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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A spot check answers a question about one lesion. A full map answers a question about your skin over time. Most people arriving with a specific worry need the first, and paying £300 for the second would be answering something they did not ask. The exception is worth knowing, because it is the situation in which a spot check can be actively misleading: when the lesion you are worried about is not the one that matters.
The Two Services Side by Side
| Spot check | Full mole mapping | |
|---|---|---|
| Covers | The lesions you raise | The whole visible skin surface |
| Question answered | Is this one a problem? | Has anything changed since last time? |
| Method | Consultant examination with dermoscopy | Standardised total-body photography plus dermoscopy of 60–100 catalogued lesions |
| Record kept | Clinical notes | Images stored against a body map for year-on-year comparison |
| Time | Within a standard consultation | 45 to 60 minutes |
| Cost | £100 | £300 |
| Removal at the same visit | Yes, if indicated | Yes, if indicated |
When a Spot Check Is the Right Purchase
- One lesion has changed and you want it assessed and dealt with.
- You have few moles, none atypical, no family history and no significant sun damage.
- Something is new and you want to know what it is.
- A lesion is catching, bleeding or irritating you and you want it removed.
- You want a mole removed for appearance and need it confirmed benign first.
In each of these, the examination and dermoscopy answer the question completely. Where removal is the answer it happens at the same appointment, and the tissue goes for histology if the lesion’s features warrant it.
The Limitation, Stated Plainly
A spot check assesses what you point at. That is fine when the lesion you are worried about is the lesion that matters — and it usually is.
The problem arises when it is not, and there is a specific reason this happens more than people expect:
“Patients are very good at spotting the mole that is dark, raised and obvious — usually the one that has been there for twenty years. They consistently miss the ones on the back and the back of the legs, and the pale and pink ones that do not look like moles at all.”— Mr Onur Gilleard, Consultant Plastic Surgeon
The lesion that draws attention is the one that looks dramatic. The lesion that matters is often the one that looks unremarkable, or sits somewhere you cannot see. That mismatch is not carelessness — it is how visual attention works.
The second limitation is temporal. A spot check judges appearance at one moment. It cannot tell you whether a lesion has changed, because there is nothing to compare it against. Since melanoma is diagnosed by change more reliably than by appearance, that is a real constraint rather than a technical footnote — discussed in how dermoscopy and mole mapping detect melanoma early.
When Mapping Is Worth the Difference
Mapping earns its cost where there is enough to track that memory and attention are unreliable:
- More than roughly 50 to 100 moles, or a significant number of clinically atypical ones
- Atypical mole syndrome, or a known CDKN2A mutation or FAMMM kindred
- A previous melanoma — the single strongest risk factor for a second primary
- A first-degree relative with melanoma, particularly diagnosed young
- Fitzpatrick I–II skin, marked freckling, blistering sunburn history or sunbed use
- Immunosuppression — transplant, long-term immunosuppressive therapy
- Practical inability to self-examine: extensive naevi on the back, poor vision, or nobody to check for you
That last one is underrated and worth saying out loud. If you physically cannot inspect your own back and nobody else does either, a documented photographic record is not a luxury — it is the only thing looking at that skin.
Equally, the honest inverse: mole mapping is a risk-stratified service rather than a population screening test. Someone with a small number of ordinary moles, no atypical lesions, no family history and no immunosuppression is well served by regular self-examination and a low threshold for review. The full weighting is in who is at high risk of melanoma.
Starting With One and Moving to the Other
The two are not mutually exclusive, and the sequence people most often take is sensible: come about the lesion that is worrying you, and let the examination inform whether surveillance is warranted.
A consultant assessing one mole will see the rest of the skin around it. If the picture is a person with 90 naevi and several atypical ones, that will be said, and mapping can be arranged as a separate appointment. If the picture is six ordinary moles and one that needed removing, that will be said too — and no further service is required.
Booking a £100 consultation first is therefore rarely wasted, even where mapping turns out to be the eventual answer.
Cost
| Item | Price |
|---|---|
| Consultation — single or few lesions | £100 |
| Mole mapping — complete package | £300 |
| Mole removal | £350 |
| Each additional mole removed | £200 |
| Histological analysis | £180 |
Mapping is available at 101 Harley Street; mole checks are available there and at the St Albans clinic. Book: mole mapping, mole removal or contact the clinic. Full breakdown in what the £300 includes.
Frequently Asked Questions
- Do I need a spot check or a full mole map?
- If you are worried about one lesion and have few moles, no atypical ones and no family history, a spot check answers your question. If you have many or atypical moles, a family or personal history of melanoma, or cannot examine your own back, mapping is the appropriate service.
- What does a single mole check cost?
- £100 for the consultation, which covers examination and dermoscopy of the lesions you raise, with removal at the same visit if that is the answer. Removal is £350 and histology £180 where warranted.
- Can a spot check miss something?
- It assesses what you point at, and patients reliably point at the most obvious lesion rather than the most significant one — the ones missed are typically on the back or the backs of the legs, or are pale and pink and do not look like moles. A consultant will notice concerning lesions nearby, but a spot check is not a whole-skin examination.
- Can a spot check tell me if a mole has changed?
- Only from your description. Without a previous image there is nothing to compare against, and melanoma is diagnosed by change more reliably than by appearance. That gap is exactly what photographic surveillance exists to fill.
- Can I start with a spot check and upgrade later?
- Yes, and it is a sensible sequence. The consultant assessing one lesion sees the surrounding skin and will say whether your overall picture warrants surveillance. Mapping is then booked as a separate appointment.
- What if I want several moles looked at?
- A consultation covers the lesions you raise, however many that is. The distinction is not the count but whether you want specific lesions assessed or a documented record of your whole skin for future comparison.
- Is a map worth it if I have no symptoms?
- That depends entirely on your risk profile. For someone with many or atypical moles or a previous melanoma, the baseline is what makes future comparison possible. For someone with a few stable moles and no risk factors, it is a reasonable choice but not a clinical necessity — and it is presented that way rather than sold.
- I cannot see my own back. Does that change things?
- It is one of the clearest indications for mapping. Where nobody is examining a large area of skin, a documented photographic record is the only thing that is.
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