Cyst Removal Question

Dear Aurora Clinics,
I discovered a cyst in my armpit a couple of years ago and sought the advice of my doctor who informed me that it should be surgically removed. This was carried out six months ago but one month after surgery I had to return because of pain. I still take oral antibiotics and cream and the wound is still red. Sometimes I can see white coloured thick liquid oozing out when I apply pressure to the wound. How long will it take to heal completely?

Cyst Removal Answer

It does sound as though you have a residual infection in your arm pit area. Generally we would advise that you have a further course of antibiotics. When the area has settled down, the scarred region would need to be removed in order to reach the source of the infection.

It would be better to see you at the clinic so as we can discuss the best way forward for you. Please schedule a consultation by ringing us on: 0800 328 5743.

Best Wishes,

The Aurora Cosmetic and Plastic Surgery Team

Is it possible to excise this area again and re-stitch it?

Answer :
It sounds as though you have cross stitches in your incision which have left dots on either side of the scar. These dots are caused by an in growth in the top layers of the skin and the passages are made by the cross stitches. They normally occur if the stitches have been left in for more than five days.

To eliminate them, the scar and the dots will have to be removed but this will result in a longer scar than the one that you currently have.

It would probably be better to see you in person so as we can take a better look at the region. Alternatively, you could email a photo to: info@aurora-clinics.co.uk.

If you would like to schedule a consultation with one of our specialist surgeons you can do so by calling our offices on: 0800 328 5743.

Many thanks for getting in touch. We look forward to hearing from you soon.

Best Wishes

The Aurora Cosmetic and Plastic Surgery Team

Why do so many teachers opt for plastic surgery?
At Aurora Clinics, many of our surgeons have noticed a trend for more teachers than other professions opting for plastic surgical procedures.

The possible causes for this that we have discussed include:

Pressure to remain youthful:
Teachers are one of the only professions who frequently work with people who are younger than them. As teachers typically start in their 20s, it may be that the comparison with the youthful appearance of their pupils does make them more aware of the ageing process than people in other professions. We feel it may be this comparison which is prompting more teachers to seek plastic surgical treatment.

Awareness of certain physical characteristics:
As we know, children can be quite open and frank with their opinions. We have seen teachers who have come to us for simple procedures such as facial mole removal because their pupils have remarked about their facial moles and wish to have them removed so this does not draw attention to this region. We feel that teachers opt to have moles and other facial lesions removed more frequently than non-teachers for this reason.
We also treat more than average number of teachers for conditions such as prominent ears and for nose reductions. Again these are physical characteristics which can be picked up by students and often teachers opt to have these corrected so these features will not cause any further undue attention.

Overall we have noticed a significant increase in the number of teachers opting for plastic surgery over other professions. Whilst we are not absolutely sure of the reasons for this we feel that the above may be contributory and we welcome any further opinions for this trend. Email info@aurora-clinics.co.uk if you have any ideas.
The most popular times for teachers to have plastic surgery procedures are at the beginning of the summer holidays for more major procedures and the beginning of the other holidays for smaller procedures with a quicker recovery rate.

One thing is for certain is that our operating list will contain a significant amount of both teachers and pupils considering treatment such as prominent ear correction at the beginning of the summer holidays.

The warning signs…

Each and every one of us has blemishes on our skin, in the form of freckles moles, birth marks and spots: some people have more than others. On average, we have around 25 moles throughout our bodies although this number can increase or decrease from person to person.

With this in mind, it is important that we examine ourselves on a regular basis so as we become familiar with the moles that we already have and aware of any new ones. Moles are a unique feature in human beings as they are scattered in so many different ways, they are part of our make-up and nearly always non-cancerous. If however any moles show a change in size, appearance or display symptoms such as itching or bleeding there is a chance that they could become cancerous. There are many types of skin cancer ranging from very benign through to more serious types. Let’s take a look at some of the signs and symptoms.

The safest type is also the most common one is known as a basal cell carcinoma (BCC) or a rodent ulcer.

This type of skin cancer can generally occur on sun exposed areas such as the face, head or neck and is thought to be caused by strong exposure to the sun during the teenage years and twenties. This is particularly common in countries where fair skinned people are subjected to excessive amounts of sun such as Australia and New Zealand. It is also found in European countries where high levels of UV rays can cause such damage. Therefore, Europeans who worked in hot climates during their youth could become vulnerable to a BCC in later life.

