Skin lesions of the face, scalp and neck

Assessment and surgical removal of moles, cysts, skin tags and other lumps and lesions on the face, scalp, ears and neck, by a surgeon whose specialty is the face.

Why a maxillofacial surgeon for skin lesions?

Removing a lesion from the face is different from removing one from the back. The skin is thinner, the nerves that move the face run close beneath it, and the result is on show every day. Oral and Maxillofacial Surgeons operate on the face routinely and are trained to place incisions along natural skin creases and close them so that the scar is as inconspicuous as possible.

Chris assesses and removes a wide range of skin lesions, including:

Moles and pigmented lesions where removal is appropriate
Cysts of the skin and scalp
Lipomas (soft fatty lumps) of the face and neck
Skin tags, warts and seborrhoeic keratoses
Suspicious lesions that need to be removed and examined
Lesions on the lip, eyelid margin, nose and ear, where careful reconstruction matters

Assessment

Chris will examine the lesion, discuss how long it has been there and whether it has changed, and explain whether he recommends removal, monitoring or a biopsy first. Anything removed is sent for examination under the microscope, and he will go through the result with you.

If a lesion turns out to be a skin cancer, Chris will explain what that means and make sure you are treated by the right team without delay. Many facial skin cancers are treated by maxillofacial surgeons, and Chris manages them in his NHS practice. Whether further treatment is carried out privately or through the NHS is something he will discuss with you.

Removal

Most lesions are removed under local anaesthetic in a single visit of around thirty to forty-five minutes. The wound is closed with fine stitches, which are removed after five to seven days, or with dissolving stitches. Some larger lesions, or those in awkward places, are closed with a small local flap or graft; Chris will explain if that applies to you. The scar will be red for some weeks and continues to fade for up to a year. Sun protection matters during that time.

Do I definitely need treatment?

Not necessarily. Chris will first establish whether treatment is needed at all and whether there are reasonable alternatives to surgery. He may recommend leaving things alone when:

a mole is stable, symmetrical and has all the features of a harmless lesion, when the scar from removal would be more noticeable than the mole
a lesion is best treated by a dermatologist with a cream or freezing rather than by surgery
a lump is a harmless cyst or lipoma that is not bothering you, when it can be left and watched

What does the next week look like?

A typical recovery. Yours will be discussed with you individually before you decide to go ahead.

That evening: A small dressing and mild discomfort. Keep the area dry tonight.
Day one: Some bruising and slight swelling, more so near the eye or lip. Keep the wound clean and dry.
Days 2 to 3: Bruising is at its most colourful. Lesions near the eye can cause noticeable puffiness which then settles quickly.
By one week: Stitches out at 5 to 7 days. The scar is pink and will keep fading for up to a year; protect it from the sun.
Practicalities
Driving: Same day, unless the dressing is near the eye and affects your vision.
Work: Next day for most people; a few days for facial lesions if you would rather not be at work with a dressing.
Eating: Unaffected, except for lip lesions, where soft food for a day or two helps.

Chris's view

"Taking a lesion off the face is easy. Leaving a scar nobody notices is the skill, and it starts with where the incision goes."

Mr Christopher Vinall

When should I get advice?

Arrange an assessment if a mole has changed in size, shape or colour, if a spot or lump has appeared and not gone within a few weeks, if something bleeds, crusts or itches, or if you'd simply like a lesion removed and want it done with the least visible scar.

Arrange a consultation