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 mole biopsy is a short procedure done under local anaesthetic to remove a mole, or part of one, so it can be examined under a microscope. In practice it feels much like having a mole removed: a brief sting from the anaesthetic, then no pain — only light pressure — for the few minutes it takes. The main difference from purely cosmetic removal is that the tissue is sent to a laboratory. This guide walks through exactly what happens, the types of biopsy, whether it hurts, and when you get results.
Why a Biopsy Is Done
A mole is biopsied when a clinician wants laboratory certainty about what it is — typically because it has one or more suspicious features or has changed. The laboratory examination (histology) is the only way to confirm a mole is benign, or to detect a melanoma early. This is precisely why a mole that needs checking is excised rather than lasered: laser leaves nothing to examine.
The Types of Mole Biopsy
- Excisional biopsy — the whole mole plus a 2 mm margin is removed, with a cuff of fat beneath it. This is the method used for any pigmented lesion, because the pathologist sees the entire lesion including its base. The margin is deliberately narrow at this stage: it is a diagnostic excision, and if the histology shows a melanoma a wider definitive excision follows, sized by the reported thickness.
- Shave biopsy — the lesion is shaved level with the skin. It has a place for raised, clearly benign, non-pigmented lesions, but it is not used to biopsy a pigmented mole here. Breslow thickness is measured in millimetres from the granular layer of the epidermis to the deepest tumour cell, and it determines the width of the definitive excision and whether a sentinel lymph node biopsy is offered. A shave that transects the base destroys that measurement — the report can then only say “at least X mm”, which risks under-staging and under-treating the patient. A shave that loses the base can cost a patient a sentinel node biopsy they should have been offered.
- Punch biopsy — a small circular tool removes a full-thickness core, used for larger lesions or when only a sample is needed.
Your surgeon chooses the method based on the lesion’s appearance, size and site — but where a mole could be a melanoma, the choice is already made: excision, so that the base is preserved for measurement.
Across roughly 2,000 removals a year at this clinic the split is about 60% surgical excision, 30% CO2 laser and 10% shave, and around 25% of removals are sent for histology — a clinical decision rather than a routine one.
Patients often ask whether histology is worth it on a mole that looks entirely ordinary. The surgeon’s answer is direct:
“Even when a mole looks completely benign, the safest approach is usually to send it for histological examination. Looking at a mole under the microscope gives us the most accurate diagnosis and provides reassurance that there are no unexpected changes.”— Mr Onur Gilleard, Consultant Plastic Surgeon
That is not a theoretical position. About twice a year, a mole removed purely because the patient disliked it comes back from the laboratory as something other than an ordinary mole.
Step by Step, on the Day
- Assessment and consent. The mole is examined (often with a dermatoscope) and the plan explained.
- Cleaning and marking. The area is cleaned and the excision marked.
- Local anaesthetic. A small injection numbs the area within a minute or two.
- Removal. The mole is excised, shaved or punched — a few minutes.
- Closure and dressing. Sutures if needed, then a dressing.
- To the lab. The specimen is sent for histological analysis.
Does It Hurt?
The only sensation most people feel is the brief sting of the anaesthetic going in. After that the area is numb and you feel pressure but not pain. Mild tenderness for a day or two afterwards is normal. Aftercare is the same as for any mole removal — see the aftercare guide.
Recovery and Results
The wound heals like any minor excision: sutures out at one to two weeks, full healing over two to four. Histology results typically take one to two weeks. When yours arrive, our guides on reading your pathology report and what each result means and the next steps explain the terminology and what happens next. Histological analysis at London Skin Clinic is £180.
Frequently Asked Questions
- How long does a mole biopsy take?
- The procedure itself takes only a few minutes; allow 20 to 40 minutes for the whole appointment including assessment, anaesthetic and closure. It is done in a single same-day visit under local anaesthetic.
- Will a biopsy leave a scar?
- Yes, some mark is unavoidable. An excisional biopsy leaves a thin line; shave and punch biopsies leave smaller marks. Good aftercare and sun protection while the scar matures keep it as pale and flat as possible.
- How long do biopsy results take?
- Histology results usually take one to two weeks. Your clinic will contact you with the result and, if any further action is needed, explain the next steps clearly.
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