting.

Serial excision involves multiple surgical excision depending on the size of the mole. The idea is to give time for the surrounding tissues to "recuperate" after each surgery. This is a piece-meal procedure wherein a small portion of the mole is removed and the space created is sutured together.

Three to six months are allowed to pass before the next portion is removed. By this time, the surrounding tissues have rested and regained back their elasticity and turgidity to allow ease in suturing the wound. The procedure is repeated until the entire mole is removed and a fine linear scar is created.

Should you decide to have it removed in one sitting, a skin graft will have to be used to cover the space created after the mole has been removed. This means that a patch of skin will be removed from other parts of your body and transplanted to the area where the mole was removed. This will later develop blood vessels and will become part of the surrounding tissues. The risk here is, if it does not develop blood vessels and dies—then you will end up with a patch of scar.

Dr. Perry de la Cruz obtained his medical degree from the University of Sto. Tomas. He is a diplomate of the Philippine Board of Cosmetic Surgery; a fellow of the Philippine Society for Cosmetic Surgery and the American Academy of Cosmetic Surgery; and a member of the Asian Pacific Academy of Cosmetic Surgery. He pioneered research on "Serial Revision of Leg Scars" in 1988. His clinic is at:

Asian Hospital and Medical Center
Unit 518 Medical Office Building
205 Civic Drive, Alabang, Muntinlupa City
Telephone no. (632) 771-9246

Visit his web site at www.geocities.com/docperryster or e-mail him at docperryster@gmail.com.

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Current Comments

3 comments so far (post your comment)

Dear Jay,

Yes, I've heard about this topical treatment. Actually it can be used for both moles and warts. The mechanism of action is the "burning" efffect of the chemical in it. It is actually derived from the cashew fruit. It literally burns the lesion. the disadvantage is that no tissue will be left if you want to send it to the laboratory for biopsy studies to rule out the possibility of cancer. Moreover, I don't think this will work on bigger lesions.

Posted by Dr. Perry on Friday, 05.7.10 @ 11:28am

Oh, I didn't know about that effect of an unsuccessful skin graft.

Posted by Ria on Tuesday, 05.4.10 @ 14:38pm

Dear Doc,
I have seen advertising for a topical treatment for the removal of moles. It's supposed to work like the salacylic ointments on corns or something like that. It claims to be all-natural and plant-based. Have you heard of these and what is your opinion of them?

Posted by Jay on Tuesday, 05.4.10 @ 14:06pm