Surgical Excision in
Marietta & East Cobb
Board-certified surgical dermatology care for the precise removal of skin cancers, suspicious lesions, and benign growths – with complete margin analysis, pathology review, and advanced closure techniques for optimal cosmetic outcomes.
What Is Surgical Excision?
Surgical excision is the gold-standard method for removing skin cancers, suspicious lesions, and certain benign growths by cutting them out with a scalpel along with a surrounding margin of healthy tissue. Unlike destructive techniques (cryotherapy, electrodessication), excision provides a complete tissue specimen that can be examined under a microscope to verify that all cancer cells have been removed.
This margin analysis is the most reliable way to confirm complete removal – giving you both a definitive diagnosis and documented proof that the lesion is gone. The wound is then closed with meticulous suture technique designed to minimize scarring and optimize the cosmetic result.
At DESSNA, surgical excision is performed by board-certified dermatologists with extensive experience in both cancer removal and cosmetic closure. We select the excision technique and margin width based on the lesion type, size, location, and your individual risk factors – ensuring the highest cure rate with the best possible aesthetic outcome.
Excision techniques we perform
Elliptical (Fusiform) Excision
The most common technique. A football-shaped incision removes the lesion with a surrounding margin of healthy tissue. The wound is closed in layers with fine sutures along natural skin tension lines for a thin, linear scar.
Punch Excision
A circular punch tool removes small, well-defined lesions with a precise margin. Ideal for small moles, cysts, and biopsy sites. Closed with one or two sutures or allowed to heal by secondary intention depending on size and location.
Wide Local Excision
Used for melanoma and high-risk squamous cell carcinomas where broader margins are required based on tumor thickness. Margin width is calibrated to pathology findings to ensure complete clearance while preserving as much healthy tissue as possible.
Excision with Flap or Graft Reconstruction
For larger or cosmetically sensitive defects, the excision is followed by local tissue rearrangement (flap) or skin grafting to achieve the best functional and aesthetic outcome. Our fellowship-trained surgeon has extensive reconstruction experience.
When Is Surgical Excision the Right Choice?
Surgical excision is recommended when complete removal with pathology-verified margins is the safest and most effective approach. Your dermatologist selects this technique based on the lesion type, location, and your individual risk profile.
Basal Cell & Squamous Cell Carcinoma
The most common indication for surgical excision. Complete removal with verified margins provides cure rates of 95 – 97% for primary non-melanoma skin cancers on the trunk and extremities.
Melanoma
Wide local excision with margins calibrated to Breslow depth is the standard of care for melanoma. Early-stage melanoma treated with appropriate excision margins has a 5-year survival rate above 99%.
Atypical or Suspicious Moles
Moles with concerning dermoscopic features or biopsy results showing atypia may require complete excision with clear margins to prevent progression to melanoma and provide definitive pathological diagnosis.
Benign Growths & Cysts
Lipomas, epidermal cysts, dermatofibromas, and other benign growths that are symptomatic, growing, or cosmetically bothersome can be completely removed with surgical excision and sent to pathology for confirmation.
How We Perform Surgical Excision at DESSNA
We combine surgical precision with a cosmetic eye – removing the lesion completely while minimizing visible scarring and ensuring a definitive pathological result.
Pre-Surgical Planning
Your dermatologist reviews your biopsy pathology (if applicable), examines the lesion, and determines the appropriate excision margins based on the diagnosis. We discuss the procedure in detail, plan the incision along natural skin tension lines for optimal cosmetic outcome, and set clear expectations for recovery.
Precise Surgical Excision
Under local anesthesia, the lesion is excised with the predetermined margin of healthy tissue. The specimen is carefully oriented and sent to a dermatopathologist for microscopic margin analysis. The wound is closed in layers using fine absorbable deep sutures and surface sutures or adhesive strips for a clean, tension-free closure.
Pathology, Healing & Follow-Up
Pathology results are reviewed within 7 – 10 business days to confirm complete removal and definitive diagnosis. We provide detailed wound care instructions, schedule suture removal (typically 7 – 14 days), and monitor healing. If margins are positive, we discuss re-excision or referral for Mohs surgery.
