Adrian Richards explains the surgical removal of Skin Lesion and the recovery time. For more information or should you wish to book a FREE Consultation with our specialist plastic surgeon, please call us on 01844 214362.

Recovery Following Surgical Removal of Skin Lesions

Hello. My name is Adrian Richards. I’m a consultant plastic surgeon and the Surgical Director of Aurora Clinics. Today I’m going to be talking a little bit about recovery period following surgical excision of a skin lesion. By surgical excision, I mean that the skin has been cut the full depth to remove the full thickness of the skin, and the wound has been stitched. Normally, the wound will be stitched internally with absorbable stitches, and these internal stitches actually hold the skin together. So the external stitches, the ones you see, are just holding the skin gently together, but aren’t actually doing any of the pulling work. That’s done by the deep stitches which you won’t see. The superficial stitches just really approximate the top of the skin.

Depending on where in the body the stitches are they’ll be removed at a different time. This is really to stop the dot marks that you sometimes get around on either side of the scar. The old fashioned scar would be a scar in the middle with dots on the side. The dots are caused by growth of the top layers of the skin down the sides of where the stitches are. This only occurs if the stitches are left in too long. The best time to remove the stitches varies from site to site. On thin skinned areas, such as the face, we tend to remove the stitches at about five days. On thicker areas, such as the palm of the hand where the skin’s really quite thick, we can leave the stitches for up to two weeks without getting the surrounding dots.

When you’ve had your skin lesion removed, we will give you or you should be given an appointment to have your stitches removed. It’s very important that you do attend this so that the nurses or doctors can check that everything’s healing well and remove the stitches as planned and hopefully give you the results of your histology at that stage.

In the intervening period, if you had an operation on your face, it’s very important to try and reduce the excess blood flow to the area. That means in the first couple of days avoiding anything that increase blood flow – aerobic activity, alcohol, and in particular any sort of leaning down activity which puts your head lower than your heart because that tends to cause blood to rush to the face and more chance of bleeding and swelling of the area. So try and keep your head up, a couple more pillows at night to reduce the swelling. That applies to any area of the body. Try and elevate whichever bit as far as you can and reduce anything that causes blood to go there.

If it is tender, once the anaesthetic wears off, we tend to recommend that you just take paracetamols. That is actually very effective in controlling pain. Non-steroidal drugs, such as ibuprofen and voltarol, are generally not recommended because they can increase the risk of bleeding. They can thin the blood and you’re more likely to get bleeding from the areas. So generally we don’t recommend those. Normally paracetamol should be absolutely fine. If the pain is not controlled by paracematol, we would normally encourage you to contact us because it might be good just to check everything’s okay because normally after these procedures you really shouldn’t be that uncomfortable.

So we’d like you to keep the wound dry until you have your stitches removed so you can shower. Just try and keep the area as dry as possible. The dressings we use will stay on for a week. When the stitches are removed, the nurse or doctor will give you instructions about what to do with the scar. The scar normally heals very well initially. Then it will go through a red phase which lasts two to three months following surgery, and thereafter the scar tends to settle. The reason you get the red phase is the body’s trying to heal the area. Once the body senses it’s healed, it remodels the scar and then the scar becomes flatter, paler, and eventually we hope that the scar will turn to a very fine, silvery line which is difficult to see. As I mentioned, we try and orientate it along a natural crease so it’s difficult to see.

So surgical removal is generally under local anaesthetic. The anaesthetic itself going in is slightly uncomfortable, but thereafter you shouldn’t feel any pain and the recovery should be fairly straightforward. You do need to, obviously, contact us if you have any concerns.

I hope that’s been helpful. If you would like any more information about skin lesions and their removal, please contact us either via ringing 01844 214362, or by contacting us via the Aurora Clinics’ website, which is Aurora-Clinics.co.uk. Thanks very much for listening, and we look forward to seeing you soon.