Congenital nevi, often called moles, are very common and are not a problem in the vast majority of cases. However, some individuals are affected by ‘atypical nevi’ or ‘giant nevi’, which carry an increased risk of developing malignant melanoma (skin cancer). Such nevi can be relatively small, like normal moles, or can cover large areas, such as the entire back, an entire limb or part of the scalp. Patients who are affected by these atypical nevi should be followed closely by their pediatrician or dermatologist. If the nevi have changed or are at risk of developing skin cancer, the doctor will often recommend that they be removed. In some cases, patients may request the removal of these atypical nevi, in order to improve appearance and self-esteem. Because of the size of these moles, and the fact that they are often in sensitive or visible places, like the face, a plastic surgeon is usually consulted.

Dr. Sati, MD, will carefully evaluate each patient with atypical nevi and clearly explain their treatment options. Because of the unique nature of each patient, this evaluation process may take more than one visit. For smaller nevi, the critical issue is to perform the procedure in a way that minimizes scarring. Larger nevi often require special reconstructive surgery to restore the appearance of the skin, including skin grafts and tissue expansion. In all cases, the goal is to remove potentially harmful or unsightly nevi while achieving aesthetic results that satisfy the patient.

 

About the procedure:

The details of the procedure may vary greatly from patient to patient, depending on the size and location of the nevus. Most procedures can be performed on an outpatient basis, typically requiring no more than a 24-hour hospital stay. For children under six years of age, a general anesthetic is recommended.

 

Post- operative instructions:

  • Following the operation, you will have bandages or paper tape over the incisions. If more complex surgery is required, Dr. Sati, MD, will go through the procedure in specific detail.
  • Occasionally, patients complain of nausea following the operation. This generally passes after 24 to 48 hours, and is minimized by consuming liquids frequently and avoiding taking pain medication on an empty stomach.
  • The bandages must stay in place for two days. You should avoid taking a shower during these days, as the dressing needs to stay dry. These bandages will stay on until your follow-up appointment, which is usually scheduled for two days after the operation.
  • Light exercise may be resumed after two weeks, although it is important to confirm this with Dr. Sati, MD, as each case is unique. Swimming is not permitted for at least two weeks.

 

The healing process:

  • Following the procedure, the skin will be sore, swollen and bruised. Pain medication should be used as prescribed. Swelling and bruising will take several weeks to subside.
  • Most patients will take a few days off school or work.
  • Occasionally, patients experience drainage from the incisions, which may last a few weeks. To protect your clothes, place a piece of gauze or a cotton sanitary napkin over the incision.
  • The incisions may be raised and red for several weeks.
  • The final results of the procedure may be judged three to six months after the operation, although it may take approximately one year for the scars to fade and heal completely.

 

Follow-up appointments:

  • First follow-up: Within one week of the operation
  • Second follow-up: Three weeks after the operation
  • Subsequent appointments are typically scheduled for three months after the procedure.