Primary excision

By Mia Wangsmo Steffenssen MD, Mike Mikkelsen Lorenzen, MD and Pia Sjøgren MD

Introduction

Suspicion outside the plastic surgery specialty: Should refer the patient to the Department of Plastic Surgery.

At the Department of Plastic Surgery: the element should be excised with a 3-5 mm distance. Whenever possible, an excision margin of 5 mm should be chosen, as this serves as radical treatment of benign lesions as well as in situ melanoma.

Lower margins of excision biopsy can be chosen due to cosmetic or reconstructive purposes.

Before and after

Step 1: Preoperativt photo

Preoperative image of the pigmented lesion

Step 2: Preoperative drawing

The pigmented lesion is marked with a 5 mm excision margin

Step 3: Excision

The element is excised in a circular fashion with a macroscopic layer of subcutaneous fat

Step 4: Closure

The defect is closed in two layers using a combination of a deep buried absorbable suture and a cutaneous Nylon suture