Skin lesion excision

What are the most common types?

Lipomas and sebaceous cysts are the most common conditions referred for surgical excision by a general surgeon.

What are they?

Lipomas – These are benign lumps made of fatty cells occurring in around 1 % of the population. They can appear anywhere on the body and are usually painless. Some patients have multiple lipomas and this can be hereditary. Cancerous change in a simple lipoma is very rare. They are removed if they cause symptoms, if there are multiple lesions or if there is a change in size or appearance.

Sebaceous Cysts – These are benign cysts of the skin, which can become infected. Infection causes them to enlarge and become red and painful. They most commonly occur on the scalp or back.

How are they removed?

Both of these lesions can usually be removed under a local anaesthetic. The skin around the area is injected to make it numb. The lesion can then be removed without pain. The incision is then closed with dissolvable sutures and a waterproof dressing applied. The dressings can usually be removed after 5 days.

Occasionally larger lesions will require a general anaesthetic. Your surgeon will discuss this with you.

What are the risks?

The risks of the procedure are minimal. Wound infections are uncommon but can happen with any type of surgery. After removal of larger lesions, fluid can collect in the space left behind, called a seroma. You do need to be careful to avoid strenuous activity that places stress on the sutures for a few weeks after surgery. Opening of a wound delays healing and may require packing or regular wound reviews to allow it to heal.

Post operative follow up?

A clinic appointment is required a few weeks after the procedure to discuss the result of the specimen after a pathologist has assessed it. The wound will also be inspected and any concerns addressed.

Can they come back?

Yes, but it is uncommon for the lesions to return.