Surgical Excision Options at Our Marietta Practice
The specific excision technique and margin width are selected based on the lesion type, size, location, and pathology findings. Here are the surgical tools we use for safe, complete removal.
Standard Elliptical Excision
The workhorse of surgical dermatology. A football-shaped incision removes the lesion with predetermined margins, and the wound is closed in layers with fine sutures. Provides a complete tissue specimen for pathological margin analysis and definitive diagnosis.
Punch Excision
A circular punch tool removes small lesions (up to 8mm) with a precise, uniform margin. Ideal for small atypical moles, residual lesions after shave biopsy, and small cysts. Closed with one or two sutures for a minimal scar.
Wide Local Excision
Excision with wider margins calibrated to tumor thickness and pathology. For melanoma, margins range from 0.5cm to 2cm based on Breslow depth. For high-risk SCC, wider margins reduce recurrence risk. May require flap or graft reconstruction.
Advanced Flap Reconstruction
Local tissue rearrangement using advancement, rotation, or transposition flaps to close larger surgical defects while preserving natural contour and appearance. Our fellowship-trained surgeon has extensive experience in facial and body reconstruction.
Pathology & Margin Analysis
Every excised specimen is sent to a board-certified dermatopathologist for microscopic analysis. Pathology confirms the diagnosis, evaluates margin status (clear vs. positive), and identifies any features that may influence further treatment or surveillance.
Scar Optimization & Aftercare
Detailed wound care instructions, silicone-based scar therapy recommendations, and scheduled follow-up visits ensure optimal healing. We address any concerns about scarring and can offer additional treatments if needed to improve the final cosmetic result.
Excision vs. Mohs Surgery: Understanding the Difference
Both are effective surgical approaches, but they differ in how margins are analyzed and when each is most appropriate:
Predetermined margin based on diagnosis
Real-time analysis of every tissue edge
Excellent for trunk & extremity cancers
Preferred for face, ears, nose
Results from pathology in 7 – 10 days
Why Surgical Excision Remains the Gold Standard
Pathology-Verified Margins
Unlike destructive techniques (cryotherapy, electrodessication) that destroy tissue without verification, surgical excision provides a complete specimen for microscopic margin analysis. This is the only way to confirm – with certainty – that the entire lesion has been removed and that margins are clear of cancer cells.
Optimal Cosmetic Outcomes
Surgical excision allows precise wound closure with layered sutures placed along natural skin tension lines. This produces a thin, linear scar that fades significantly over time – far superior to the round, often depressed scars left by destructive techniques. For visible areas, this difference in cosmetic outcome is substantial.
If you have a skin lesion that needs removal – whether cancerous, precancerous, or benign – a dermatologist evaluation will determine whether surgical excision, Mohs surgery, or another approach is the most effective and cosmetically favorable option for your specific situation.
What Our Patients Say
“Doctor Edward Chen is the BEST! He's very professional, very caring, he will always give you his honest advice. He helped my son who had acne issues – his skin now looks great like never before.”
“Dr. Candace Green has a very warm bedside manner and makes you feel very comfortable! Great office, staff, and overall experience.”
“The office is well run and Dr. Green is thorough.”
Surgical Excision FAQs
Answers to the questions our Marietta and East Cobb patients ask most about surgical excision.
No. Surgical excision is performed under local anesthesia, so you will not feel pain during the procedure. You may feel a brief pinch from the numbing injection, but the excision and closure are painless. Most patients describe the experience as far more comfortable than they expected. Mild soreness at the site for 2 – 3 days afterward is normal and manageable with over-the-counter pain relievers.
Have a Lesion That Needs Removal in Marietta or East Cobb?
Your first step is a consultation with one of our board-certified dermatologists. We will evaluate the lesion, review any biopsy results, and determine whether surgical excision is the most effective approach – with a clear plan for both removal and reconstruction.
Most surgical excisions are completed in a single visit with pathology results within 7 – 10 business days.
Related Conditions & Services
Explore other surgical dermatology services we offer at our Marietta practice