Basal cell carcinomas tend to appear as smooth, shiny, wax like bumps which are white, red or pink in colour and enlarge slowly over time. They hardly ever spread around the body and once removed are very unlikely to recur. Someone who has had a BCC in the past is more at risk of developing a further one. However, mole removal is an effective way of treating this cancer without any further problems.

The second most common form of skin cancer is a squamous cell carcinoma (SCC).

Again, this type of cancer tends to appear on parts of the body which have been exposed to the sun such as the face, lips, neck, scalp, ears and back of hands. It is a by-product of long term exposure to the sun and is likely to remain dormant during the late teens or twenties and surface during middle or old age.

SCC’s can spread around the body if not detected quickly but during the early stages, they tend to stay relatively small and confined to one region.

A squamos cell carcinoma appears as a crusty or scaly base of reddened skin which acts as a base for a growing lesion. The only answer for this type of cancer is mole removal which is then treated with a safe cuff of tissue which is secured around the area. This region should continue to be monitored for many years afterwards.

In some cases squamos cell carcinomas can spread to the surrounding skin or lymph glands in the neck. Therefore, it is important for people who have previously had a SCC to regularly check for swelling in the neck glands.

Melanoma merkel cell tumours.

Melanomas are cancers which originate in the pigment cells of the skin (melanocytes). They can appear on any part of the body and are often prevalent in the 45-50 age bracket. They are common amongst Caucasian people who are fair skinned, light haired and have more than 100 moles on their body or have a funny looking mole which stands out from the rest.

The melanocytes are the cells which produce the brown blemishes on our skin known as melanin, which is evident as a raised mole or flat brown freckle. If the pigment cells grow out of control, they tend to produce too much melanin and form a dark coloured tumour known as a melanoma.

Melanomas can spread around the body and are a potentially dangerous form of skin cancer which requires mole removal.

Melanin is also responsible for changing the skin from a pale white to golden bronze during a spell in very hot weather. When the body is exposed to UV rays from the sun, the melanocytes secrete an increased amount of melanin which gives the skin its tanned appearance. Many believe that a sun tan is the sign of good health but it is quite the reverse and provides medical evidence that the skin has been damaged.

Merkel cell carcinomas (MCC’s) are also highly aggressive skin cancers which tend to appear on the face and neck of elderly people. They are often the result of intense sun exposure during the younger years and may require mole removal with utmost urgency as they can spread around the body quite rapidly.

Malignant melanomas are potentially dangerous skin cancers and can arise from a pre-existing mole or from a normal area of skin. They appear as a painless, firm, flesh or red-violet coloured bump which enlarges over a period of weeks and months.

Anyone who suspects that they have a melanoma or indeed a squamous cell carcinoma should have the area thoroughly assessed by a skin specialist who will advise whether mole removal is the best form of treatment.

Generally, mole removal is the easiest way to stop skin cancer before it has a chance to spread. It also increases the chances of a full and complete recovery.

TELL-TALE SIGNS OF SKIN CANCER.

The one thing to look out for with any skin lesion is change. Skin cancers can either arise from unblemished skin or from skin which has a pre-existing mole.

A mole which has been prevalent since childhood and has shown no sign of change is unlikely to develop into skin cancer. However, a lesion which has changed in colour, increased in size or produced symptoms such as itching or bleeding could become cancerous.

CHANGE IN SIZE: Any lesion which increases in size could be cancerous as cancer cells tend to multiply. It is often difficult to tell if a mole is growing, especially if it is seen every day so it may be worthwhile taking a photo of the area. It would also be wise to ask a family member to take a look at any lesions which cause concern.

If a mole has changed in any way, it is highly recommend that an appointment is sought with a specialist skin doctor or plastic surgeon to assess the region and advise whether it could be cancerous and thus treated via mole removal.

CHANGE IN COLOUR: If a lesion has changed from a lighter shade to a darker brown or even black, it could be cancerous. The same applies if only a part of it has changed colour and appears darker. Therefore, it is highly recommended that a consultation is made with a skin specialist to assess the area and advise whether mole removal is necessary, the tissue will then be submitted for analysis.

