Skin Lesion Excision London: Complete Surgical Removal Guide

What Counts as a Skin Lesion, and How It Comes Off

The word covers anything raised, coloured or textured that is not ordinary skin. The technique follows the lesion type and its depth.

The pattern in the right-hand column is the important one. Whether tissue goes to the laboratory is decided by diagnostic uncertainty, not by the size of the lesion or the price of the procedure.

The Two Questions That Decide the Method

First: is the diagnosis certain? If a lesion could be a melanoma or another skin cancer, it is removed whole so the pathologist can see all of it, including the base. Techniques that destroy tissue — laser, cryotherapy, hyfrecation — are ruled out at that point, not because they work badly but because they leave nothing to examine. Where a pigmented lesion turns out to be a melanoma, Breslow thickness is measured from the granular layer to the deepest tumour cell, and it determines the width of the definitive surgery and whether a sentinel lymph node biopsy is offered.

Second: does the lesion have a deep component? A dermatofibroma, a cyst or a deep naevus extends below the surface, and taking only the visible part reliably produces recurrence. Removing a cyst means removing the whole sac; leaving the lining behind is the usual reason a cyst comes back.

Everything else — how quick it is, whether there are sutures, what the mark looks like — is downstream of those two answers. The full method comparison is in shaving versus excision.

Facial Lesions and the Scar Question

The honest starting point: no removal is scarless. Any technique that takes something out of skin leaves a mark, and a clinic promising otherwise is describing a marketing position rather than a surgical one. What is realistic is a mark that is flat, pale and inconspicuous enough that nobody looks at it.

Four things influence that, roughly in order of how much they matter:

1. Choosing the technique to suit the site. On concave facial surfaces — the inner corner of the eye, the side of the nose, the ear — a wound is sometimes left to heal by secondary intention after a shave, because a sutured line can distort the surrounding anatomy. It is used in a minority of facial cases and is a decision about anatomy rather than about scar quality. On convex surfaces, a closed line usually wins. Applying one technique everywhere is what produces poor facial results.
2. Where the line is placed. A closure oriented along a natural skin crease or a relaxed skin tension line settles far better than one that cuts across it. This is the part that depends most on who is holding the instrument.
3. What you do for the first two weeks. Avoiding tension on the wound matters more than any product. On the face this is easier than on the back, which is why facial scars tend to be finer to begin with.
4. Silicone and sun protection. Silicone gel or tape from two to three weeks, daily for at least three months, and SPF 50 over the site for twelve months. A new scar that gets burnt pigments permanently.

Expect a red, firm, slightly raised scar for 6 to 12 weeks, with remodelling continuing for 12 to 18 months. Judging a result at six weeks is judging it far too early. In darker skin the additional consideration is post-inflammatory hyperpigmentation — covered in removal in darker skin.

What It Costs

For moles and comparable small lesions:

Cysts, lipomas and larger or more complex lesions are quoted individually, because the work involved varies with size and site rather than following a single figure; the pricing page is the current reference and everything is quoted before treatment.

Two points on comparing prices. A headline figure that excludes the consultation is not the same as one that includes it, and a figure that excludes histology is not comparable to one that includes it — histology is where an unexpected cost usually appears. And a cheaper technique that leaves no specimen is not a cheaper version of the same service; it is a different service with a different risk attached.

Where, and Who Does It

Excisions are carried out by consultant plastic surgeons on the GMC Specialist Register, at 101 Harley Street, London W1G 6AH and at the St Albans clinic, which serves Hertfordshire and the surrounding towns including Watford, Harpenden, Hemel Hempstead and Luton. The same surgeon assesses, removes and follows up — the assessment is not delegated to one person and the surgery to another.

No GP referral is required. If a lesion looks urgently suspicious, the NHS two-week suspected-cancer route through a GP is fast and is the right choice; the criteria are in removal on the NHS.

Afterwards, and the Result

The dressing stays dry and intact for five days. Sutures come out at 5 to 7 days on the face and 10 to 14 days on the trunk, back and limbs — back, shoulder and chest wounds are under the most tension and spread the most, which is why the two-week restriction on gym, lifting and stretching matters more than anything applied to the skin.

Where tissue has gone to the laboratory the report is typically back in 3 to 7 days. A benign result is emailed; a pre-malignant or malignant result is telephoned before the written report is sent. Full detail in the aftercare guide and reading a pathology report.

Common Questions

What is skin lesion excision?

Surgical removal of a lesion from the skin under local anaesthetic, in an appointment lasting about an hour. This clinic performs around 2,000 lesion removals a year, roughly 60% by surgical excision, 30% by CO₂ laser and 10% by shave. It covers moles, cysts, lipomas, dermatofibromas and other growths, and the technique used depends on what the lesion is and how deep it goes.

Can a facial lesion be removed without a scar?

No. Every removal leaves a mark; the realistic aim is one flat and pale enough not to draw the eye. What influences that is matching the technique to the site, placing any line along a natural crease, keeping the wound free of tension for two weeks, and silicone plus sun protection afterwards.

How much does lesion removal cost in London?

£350 for a mole or comparable small lesion, £200 for each additional lesion at the same visit, with a £100 consultation and £180 for histological analysis where warranted. Cysts, lipomas and larger lesions are quoted individually, always before treatment.

Is every lesion sent for analysis?

No — it is a clinical decision based on the lesion’s features, not an automatic addition. Any lesion where the diagnosis is uncertain, and any pigmented lesion where melanoma cannot be excluded, is sent.

Can lesions be removed by laser instead?

For small, flat, confirmed-benign lesions in cosmetically sensitive sites, yes. Laser destroys the tissue, so nothing can be examined afterwards, which rules it out wherever there is a diagnostic question — see laser mole removal.

Why do some lesions come back?

Because part of them was left behind. Cysts recur when the lining of the sac remains; naevi recur when pigment cells in the base repopulate the site after a superficial removal. Full-thickness excision is how that is avoided where it matters.

Can several lesions be removed at once?

Usually. The practical limits are the sites involved, the tension on the wounds and the total local anaesthetic dose rather than a set number — more in removing several moles.

Do I need a GP referral?

No. You can book a consultation directly with a consultant plastic surgeon at either clinic.