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Moles, Lumps, Bumps & Scars
benign skin lesions
Skin lesions come in many forms, from pigment changes and fluid-filled cysts to raised fibrous bumps and tethered scars. While many are medically benign, they can cause significant physical irritation, catch on clothing, or impact your self-confidence due to their size or location. As a plastic surgeon, Mr Nakul Patel provides a comprehensive service for the removal and revision of these concerns. By utilising advanced microsurgical techniques, the goal is not only to remove the “lump or bump” but to restore the skin’s natural contour and minimise any resulting marks. Every excised lesion is handled with clinical precision, ensuring that safety and aesthetics go hand-in-hand.
Procedure Overview
The Different Techniques of Moles, Lumps, Bumps & Scar Removal
The method chosen depends on the nature of the lesion, its depth, and whether a laboratory analysis (histology) is required.
Moles, Lumps, Bumps & Scar Removal Journey
Before & After Gallery
Benefits of Moles, Lumps, Bumps & Scar Removal
Are You Suitable for Moles, Lumps, Bumps & Scar Removal?
You may be suitable if
- Changed Mole: You have a mole that has changed in size, shape, or colour (ABCDE criteria).
- Irritating Lump: You have a persistent lump, such as a cyst or lipoma, that occasionally becomes inflamed, painful, or unsightly.
- Bothersome Scar: You have an old scar from a previous surgery or injury that is wide, raised, itchy, or aesthetically bothersome.
- Private Management: You have been told your lesion is "cosmetic" and cannot be treated on the NHS, but you still wish to have it removed privately for peace of mind or comfort.
Alternatives
- Clinical Monitoring: For benign moles or small, stable lipomas that are not causing physical symptoms, "watchful waiting" or annual mole mapping may be a suitable alternative to surgery.
- Non-Surgical Scar Therapy: If a scar is raised or red but not wide, non-surgical options like steroid (Kenalog) injections, silicone sheeting, or laser therapy may help flatten and fade the tissue without further surgery.
- Dermal Fillers: For "pitted" or depressed scars (such as those from acne or chickenpox), injecting a small amount of dermal filler can temporarily lift the skin to match the surrounding surface.
- Cryotherapy: For very superficial surface lesions like viral warts or sun spots (actinic keratosis), freezing the tissue with liquid nitrogen may be an option, though this does not provide a tissue sample for histology.
The Procedure: What's Involved ?
Step 1: Local Anaesthesia
A tiny needle is used to numb the skin around the lesion. You will feel a brief sting, followed by total numbness in the area.
Step 2: Expert Removal
Depending on the plan, the lesion is either shaved or excised. Mr Nakul Patel ensures that the margins are clean and the tissue is handled delicately to preserve it for the laboratory.
Step 3: Closure and Dressing
For excisions, the skin is closed with fine sutures. A sterile, waterproof adhesive dressing is applied so you can shower comfortably the following day.
- We confirm that all relevant excised tissue (moles, cysts, and lumps) will be sent for formal pathology.
- We orient the repair to sit within your natural skin creases (Langer’s lines) so the scar is as discreet as possible.
- We decide between dissolvable sutures or removable ones based on the location and skin tension of the site.
- If you have a history of keloids, we plan immediate post-operative therapies to prevent the scar from thickening.
- We review your lifestyle to ensure you can avoid stretching the area for 1–2 weeks, especially if the lesion is on the back or a joint.
- We confirm which medications or supplements (like Aspirin or fish oils) should be paused to minimise bruising and haematoma risk.
Preparing for Surgery
Avoiding Complications
Initial Inflammation: For the first 48 hours, it is normal for the site to be red, slightly warm, and tender. This is the body’s natural “inflammatory phase” of healing.
Bruising & Swelling: This is common, particularly for deeper lesions like lipomas or cysts where the surgeon must work beneath the skin. Swelling usually peaks at 48 hours and then gradually subsides.
Maturational Scarring: Every incision results in a scar. Initially, the scar may be pink, purple, or even slightly “lumpy.” It takes 12 to 18 months
Scar Widening or Stretching: Even with perfect suturing, scars in “high-tension” areas, such as the back, shoulders, or chest tend to widen over time as the skin is constantly pulled by body movement.
