Mr David T Gault
Consultant Plastic Surgeon
Surgery for Birthmarks, blemishes and skin cancers
A number of skin conditions occur commonly and cause great distress. Congenital (present at birth) lesions or birthmarks are amongst those which can be improved greatly by treatment.
Some lesions can be treated by laser, others by a combination of excision (cutting out the problem mark) and laser, and others by excision alone.
Serial excision of birthmarks
Serial excision is a technique in which the centre of a lesion is removed repeatedly, roughly every six months to one year, so that the same scar is used to remove the lesion which gets progressively smaller. Excellent results can be obtained.
 before surgery |
 after surgery |
 after surgery |
 after surgery |
 after surgery |
This recently healed scar remains pink, but will shortly settle and become much paler so that it is difficult to see at a social distance.
Keloid scarring
Keloid and hypertrophic scars occur in all types of skin, after bites, injections and inoculations, surgery and trauma. Some keloids grow to a very large size and even after being removed can recur. To keep this risk to a minimum, the lesions are first shrunk and softenend by a course of injections, and then removed with a combination of conventional and laser surgery. Results can be excellent.
 before surgery |
 after surgery |
Early Detection of Skin Cancer
There are a number of features of a skin blemish which increase the suspicion of pre-malignant or malignant change - the more of these suspicious features a particular lesion has, the more important it is that you take medical advice. Your GP would be the usual first port of call. It is particularly important to consult early if the problem area is around the eye or on the ear, since these areas are more likely to need flaps and grafts to ensure that after an adequate clearance, the cosmetic result is good.
The following features give cause for concern:
- Bleeding
- Itching
- Trauma
- Colour change
- Halo
- Enlarging
- Satellites
 A small skin cancer behind the ear |
- Good cancer
- Slow growing
- Usually easy to treat
- Doesn't spread
Basal Cell Carcinoma (BCC)
Basal Cell Carcinoma
Unhealed mark on shin
Diagnosis BCC
BCC excised and healed
with full thickness graft
- More serious
- Can spread
Squamous Cell Carcinoma (SCC)
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Rapidly growing Bowens
disease (early SCC)
Excision: defect filled with
full thickness graft
Well healed
Squamous cell carcinoma
- Worst skin cancer
- Excellent results if caught early
Malignant Melanoma (MM)
Melanoma 1
Melanoma 2
When in doubt, check it out!
This seemingly small blemish required an extensive excision to clear all the suspicious cells
 Small lesion in sideburn |
 Large excision required |