CHANGE IN SYMPTOMS SUCH AS BLEEDING AND ITCHING:

In some cases bleeding and itching can occur if a mole is accidentally scratched or traumatised by clothing such as a bra strap or belt.

However, bleeding and itching and a change in sensation can also be a sign that a lesion is becoming cancerous. If a mole itches, bleeds or has changed in appearance for more than a week or two, an early consultation with a skin specialist is vital to assess the area and advise whether mole removal would be the best option.

It is important to have a lesion checked out by a suitable medical practitioner. Specialist surgeons at: http://www.aurora-clinics.co.uk/ will provide the peace of mind that you need to stay well. It is always better to seek advice straight away as earlier detection is vital for a good outcome. Call us on 0800 328 5743 today if you would like a Consultation.

I recently had a mole removed from the front bicep of my arm and I believe it has healed into a hypertrophic scar.

My GP did it for me and used stiches that were left in for about a week and a half. In your opinion was that too soon to remove the stitches?

This is actually my second mole removal. My first one also looked like a hypertrophic scar and has healed now to be almost the same colour as my skin. The thing that makes me self conscious about this mole removal is because it is in a much more noticeable place and not healing as well as the previous one.

I was using Bio-oil on the scar for about 2 months then discontinued use because I ran out. Even when this scar does turn into the similar pigment as my skin it will still be noticeable because of the position.

I saw there is a possibility of scar revision surgery but they say there is a high risk of hypertrophic scarring reoccuring?

Thank you so much for reading!

Answer :

Many thanks for sending me your photographs.

It does look as though you have a hypertrophic scar and that your scar may have opened slightly whilst it was healing.

It is difficult to say whether your stitches were taken out too soon without knowing more about your case.

I would advise you get more Bio-Oil to continue massaging the scar with and also you should apply silicone sheets such as Cica-Care to the area on a daily basis. This will greatly help the area settle and fade.

I think the scar is likely to get slightly smaller with time but is unfortunately unlikely to heal into a fine line.

I think it would be sensible to leave the area to settle completely for 12-24 months before considering surgery: as it is a hypertrophic scar, it is likely to improve with time.

I hope this information has been useful. Please do not hesitate to contact me again if you feel that I can be of any further help.

If you have any skin lesions which concern you it is best to have them checked out. At Aurora Clinics, we are offering a free mole consultation with our Consultant Plastic Surgeon. Most will turn out to be normal with only a minority of skin lesions requiring removal.

Below Mr Adrian Richards goes through the nature and treatment of some of the more common skin lesions:

Juvenile moles

These are what we normally think of as moles. They tend to occur either at birth or before the age of 30. These lesions are flat or slightly raised, brown and may develop hairs. These lesions are very unlikely to develop into skin cancers and most are left alone. Some people prefer to have them removed particularly if they are large or on the face. Removal is straightforward and can be performed at Aurora Clinics under local anaesthetic.

Intradermal moles

These moles tend to develop later in life- typically after the 30th birthday. They look like small skin coloured rounded nodules. They usually occur on the face and slowly increase in size and develop hairs. Long-standing lesions develop into the lesions we associate with witches chins.

Intradermal moles are very unlikely to develop into skin cancers. They are easily removed at Aurora Clinics. It is advisable to have them removed before they become too large as this minimises any scarring.

Basal cell carcinomas

These lesions are also known as BCC’s or rodent ulcers. They tend to occur in sun exposed areas most commonly the face and neck. They usually look like small pearls in the skin. Although they are technically skin cancers they do not spread around the body and do not come back once they have been removed.

Melanoma

These skin cancers arise from the brown pigment cells in the skin. They can arise from existing moles or develop on their own. They can occur at any site around the body and are usually dark. As they are growing they are characterised by change. This is why it is important to have any moles checked out if you feel they are becoming larger, darker or itchier.

Melanomas are associated with sun exposure early in life and can be life threatening if not treated early. Early lesions are removed and unlikely to cause any further problems.

Most people have moles and the vast majority of these are harmless but can be removed if you wish. If you are concerned about any skin lesion it is important to have it checked by a specialist.

Aurora Clinics are offering free mole assessments by a specialist. To book your appointment please ring 0800 328 5743 to arrange your complimentary consultation.