Removing Moles with Clear Medical Judgment

Hello.

This is Mutoel Plastic Surgery.

Many people find themselves reaching for the mirror because a small mole is bothering them.

A small mole on the face can be a cosmetic concern, but medically, the most important thing is to distinguish whether it is simply a dark mole or an early sign of a more serious lesion.

The medical team at Mutoel also repeats the same phrase whenever we consult with patients as doctors:

“Safety first.”

In particular, because there can be major differences in treatment depending on the size and shape of the mole, and whether it has changed recently, the process of establishing an accurate diagnosis and treatment plan together is essential rather than simply thinking in terms of ‘removing it.’

Today, I would like to explain in detail what criteria are used to diagnose mole removal and what is needed for safe treatment.

You can’t tell by size alone.

First of all, size is the most basic criterion we look at, but size alone cannot determine everything.

In general, moles that are 5 mm or smaller in width/length can often be approached with superficial treatment, but even if they are small, if the color is uneven, the border is irregular, they have grown quickly, or symptoms such as bleeding or itching are present, then they are exceptions.

In the clinic, visual examination, medical history taking, and review of the patient’s past history are standard, and if necessary, in addition to a simple visual check, we use dermoscopy to examine the shape of the lesion in detail.

If a patient says, “It grew within a month” or “It seems to be spreading sideways,” we should seriously consider proceeding with a pathology biopsy right away.

How is mole removal for lesions 5 mm or smaller performed?

Under general standards, mole removal for lesions 5 mm or smaller is often safely performed in dermatology with a CO2 laser. Because CO2 laser treatment works by precisely vaporizing the superficial tissue, it has the advantage of minimizing scarring and allowing quick recovery. However, the important point is that when a lesion is burned and removed with a laser, the tissue is damaged, making pathology examination impossible.

Therefore, CO2 laser treatment is recommended only when the lesion is judged to be typically benign and there is absolutely no suspicion of malignancy.

In other words, CO2 laser can be a good option only when, after 충분한 상담 between the medical staff and the patient, both sides confirm that there are no suspicious findings.

If the lesion is larger than 5 mm or shows suspicious findings

On the other hand, if the mole exceeds 5 mm (6 mm or more), or if it has an irregular shape, mixed colors, rapid growth, bleeding, ulceration, or other abnormal findings, then surgical excision should be performed quickly to secure the tissue intact and carry out a pathology examination.

After collecting enough tissue, including the dermis and the surrounding margin through surgical excision, the pathology department directly examines the lesion under a microscope.

Depending on the pathology results, it is determined whether additional excision is necessary or whether other tests or follow-up observation are needed, so this process is central to diagnosis and treatment.

In particular, in cases such as malignant melanoma, the initial tissue examination and accurate pathological findings determine the patient’s prognosis. Therefore, if the mole is unusually large or has unusual external features, it is most important to check it carefully.

What should be checked before treatment?

The most important thing is to identify when the lesion appeared and whether there have been any recent changes.

In addition, it is necessary to check family history (history of skin cancer), whether the mole was previously irritated or injured, and whether there has been exposure to ultraviolet rays or contact with chemicals in daily life.

Also, when patients visit Mutoel and want removal for cosmetic reasons, if a malignant tumor is suspected, we explain that an accurate diagnosis is impossible without performing a tissue examination, and if there is even a slight suspicion of malignancy, we recommend excision plus pathology examination.

At all times, balancing cosmetic results and safety is the medical team’s role.

Why is collaboration among specialists important?

To balance cosmetic results and safety, collaboration among specialists from different fields is truly important.

Mole removal can be handled by a single department, but to increase patient safety and satisfaction, collaboration among at least three specialists is ideal.

Dermatology has extensive experience in initial screening and noninvasive treatment (laser), so it can reduce unnecessary surgery while also enabling accurate diagnosis,

and plastic surgery is responsible for the final appearance through cosmetic surgical planning and microsuturing techniques.

In addition, pathology can provide an accurate diagnosis and suggest future treatment directions based on tissue findings, so if there is organic communication among the three specialists, the patient can be safely managed from diagnosis to cosmetic outcome and follow-up.

Also, if necessary, dermatology sometimes performs excision as well.

The reason plastic surgery techniques are considered important when excising is because of ‘scarring.’

Simply removing the lesion alone makes it difficult to achieve a satisfactory cosmetic result, and especially for larger moles exceeding 5 mm or in frequently exposed areas such as the face, arms, and neck, the incision line and suturing technique must minimize scarring.

A plastic surgery specialist can perform delicate work such as matching the excision range and suture direction to the skin’s natural crease lines, and can minimize cosmetic scarring by distributing skin tension through layered suturing.

Only when the entire process is supported by an accurate judgment from a dermatology specialist from the start, followed by a careful pathological examination from a pathology specialist, and then cosmetic reconstruction by a plastic surgery specialist, is the ideal treatment process completed.

To conclude..

If you are worried about mole removal, I recommend first consulting a specialist.

However, the most important thing in this process is not simply ‘removing’ the mole, but ‘diagnosing it safely and treating it appropriately.’

Moles 5 mm or smaller can often be treated sufficiently with a CO2 laser in dermatology, but if they are larger than that or there are suspicious signs of malignancy, considering surgical treatment together with pathology examination is the way to receive customized treatment that takes both cosmetic satisfaction and medical safety into account.

If you take a moment before removing a mole and discuss it thoroughly with specialists in each field, even a small mole can be removed neatly and safely.

This concludes the article from Yongsan Plastic Surgery, and we will return next time with even better information.

This has been Mutoel Plastic Surgery.

Thank you.