Lesion Excision
Important information:
Lesions, also called nevi, are discolored areas of the skin. They are also commonly called “moles” or “birthmarks.” They can be present at birth (congenital) or develop anytime during childhood. There are many kinds of lesions. They can be tan, brown, pinkish or black, flat or raised. They can be with or without hair growing from them, and with round or irregular edges. Your child could have a few or many. They may even have one very large lesion that covers an entire area of the body.
Lesions are typically watched by dermatologists who will check them for any changes. If your child’s lesion is changing, they are often referred to a plastic surgeon to have it removed.
About the operation
Most lesions are removed in a surgical procedure. If the lesion is large, it may need to be removed in stages. The surgeon will recommend the safest plan. Your child will be asleep under anesthesia for this procedure. The surgeon will make a small incision (cut) to remove the lesion. After the procedure, your child will go to the recovery room (PACU) to wake up. Most children go home the same day as their surgery.
Instructions after the operation:
Your team will explain the type of dressing your child has in place.
If your child has absorbable sutures Dermabond™ (skin glue) on the site:
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Dermabond is a sterile liquid that holds the wound edges together. It can stay in place for 5 to 10 days.
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Dermabond does not need special care. Your child should not scratch, rub, or pick at the site. This may loosen it before your child’s wound is healed.
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Avoid heavy sweating until the Dermabond falls off.
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Do not apply ointments, such as Vaseline®, to your child’s wound while the Dermabond is in place, this may loosen it before the wound heals.
If your child has Steri-strips™ (paper tape) over the incision:
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Steri-strips will stay on for 7–14 days and will then begin to loosen and come off.
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Do not pull them off.
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Do not apply any lotion or ointments to the wound while the steri-strips are in place.
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Steri-strips may get wet. Wash over them gently as directed.
Skin care
If there is a gauze dressing covering the incision, you may remove it the day after surgery.
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If the incision has visible sutures that need to be removed and there are no steri-strips over the incision, you can gently wash over the incision starting 1-2 days after surgery or as directed by the surgeon.
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Your child can shower or take a brief tub bath 2 days after surgery.
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No swimming for one week.
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It is normal to have some swelling around the site. This will go away. It will begin to look normal over the next few weeks or months.
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Your child may have some pain or act fussy after the surgery. Acetaminophen (Tylenol®) can be given every 4 hours as needed for pain. Follow the dosage instructions on the label.
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Your child will be given something to drink in the PACU before discharge. Once home, they can resume a normal diet when they are feeling better.
Follow-up care
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If your child has sutures that need to be removed, please call and schedule an appointment for 7–10 days after surgery or as directed by the surgeon.
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The nurse will tell you if your child has resorbable sutures. If so, please call to make a follow up appointment for 4-6 weeks after surgery.
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Your child may return to school 1-2 days after surgery. There should be no gym or recess until the follow-up appointment or according to your surgeon’s recommendations.
Scar care
Once your child’s nevus is completely removed, they will have a scar. Once the incision is completely healed, sun block must be used to avoid direct sun on the scar. Sunburnt scars tend to remain red and visible for a long time. Your surgeon will give you specific instructions on the use of silicone gels or silicone creams.
Contact your surgical team with questions, concerns or if:
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Your child shows any signs of infection including bleeding, swelling, green or yellow drainage from the wound
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The wound edges re-open or separate
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Your child has a fever greater than 101°F (38.3°C) under the arm or 102°F (38.8°C) by mouth or rectally
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Your child’s pain is not relieved by medicine
Monday through Friday, 8 AM -5 PM
215-590-2208
Evenings, weekends, and holiday, call 215-590-1000 and ask to speak with the plastic surgery resident or fellow on call
Reviewed December 2023 by Kelsey Reilly, CRNP