Mr. Onur Gilleard
Qualifications & Experience
Mr Onur Gilleard is a distinguished consultant plastic surgeon on the GMC specialist register. He previously held an NHS consultant post at St Bartholomew’s Hospital in London, specialising in skin cancer and microsurgical reconstruction. In 2021, Mr Gilleard transitioned from the NHS to dedicate himself fully to private practice, allowing him to focus exclusively on providing personalised, high-quality care to his patients. He is recognised as an expert in laser treatments, having conducted research and developed advanced treatment protocols using cutting-edge laser technology to optimise both clinical outcomes and cosmetic results.
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The two main ways to remove a skin lesion are shave removal (taking the lesion off level with the
skin, no stitches) and surgical excision (cutting it out fully and closing with sutures). Shave
suits small, raised, clearly benign lesions and leaves a flat mark; excision suits deeper lesions, anything that
needs the full depth analysed, and gives the most complete removal. Both can provide tissue for the laboratory.
The right choice depends on the lesion, its depth, and whether a diagnosis needs confirming. This guide compares
the two so you know what to expect.
Shave Removal
Under local anaesthetic, the lesion is shaved flush with the skin using a fine blade. There are no stitches; the
area heals over a couple of weeks leaving a small, flat, often pale mark. It’s quick and well suited to raised,
superficial, clearly benign lesions — including many skin tags and some moles. The shaved tissue can still be sent
for analysis.
Surgical Excision
The lesion is cut out completely, including a margin of normal tissue where needed, and the wound is closed with
sutures, leaving a thin line. Excision removes the full depth, which makes it the method of choice for deeper
lesions and for anything that must be examined thoroughly — for example a suspicious mole.
The whole lesion goes for histology, giving a definitive diagnosis.
Which Is Right for Which Lesion
| Shave | Excision | |
|---|---|---|
| Best for | Raised, superficial, benign lesions | Deep lesions; anything needing full analysis |
| Stitches | No | Yes |
| Scar | Small flat mark | Thin line |
| Full-depth removal | No | Yes |
| Suspicious lesions | Not preferred | Preferred |
For skin tags specifically, see the complete skin tag guide; for moles, the mole removal guide. Book an assessment to find out which suits your lesion.
Frequently Asked Questions
- Is shave or excision better?
- Neither is universally better — it depends on the lesion. Shave suits small, raised, clearly benign lesions and leaves a flat mark; excision removes the full depth and is preferred for deeper lesions and anything that needs thorough analysis. A clinician matches the method to the lesion.
- Does shave removal leave a scar?
- It usually leaves a small, flat, sometimes pale mark rather than a line. Careful technique and sun protection while it heals keep it minimal. Excision leaves a thin line instead, which can be the better trade-off for a deeper lesion.
- Can both methods be analysed in the lab?
- Yes. Both shave and excision provide tissue that can be sent for histology. For a lesion that genuinely needs the full depth assessed — such as a possible melanoma — excision is preferred so the whole lesion is examined.
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