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Moles are benign, or non-cancerous skin growths which are also called birthmarks or nevi.  Moles can be very raised or nearly flat, and typically have round or oval borders.  Their colors can be flesh-colored, red or pink, or dark brown to nearly black or blue.  Moles can appear anywhere on the body, and most commonly do not cause symptoms or pain.  Some patients are bothered by the appearance of moles, and facial plastic surgeon Dr. Inessa Fishman shares her thoughts for treatment preferences for moles.

“In general, the treatment of moles involves removing the mole tissue with minimal scarring,” says Dr. Fishman, “and my approach to treating moles takes into account the mole’s treatment history, the surrounding anatomy, and the patient’s tendency towards scarring.”



The most common approaches to mole treatment are excisional biopsy and shave biopsy.  “With any mole treatment, I send the tissue removed for Pathology analysis,” says Dr. Fishman, “and this is the part to which the biopsy term refers”. With most moles that have not been previously treated and don’t have nearly wrinkles, Dr. Fishman usually recommends the shave procedure; with this treatment, the mole is surgically shaved flat with the surrounding skin and then lightly cauterized with a surgical instrument.  The cautery, or light burning, treatment allows Dr. Fishman to create a slightly depressed appearance to the mole site, with the aim of having this area heal in a flat manner.  Cautery also decreases the risk of mole recurrence, or growing back.  The ideal resulting scar from a mole treated with shave biopsy is a flat, initially red or pink spot that eventually blends in to the surrounding skin color.

birthmark mole nevus removal

In contrast, excisional biopsy is the surgical removal of mole tissue below the level of the skin, with subsequent stitching to bring the cut skin edges together.  The resulting scar usually looks like a faint line a tiny bit longer than the diameter of the original mole.  “I usually recommend excisional biopsy for moles that have been previously treated and have grow back, or if they have very deep wrinkles or lines nearby,” shares Dr. Fishman.  The linear scar resulting from the excisional biopsy can be easy to “hide” within a naturally occurring wrinkle or border between the facial features, and the surrounding anatomy around the mole to be treated thus affects Dr. Fishman’s decision making in creating a treatment plan.

No matter the treatment option, mole treatments leave scars, and the expert staff of Aviva Plastic Surgery is invested in making those scars as imperceptible as possible.  Injections of steroids and anti-inflammatory medications, laser treatments, microneedling, sun protective topical agents, and silicone anti-scar treatments are all commonly employed in our practice to ensure the best possible healing outcome from mole treatments.  “The mole treatment sites are usually red and mildly inflamed for a couple of weeks after treatment,” says Dr. Fishman, “but ultimately they settle down to essentially imperceptible marks, even if they need a bit of help getting there.”

Ultimately, while the treatment options for mole removal are not unlimited, Dr. Fishman says nothing replaces an individual consultation and physical exam in creating a tailored treatment plan for each individual patient.  If you’re considering treating a facial mole, schedule your consultation with Dr. Fishman to discuss the treatment options personalized to you.

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