Suture “Spitting”: Sometimes the body identifies a dissolvable stitch as a foreign object and tries to push it out. This can cause a small, pimple-like bump on the scar line. It is easily resolved by the surgeon removing the tiny thread.
Nerve Sensitivity or Numbness: Tiny sensory nerves in the skin are inevitably divided during an excision. This can lead to a patch of numbness around the scar or, occasionally, a “pins and needles” sensation. In most cases, this resolves within a few months, but it can occasionally be permanent.
Pigment Changes: The new skin of the scar may heal darker (hyperpigmentation) or lighter (hypopigmentation) than the surrounding skin. This is often exacerbated by sun exposure in the first year.
Wound Infection: While we operate in a sterile environment, bacteria can enter the wound post-operatively. Signs include spreading redness, throbbing pain, pus, or a fever. This requires a course of antibiotics.
Hematoma or Seroma: Occasionally, blood (hematoma) or clear fluid (seroma) can collect in the space where a large cyst or lipoma used to be. If the collection is large, it may need to be drained with a small needle to allow the skin to heal flat.
Wound Dehiscence: This is when the edges of the wound pull apart. It most commonly happens if the area is strained by heavy lifting or exercise too soon, or if an infection is present.
Keloid or Hypertrophic Scarring: In some individuals, the body overproduces scar tissue, leading to a thick, itchy, or painful raised scar that extends beyond the original incision. This is a biological response and may require further treatment with steroid injections.
Recurrence: For cysts, if the microscopic lining of the sac is not entirely removed (which can happen if the cyst was previously ruptured or inflamed), there is a small chance the cyst could reform. Similarly, a mole may occasionally show a small spot of regrowth if it was very deep.
Frequently Asked
Questions about Moles, Lumps, Bumps & Scar
Will I be left with a "hole" after a large cyst or lipoma is removed?
No. We use "dead space closure" techniques, where internal stitches bring the deep tissues together to fill the gap left by the lump. This ensures your skin heals with a flat, natural contour rather than a depression.
How soon can I swim after mole or cyst removal?
You should avoid swimming in pools, lakes, or the sea for at least 2 weeks, or until the wound is completely closed and any stitches have been removed. Submerging a fresh wound in water increases the risk of infection and can soften the healing tissue, potentially causing the wound to open.
Can I apply make-up or concealer over the area?
You should wait until the wound is fully healed and any scabbing has naturally fallen off—usually around 10 to 14 days. Applying make-up too early can introduce bacteria into the wound or cause "tattooing," where pigment from the make-up becomes trapped permanently in the healing scar.
Why is my scar still red after 3 months?
Scars stay red as long as the body is still sending extra blood flow to the area to build new collagen. This "vascular" phase is normal. The redness will gradually fade to pink and eventually white over the course of a year.
What happens if the histology report shows something suspicious?
If a lesion is found to be atypical or cancerous, Mr Nakul Patel will discuss the report with you in person. Mr Patel will perform further "wide local excisions" or reconstructive surgery if necessary to ensure your health and safety.
Does the procedure require a general anaesthetic?
The vast majority of these procedures are performed under local anaesthetic. This is safer, allows for a faster recovery, and means you can eat and drink normally before and after your appointment. General anaesthesia is usually reserved for very large lipomas or for patients who are extremely anxious.
Is the procedure covered by my private health insurance?
Most insurers cover the removal of symptomatic lesions (those that are painful, inflamed, or suspicious). They typically do not cover "cosmetic" removals. We can provide you with the specific procedure codes (e.g., S0632) to check with your provider.
Will the hair grow back if a lesion is removed from my scalp?
When we remove a cyst or mole from the scalp, we aim to make the incision as narrow as possible. While hair will not grow directly through the linear scar, the surrounding hair usually covers the area completely. If the lesion was very large, there might be a tiny permanent "parting" where the scar sits.
What is the difference between a "shave" and an "excision"?
A shave removes the part of the mole that sits above the skin surface and requires no stitches; it is best for benign, raised moles. An excision removes the entire thickness of the skin and requires stitches; it is necessary for cysts, lipomas, and any mole that needs to be checked for safety.