Mole Removal
Moles can come in a variety of shapes and sizes. Most often these are dark brown or black but they can also be raised and skin coloured.
People seek mole removal for a variety of reasons which may include:
- For improved cosmetic appearance especially when moles are located on the face
- For functional reasons where moles especially those that are raised or pedunculated can catch whilst shaving, wearing clothes, etc.
- For concern regarding changing appearance of the mole
All of us are born with a number of moles, and in our growth years the number of moles increases
Most moles are benign and have the following features:
- They have a uniform colour
- They have a uniform contour
- They look symmetrical
- Their edges are close to being round as possible
- They remain stable over long periods (over years, or grow very slowly over this time).
Benign moles can be left alone, and do not require surgical excision. However even if they are left alone, two things are extremely important:
- Sun protection: wearing a hat & sunglasses, covering up as much skin from exposure to direct sunlight, and applying (and regularly reapplying) high SPF sunscreen to sun exposed skin areas when out in the sun especially whilst outdoor swimming.
- Regular skin checks: This is for early detection of mole change, as well as non-melanoma skin cancer. Regular skin checks can lead to early detection and simpler treatment.
Moles that are changing and are deemed suspicious are those that have the following – these changing features are summarised as ‘the ABCD rule’:
- A – Asymmetry
- B – Irregular borders
- C – Uneven colour
- D – Diameter>6mm
- If you detect these, you should seek advice from a medical practitioner
The best candidates for mole removal are those who:
- Are physically and mentally healthy
- Have a cosmetic concern with realistic expectations
- Are willing to trade off the mole excision for a scar
- Hare concerned their mole is changing
We can perform mole removal in our rooms at Gordon, under local anaesthetic.
- Anaesthetic: Usually LA (can be assisted LA if many lesions)
- Time: 30 minutes
- Hospital: Usually performed in our rooms at Gordon, or in a day surgery/private hospital setting.
- Medicare/Health fund rebate: Yes
- A small Medicare rebate may be available for in rooms procedures
- A Medicare/health fund rebate is available if performed in day surgery/private hospital however you may need to take into account the excess on your medical insurance policy. We often do ‘known gap’ pricing for single lesions, if your fund allows this.
- Recovery: You may get some bruising or swelling at the site for a few days, but most of this has resolved by one week. If on the face, external sutures are removed early around the 1 week post-operative mark.
- Results: Usually excellent although final scar results vary according to skin colour, type and genetic background. You will be given instructions on how to improve the scar after the wound has healed at the 2 week mark, and these need to be followed for around 3 months for optimal scar results.
Cosmetic Concerns
- Unfortunately excision of a mole will always leave a scar
- If a circular area is excised from the skin and closed, it will create pleats on either side of the excision. These pleats will not settle and can look more obvious than a well-placed scar.
- It is therefore essential to convert the circular excision into a short ellipse. While the scar is initially obvious it will usually fade over 3 months in the skin crease lines.
- We will always endeavour to keep the scar as short as possible while also allowing for the best contour.
- Yes
- Health fund rebates are not available for in room’s procedures however a Medicare rebate may still apply.
- In certain areas moles can be of a size where direct closure can be difficult to achieve. This can be on certain locations of the face such as the nose, or ear.
- In these cases the options are local flaps or skin grafts if direct closure is not possible
- We will speak to you about the options during a consultation – however if it is not medically necessary (i.e. the mole is not changing) in these situations embarking on a local flap or skin graft reconstruction may not be warranted.
Procedure Information
The procedure is usually performed under local anaesthesia in our Gordon rooms. The local anaesthetic is given by Dr Aggarwal, who will check that it is working before making any incisions
- You are marked before the procedure – a round excision of the mole is converted to a short ellipse to allow the skin to flat at the time of closure. The scar is oriented to sit in the skin crease lines.
- After the local is given, you will not feel any sharp sensations or pain. You will however feel light touch, pushing and pulling.
- The area is excised and sent for histopathological examination (examination under a microscope) but this will take several days
- Dr Aggarwal may use a device called a diathermy to control bleeding.
- The skin is closed in layers
- Dr Aggarwal will place dressings over the incisions.
- You will be able to get the area wet after 48 hours. However you will not be allowed to swim in a pool or beach for at least 2 weeks after surgery.
- You will be given a script for antibiotics by Dr Aggarwal which you must continue for 1 week (if needed). You will also be given appropriate pain relief medications.
- While most sedentary activities can be resumed when you go home, you must not perform any activities that raise your blood pressure for the first 48 to 72 hours.
- Dr Aggarwal will see regularly after your discharge from hospital.
Risks & Complications
Every surgery carries risks, and therefore one must consider if risks outweigh the benefits for your own personal situation. If they do then the surgery may be well worth it. Dr Aggarwal will discuss the pros and cons of surgery with you during your consultation.
- Risks of anaesthetic – most mole removal surgeries are performed with local anaesthetic or assisted local anaesthetic (with sedation). The risks of anaesthetic are therefore minimal but there is a small chance of a reaction to the local anaesthetic or sedation.
