SCN: What kinds of spots do you typically see?

Doctor: Often, these unsightly and unwanted lesions are moles. "Lesions" is doctor lingo for any spot or lump in the skin that causes concern or differs from normal skin. Moles, or nevi, are dark, oval-shaped beauty marks or birthmarks.

Other types of cosmetically troublesome growths include overgrown oil glands; sebaceous hyperplasia or little orange-yellow bumps; wart-like, skin-toned or brownish age spots called seborrheic keratose; and skin tags, fleshy growths that hang from tiny, narrow stalks.

SCN: How do these unwanted growths develop?

Doctor: As we age, our skin can become host to a wide variety of cosmetically-displeasing, flesh-colored or pigmented bumps and lumps. Which ones develop, when they do, how quickly they appear and how extensively they cover the canvass of the skin are determined by a combination of genes and how much sun exposure we’ve gotten over the years.

SCN: What are our options regarding removal?

Doctor: Scalpel Sculpting is an excellent method for removing growths elevated above the skin surface. Immediately following the administration of a small amount of local anesthetic just beneath the spot, the doctor uses a scalpel to remove it with a horizontal, back and forth, "sawing" motion of the scalpel blade that essentially "sculpts" the undesirable area away from the surrounding normal skin.

The wound underneath is left to heal by itself. Since the cut is so superficial, no sutures (stitches) are needed, and there’s little risk of scarring. The cosmetic result is generally excellent, and the whole procedure takes literally under five minutes.

Scissor Excision or scissor removal is essentially a variation of Scalpel Sculpting, except that instead of a scalpel, very delicate surgical scissors are used to cut away the growth. It’s particularly useful for removing skin tags, which can be snipped off at the base of the stalk. Here again, no stitches are required and the results are quite gratifying.

SCN: Are these the only options?

Doctor: Curettage is another no-stitch sculpting technique. It’s a kind of skin-scraping performed with a special instrument called a curet, hence the name curettage. A curet is a cutting instrument with a round or oval loop-shaped cutting edge attached to a handle, which is available in varying sizes. Larger curets are used for removing larger growths. Curets are used to "scoop" out or off an unwanted area. If the site to be removed is small, anesthetic might not even be required.

Wire Loop Removal is still another variation. This procedure is once again similar to the other three methods, except there’s a wand with a wire loop at its tip, used to encircle the lesion. A radiosurgical device supplies the radiowave energy (think radiowaves as the energy source that runs your AM/FM radio) necessary for the loop to "melt" through the base of the growth and free it up from the underlying normal tissue and sculpt it away.

SCN: What’s the healing process like?

Doctor: A scab usually forms within the first 48 to 72 hours, which eventually falls off sometime between days 14 and 21. Although the wound site is entirely healed by this time, there’s usually a pinkish/purplish discoloration that remains temporarily, eventually fading sometime between four and 12 weeks afterward. During this time, the site will ordinarily pass through a series of additional color changes that range from dark brown to fawn-colored before returning to normal flesh color.

SCN: Can numerous growths be removed in one session?

Doctor: Yes, in an otherwise healthy person there’s no reason not to remove several growths. In fact, I’ve removed as many as 17 moles from a young woman’s face at one time in about half an hour. However, when that many moles are done at once, immediately afterward and until the wound sites completely heal, the patient's face will look like he or she has had an outbreak of acne.

For this reason, many people who have numerous unsightly facial growths opt to have them removed over a period of several sessions. When only three or four are done at once, it’s easier to adequately mask them with cover-up cosmetics until all the color changes of the healing phase are gone.

SCN: What do the accompanying before and after photos show?

Doctor: These figures illustrate the results of the Wire Loop Removal technique for removing a mole from the upper eyelid.

SCN: What’s the cost for these procedures?

Doctor: Sculpting procedures generally run between $150-$300 for each area, depending upon the size, the exact method used and the location of the lesion.

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To learn more about cosmetic dermatologist Nelson Lee Novick, M.D., F.A.A.D., please visit his bio.