Excisions in Huntington Beach, CA

A surgical excision removes a lesion along with a thin border of normal-looking skin around and beneath it, called the margin. The margin is what makes an excision different from a biopsy: a biopsy samples a spot to find out what it is, while an excision is meant to take the whole thing out.

The removed tissue is sent to a pathology lab, where it is examined to confirm the diagnosis and to check whether the margins are clear. If cancer cells reach the edge of the specimen, more tissue may need to be taken at a second visit.

Excision is most often used for:

• Basal cell carcinoma and squamous cell carcinoma
• Melanoma, once the diagnosis has been confirmed by biopsy
• Atypical or changing moles that need to come out with a margin
• A skin cancer that a previous procedure did not fully remove

If you are not sure what a spot is, that is what the appointment is for. Suspicious lesions are biopsied first, so the diagnosis is known before anything larger is planned.

An excision is an outpatient procedure done in our office. You are awake, and only the treatment area is numbed.

1. The area is cleaned and the planned margin is marked around the lesion.
2. The area is numbed with an injection of local anesthetic.
3. The lesion is removed together with its margin, usually in a narrow oval so the skin closes in a straight line.
4. The wound is closed with stitches. Deeper wounds may need a layer of dissolvable stitches underneath.
5. A dressing goes on, and the tissue goes to the lab.

Most excisions are finished in a single visit. You should feel pressure and movement but not sharpness — tell your provider if you do, and more anesthetic can be added.

Both remove skin cancer surgically. The difference is when and how the margins are checked.

In a standard excision, the tissue goes to an outside lab and a sample of the margin is reviewed over the following days. In Mohs surgery, the surgeon examines essentially the entire margin under a microscope during the appointment and takes more tissue only where cancer is still present, before closing the wound.

Excision is well suited to smaller, well-defined cancers on the trunk, arms and legs. Mohs is generally chosen for tumors on the face, ears, hands and other areas where sparing healthy tissue matters, and for cancers that are large, poorly defined, or have come back. Your dermatologist will explain which one fits your tumor and why.

You go home with a dressing and written instructions covering how to clean the wound, when to change the bandage, and when it is safe to resume exercise and swimming. Soreness, mild swelling and bruising for a few days are normal.

Stitches are removed at a follow-up visit; how long they stay in depends on where on the body the excision was. Your pathology results are reviewed with you at that visit or sooner.

Yes. Any procedure that cuts through the skin leaves a scar — the goal is to make it as fine and as well hidden as possible, which is why excisions are planned along natural skin lines wherever the anatomy allows. Scars are usually firmest and pinkest in the first weeks, then soften and fade over the following months.

Keeping the healing scar out of the sun, and covered with sunscreen once it has closed, makes a real difference to how it ends up looking. If you would like to soften an older scar, ask about our resurfacing and laser options.