Excisional surgery is the most common surgical approach for skin cancer outside of Mohs. The tumor is removed with a planned margin of surrounding healthy tissue, the wound is closed, and the specimen is sent to pathology to confirm the margins are clear.
It’s a well-established, effective procedure appropriate for a wide range of skin cancers — particularly those on the trunk, extremities, and areas where maximally tissue-sparing surgery isn’t the primary concern, or where the clinical features suggest standard margins will reliably achieve complete removal.
How it works
The procedure is performed in our office under local anesthesia. We mark and numb the area, then remove the lesion with a margin of clinically normal-appearing tissue. The margin size is planned based on the type, size, and risk characteristics of the cancer — wider margins for higher-risk tumors, more conservative margins where tissue preservation matters more.
The wound is closed in layers — the deeper dermis closed with absorbable sutures, the surface with sutures or staples depending on the location. We plan the closure to follow skin tension lines where possible, which generally produces better cosmetic outcomes. The specimen goes to a dermatopathology lab. Results return within one to two weeks. If margins come back positive, additional surgery is needed.
Recovery
Most patients return to their normal routine within a few days of surgery. The area should be kept clean and protected from sun exposure during healing. Surface sutures are typically removed at a follow-up appointment one to two weeks after surgery. We provide detailed written aftercare instructions and are available for questions if anything concerns you during healing.
Frequently asked questions
How is excision different from Mohs surgery?
Excision removes the tumor in a single pass and sends the specimen to an outside lab, with results returning in days. Mohs examines 100 percent of the margin in real time on the day of surgery, allowing immediate additional removal if needed. Mohs has higher cure rates and removes less healthy tissue, but is not indicated for every cancer. We recommend the approach most appropriate for the specific tumor.
What if the margins aren’t clear?
We review the pathology with you and discuss the options — re-excision with wider margins, Mohs surgery for the residual lesion, or in selected cases close observation. We explain the specifics clearly.
Will there be a scar?
All surgery leaves some mark. The size and visibility depends on the location, the size of the lesion, the closure technique, and how your skin heals. Incisions on the trunk and extremities tend to scar more than those on the face. We close wounds carefully and can discuss expectations for your specific situation before the procedure.