Skin Lesion Excision

Skin lesion excision at MUDr. Šimek's Olomouc clinic removes moles, warts, cysts, fibromas, and other benign or potentially concerning skin growths through surgical excision, laser treatment, or radiofrequency scalpel — with histological examination of the removed tissue as standard. The procedure is performed under local anaesthesia in an outpatient setting. Indications include malignancy risk (dermatologist-identified suspicious lesions), injury prevention (lesions in locations subject to friction from clothing or accessories), aesthetic concerns, or preventive care for changing lesions. The plastic surgery setting ensures that excision is planned with scar minimisation technique — incisions are orientated along Langer's lines where possible and closed with fine sutures.

Skin lesion removal in a plastic surgery context differs from the same procedure in a general dermatology or GP setting primarily in the scar management approach. A plastic surgeon plans each excision with attention to incision direction relative to skin tension lines (Langer's lines or relaxed skin tension lines), closure technique (layered suturing vs simple interrupted sutures), and post-closure scar management protocol. For visible body areas — face, décolleté, forearm — this planning difference produces a markedly less visible scar than an urgently performed excision. **Methods available at MUDr. Šimek's clinic** *Surgical excision with suturing* — the most common approach, particularly for larger lesions or those requiring clear histological margins. The lesion is excised with a defined margin (which varies by clinical suspicion — wider for pigmented lesions with atypical features, narrower for benign cysts). The wound is closed in layers with absorbable deep sutures and fine non-absorbable skin sutures removed at 5–14 days depending on location. *Laser excision* — suitable for superficial lesions where thermal precision is appropriate. Laser removal does not produce tissue suitable for histological examination in all cases; this is discussed at consultation if histology is clinically indicated. *Radiofrequency scalpel* — a cutting-coagulating instrument that allows precise tissue removal with simultaneous haemostasis, reducing bleeding at the excision margin. Suitable for small lesions in vascular areas. **Histological examination — a standard in this practice** All surgically excised tissue at MUDr. Šimek's practice is routinely sent for histological examination. This is clinically important because a significant proportion of lesions that appear benign macroscopically contain unexpected cellular changes (early basal cell carcinoma, dysplastic melanocyte nests). Histological clearance is the only reliable confirmation that a removed lesion was benign and fully excised. Laser-removed lesions may not be suitable for histology — patients with clinical concern about malignancy should specifically request surgical excision. **Scar care after excision** The clinic's post-excision scar protocol aligns with its general scarring philosophy: neutral fats (olive oil, pork lard) applied from suture removal through the active remodelling phase (up to 12 months). UV protection over the scar site for at least 6 months prevents post-inflammatory hyperpigmentation. **When to seek excision rather than watchful waiting** Key indicators: lesion changing in colour, border, or size (ABCDE criteria); lesion causing bleeding or persistent irritation from clothing; patient history of melanoma in themselves or first-degree relatives; dermatologist recommendation for removal.