San Antonio Facial Mole Removal
Facial moles are also known as beauty marks, or nevi. Moles are commonly brown and/or black areas or skin lesions that vary in shape, color and texture. They can either be raised from the skin’s surface, or they can be flat. In most cases they are benign and quite common in adults. However, they should be examined closely, especially if they change over time, bleed or itch. Surgical excisions or laser treatments are the two main methods of mole removal.
What Causes Moles?
Moles are caused by melanocytes which are a specialized type of cell that produces melanin. Melanin is the pigment that gives our skins its color. Typically, they spread evenly across the skin. However they will sometimes grow as a cluster.
Two factors that precipitate this dynamic include:
- Sun exposure
- Hormonal changes (e.g. puberty, pregnancy, menopause and taking hormone medication)
Types of Moles
Moles can vary in form according to shape, color, and texture.
Regular and Irregular Moles
Regular shaped moles include circles and ovals. They are symmetrical. Irregular shaped moles are asymmetrical, where one side appears different from the other side.
Brown, Black, Red and Flesh Colored Moles
Brown and red moles are common in light skin types. Black moles are common in darker skin types. Flesh colored moles are common in individuals of African descent.
Although most moles are benign, exposing these different color types to excessive levels of UV rays can trigger DNA processes within the skin that lead to skin cancer. However red moles have the highest risk factor.
Raised and Flat Moles
Depending on where the melanocyte clusters exist relative to the skin layers, moles can be raised or flat. Moles are basically lesions (abnormal tissue formations). Because they are caused by a clustering of melanocytes, they are scientifically referred to as melanocytic nevi. The term nevi is plural, while the term nevus is singular. There are many variations of the melanocytic nevus. These classifications include:
The junctional nevus is located at the border junction of the epithelial skin surface and the dermal layer underneath. This mole type is brown or black and flat in texture
The intradermal nevus is based solely in the dermis. These moles are usually flesh colored and raised.
The compound nevus is raised with a brown or black color. It is often referred to as a beauty mark. The melanocytic clustering originates at the epithelial and dermal juncture as well as the dermis. So in a way, it is a hybrid of a junctional and intradermal nevus.
The dysplatic nevus is basically a compound nevus. However its cells are abnormally developed along with their overall architectural configuration. This mole is usually larger than average. And it can be flat or raised. The border and color tends to be irregular, resembling cases of melanoma. If they occur frequently in number, they need to be examined.
The color of the blue nevus results from the fact that the melanocytes responsible for it lie deep within the dermis. These cells are shaped as spindles. Instead of being clustered, they are scattered.
The spitz nevus is a type of intradermal nevus. This mole is red and raised.
Congenital NevusThis is a mole type that is present at birth and occurs in about 1 out of a 100 babies. This nevus carries a very high risk of developing into melanoma.
As the name suggests, this nevus is acquired during later stages in life, as opposed to being present at birth. The melanocytes causing this nevus can be junctional, compound or intradermal.
Giant Pigmented Nevus
The giant pigmented nevus is a fairly large pigmented area with somewhat prolific hair growth. Melanoma occurs in 10-15% of cases.
According to the University of Maryland Medical Center, most occurrences of moles are benign. However, they do need to be examined more closely to see if they are cancerous.
The ABCDE criteria are used to roughly analyze various characteristics of moles.
- A stands for asymmetry. Typical moles are symmetrical, where both sides are identical. In asymmetrical moles, the shape is irregular.
- B stands for border. It is important to look for fuzzy or smudged borders as possible warning signs.
- C stands for color. Benign moles are uniform in color. Color irregularities should be examined by a physician.
- D stands for diameter. Moles larger than the size of a pencil eraser, or approximately 7mm should warrant further investigation.
- E stands for evolution or elevation. Look for irregularities in elevation, where one part of the mole is more raised than another. Also it is important to note any changes in how the mole evolves, or changes in appearance over time.
Mole Removal: Dermatologist vs. Facial Surgeon
After deciding you want a mole removed, the next decision is whether to see a facial surgeon or a dermatologist for your procedure.
Generally speaking, a dermatologist and a facial surgeon are equally qualified and skilled at removing a mole. Both will send the mole off to a laboratory for close examination under a microscope. The key difference is that facial surgeons usually have more experience performing incisions that can help minimize scarring. This comes from years of training on traumatic facial wound reconstruction and cosmetic surgery training as well a more in depth knowledge of the intricate facial muscles, nerves and lines. A dermatologists goal is often to simply remove the mole. As dedicated facial surgeons, our goal is to completely remove the mole, but in addition to:
- Place the incision(s) in a way that creates less pull and tension on the area, which helps reduce the formation of scar tissue and in some situations can even improve the cosmetics of the overall area.
- Perform incisions and stitches using techniques from cosmetic facial plastic surgery experience to help reduce the appearance of the resulting scar
At your consultation appointment, you will have the opportunity to meet with your surgeon and discuss your particular situation and the myriad of options to address it. We use the latest techniques including laser removal and radio frequency ablation. The mole will be examined under microscopic guidance and photographs will be taken as documentation to provide a history and to use for your insurance claim. An in depth medical history and physical exam will also be performed. Anesthesia options from using a local anesthetic, IV “twilight” sedation, or Deep sedation will be explained in detail. In certain advanced cases, the hospital operating room may be considered but it is our experience that this is rare thus, saving considerable money for you.
After your mole is removed and the area has been reconstructed, we will send your specimen to the lab for testing. We have a very close relationship with our pathologists and even have specific dermatopathologists who are experts in mole evaluation giving you the peace of mind you need to truly alleviate the problem. In the event stitches are used, they may dissolve on their own, or, if the stitches are not the dissolvable type you will be informed and scheduled your own private time to have them removed about a week or so after your procedure.