- Bleeding – the risk is higher in those on blood thinning medication. Dr Aggarwal will discuss with you what you need to do with blood thinners and discuss the pros and cons of ceasing or continuing your medication. Dr Aggarwal may need to consult with your GP, cardiologist or other physicians involved in your care before a decision to change your medication is made. Any bleeding is controlled during surgery however unexpected bleeding can occur in the immediate postoperative period. If this occurs it can usually be controlled through direct sustained pressure.
- Infection– this is rare. You may be given a course of oral antibiotics after your surgery, depending on your surgery, to keep this risk to a minimum.
- Unexpected pathology: a pigmented lesion may return after pathology examination (examination under a microscope) as:
- Benign mole – in this case no further treatment is needed.
- Dysplastic mole (changing mole) – in this case no further treatment is needed
- Melanoma in situ – in this case further 5mm clinical margins are required around the previous scar
- Melanoma – in this case further skin excision is needed of 1-2cm, and examination of the lymph nodes may be needed in some cases (Sentinel lymph node biopsy – please see our section on Melanoma for more information).
- Hypertrophic or poor scars – How one’s body behaves to scarring is individual and largely genetic. Some types of skin are more prone to hypertrophic or keloid scarring, and some individuals and families are more prone to this. We will routinely advise you on how to improve the quality of scars over time. You should also discuss any history of abnormal scarring with Dr Aggarwal preoperatively.
Procedure FAQs
- Yes, firstly it is possible to claim a Medicare rebate of approximately $73 for the consultation if you have a referral
- Furthermore, mole removal surgery is associated with Medicare Item Numbers – therefore rebates will be available from Medicare if the surgery is performed in rooms, or from both Medicare and health fund if it is performed in a day surgery or hospital.
- You can see us at our main practice at Gordon, or at one of our other locations at Hornsby, Hunters Hill or Camperdown.
- Please scroll to the bottom of the page to find out more information about these locations.
- Surgery may be performed in our Gordon rooms
- It can also be performed at any of the hospitals where Dr Aggarwal works – Sydney Adventist Hospital, SAN Day Surgery, Hunters Hill Private Hospital or Chris O’Brien Lifehouse.
- Cease fish oil, and other supplements such as Ginkgo, Ginseng.
- Please discuss with Dr Aggarwal if you are on blood thinning medications as he will discuss with you if these should be continued or temporarily stopped or altered.
- Stop smoking around the time of surgery and recovery.
- You will be given written instructions regarding these.
- It is common to use Chlrosig ointment for excisions on the face.
- Dr Aggarwal will give you instructions on scar management to improve the cosmetic results once wounds have healed.
- In general it is best to avoid any activity that raises blood pressure for 48-72 hours after surgery.
- If surgery is performed on your lower limb (leg or foot) it is best to avoid walking as much as possible and elevate the leg whenever you are still to the level of the hip.
- Dr Aggarwal will provide you with the necessary scripts for antibiotics and pain relief.
- Yes
- However we always encourage patients not to be away overseas shortly after having a procedure, and you are best to advise Dr Aggarwal of this preoperatively so the best timing of surgery can be planned.
- You may do gentle swimming in a pool or beach after 2 weeks once all wounds have healed.
- It is best to not drive for the first 1-2 days after sedation or general anaesthetic (if this was used in your mole removal treatment).
- You may be restricted from driving for longer if your surgery was on your legs.
- Yes absolutely.
- This can be performed in our Gordon rooms or in a day surgery setting.
- In general surgery is the best treatment for moles that can be removed as the entire area is removed (therefore reducing a chance of recurrence) and it is sent for histopathology examination to exclude any worrying features.
Procedure Pricing
- The cost for mole removal surgery is determined by the location and number of lesions.
- In general at Mode Plastic Surgery, we follow the guidelines for fees set out by the Australian Medical Association. The surgical fee is approximately $700-800 for a single lesion.
- If the procedure is performed in our Gordon rooms, there will be a facility fee ($250) charged for coverage of our sutures, sterilising, and nursing staff.
- For insured patients, we offer known gap pricing if you are in a suitable fund (the exception being NIB insured patients), however you must take into account the excess on your insurance policy to determine overall costs.
- We will provide you with a written quote before proceeding with surgery.
Meet Dr Aggarwal
Dr Aggarwal is a well regarded, respected, highly skilled and experienced Specialist Plastic Surgeon. Graduating at the top of his class throughout his training, Dr Aggarwal has completed fellowship training at some of the world’s most prestigious reconstructive and cosmetic plastic surgery institutions. He continues to publish research is prestigious plastic surgery journals, and is actively involved in the training of future plastic surgeons.
What sets Dr Aggarwal apart from others is his personal, affable and warm nature. Not only does he pay attention to detail, to producing natural, beautiful results but he ensures that the patient’s journey is just as special as their outcome. Dr Aggarwal looks after patients at two of Sydney’s most prestigious public hospital campuses (RPA and POWH/RHW), and operates privately on the North Shore.
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