Benign skin lesions, lumps and bumps

It is quite common for people to acquire skin lesions and lumps and bumps associated with the skin or just underneath the skin. A skin lesion is part of the skin that has an abnormal growth or appearance compared to the skin around it. Benign skin lumps and bumps include moles, warts, cysts and fatty lumps called lipomas. These can appear anywhere on the body or face. Sometimes they may have been present for a long time but may have gradually increased in size. Patients may wish to have these lumps surgically removed for a number of reasons – including a dislike of the appearance of the lesion or lump; because it keeps getting knocked or it is uncomfortable; because it keeps getting infected or discharging material. Apart from extremely large fatty lumps most skin lesions, and lumps are suitable for local anaesthetic excision biopsies as either outpatient or day case procedures. All procedures will take place in the private hospital in an operating room facility.

At the start of the procedure Mr Johnson will draw on your skin at the site of the lesion or the lump. The scar will be positioned so that it lies in a natural skin crease wherever possible. This area of skin will then be injected with local anaesthetic to numb the skin so you will not feel any pain or discomfort during the procedure. The specimen will be sent for microscopic examination which usually takes 2-3 weeks to get the results. Once the lesion/lump has been removed the skin is stitched with either dissolving stitches alone or else a combination of dissolving stitches and some surface stitches which need to be removed. For lesions of the face there is usually some stitches to be removed after 5 days. The wounds are covered with a simple dressing or tape. You will be given specific instructions as to when the dressings or tape should be removed.

Removal of benign skin lesions and lumps are very commonly performed and the complication rate is low.

AT A GLANCE

Length of surgery:

30 mins

Anaesthesia:

Local

Overnight or day case:

Day case

Recovery:

1 -2 days off work
Avoid driving day of the procedure
Limit exercise to avoid stretching the scar

Follow-up:

5-7 days for removal of sutures, 2 months

Frequently asked questions

Just before the procedure the area of skin to be excision or the lump under the skin will be injected with local anaesthetic to numb the skin so you will not feel any pain or discomfort during the procedure. The local anaesthetic used is a combination of quick acting and long acting anaesthetic. The numbing effects of the local anaesthetic usually lasts several hours. When you get home following the procedure you should take paracetamol. You should take paracetamol again before you go to bed that night (making sure you have not exceeded the recommended dose). It is unusual to need to take any further painkillers.

For removal of simple skin lesions and lumps and bumps the recovery is quick and it is usual to return to work either later that day or the following day. You should refrain from driving the day of surgery and avoid operating any machinery for at least 6 hours. If you have had any surgery to the face you should avoid bending down for 6 hours and if you have had surgery to your leg then you should rest with your leg elevated on a chair as much as you can. It is normal for there to be some tenderness, bruising and swelling which should settle over the course of the next 2 weeks. You should refrain from any activity which might stretch the wound or injury the area. Mr Johnson will advise you regarding sport and exercise depending on the exact location of the wound.

The scar direction will be positioned as close to the natural skin crease wherever possible. All scars go through a period of maturation where they become red, raised and lumpy before fading into hopefully thin, pale flat lines. This process varies from individual to individual and depending on the site of the body may take anything from 6 months to 2 years. Usually scars on the face fade within 6 months. Sometimes scars on the chest or the should or back region can stretch so that the scar is wide. Rarely scars can remain thick and lumpy and get worse with time rather than better. If you think this is occurring you must contact Mr Johnson so he can see you and discuss whether further treatment to the scar is needed.

Once they have been removed it is extremely unusual for benign skin lesions, cysts, lumps and lipomas to come back provided the histology shows that they have been completely removed. Mr Johnson will explain the histology results with you when you attend the follow up appointment.

Complications are uncommon following removal of skin lesions and lumps and bumps. During your initial consultation Mr Johnson will have a full discussion with you about the risks and complications of surgery. You will be given an information leaflet about this type of surgery which includes complications and if you decide to go ahead with surgery, these risks will again be discussed as part of the consenting process. Fortunately, with correct patient selection and appropriate procedure selection, the risks are kept to an absolute minimum. It is important that you should be reassured that Mr Johnson will not agree to perform any procedure on you unless he feels the benefits significantly outweigh the risks.

If you need any stitches or dressings to be removed the nurse will make an appointment for this for you before you leave the hospital. Mr Johnson will give you instructions for a follow up clinic appointment with him to check that the wound has healed and that the scar is settling. He will ask you to contact his secretary in order to arrange the exact follow up date and time.

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