Small lumps in or just under (subcutaneous) the skin are very common. The most common lumps are sebaceous cysts (epidermal cysts) and lipomas. These are benign and readily removed surgically. Occasionally a lump may represent a serious condition and requires medical attention. Lumps that suddenly appear, grow or cause symptoms such as pain should be checked by a doctor. Lumps at particular sites such as in the breast should always be checked medically. If in doubt consult a doctor.
The operation is usually carried out under local anaesthetic (injection to make the skin numb). It is usually classified as an outpatient or daycase procedure. You are usually only in the hospital for a short period before and after the procedure.
Usually a small cut is made over the lump which is then removed. If the lump is in the skin then it is usually excised by removing a diamond shaped piece of skin with the cyst in the centre. The diamond shape is then closed with stitches to leave a straight line. Stitches may be absorbable (dissolving) or may need to be removed. On the face, stitches that need to be removed are usually used.
It is usual practice for all bits of skin or lumps that are removed to be sent to the histology laboratory for analysis to check they are benign. In some instances with cysts the diagnosis may be so clear that this is not necessary.
With all surgery there is the possibility of complications. The main complications with removal of small moles from the skin are:
Bleeding: bleeding following surgery occasionally results in the need to re-operate to stop bleeding or to remove a build up of blood under the skin (haematoma).
Infection: there is always a small risk of an infection with surgery. Usually these will settle with antibiotics. Rarely they can be serious.
Wound break down and slow healing: if the wound opens up, usually due to infection, then healing can be slow afterwards.
Damage to nerves: at certain sites, particularly on the face, there are small but important nerves running under the skin. These can be damaged during surgery. It is most unusual with simple skin removals but more likely where there are deeper lumps.
Poor scarring: scarring depends more on how an individual heals than on how the operation is carried out. Some people make great scars that may be difficult to see. Other people’s scars may stretch or turn hypertrophic and keloid. Hypertrophic and keloid scars tend to be lumpy, red, itchy even painful and may take a long time to settle.
Recurrence: cysts and lipomas that have been removed may sometimes grow back.