• Reference Number: HEY-138/2020
• Departments: Oral Surgery, Dentistry and Max Fax, Plastic Surgery
• Last Updated: 17 July 2020

Introduction

This leaflet has been produced to give you general information about your procedure.  Most of your questions should have been answered by this leaflet.  It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is the removal of a facial skin lesion?

There are many types of lesions that can form on the skin and also different types of treatment. It has been discussed with you that the best option would be for you to have the lesion surgically removed.

The treatment involves a local anaesthetic, so you will be awake but an injection is used to numb the area. Often, the surgeon will mark around the area to be removed with a special ink.

Can there be any complications or risks?

There may be a small amount of bleeding from the area or blood staining on the dressing. If necessary, apply pressure over the wound for 20 minutes using gauze swabs you may have been given, or a clean rolled up handkerchief or towel.

Infection is uncommon, and often an antiseptic ointment will be given to you to apply to the stitch line to help prevent this. This will also help keep the stitches clean and soft, allowing for easier removal.

How do I prepare for the treatment?

We ask that you eat your breakfast or lunch as normal before coming for your treatment, there is no need to starve.

Please continue to take your regular medications as normal, unless the team has given you specific instructions regarding particular medications.

You can drive yourself to and from the appointment if you would normally do so, though some people prefer to have someone with them. This person will usually not come into the room with you during your treatment.

Depending on the type of work you do, we would advise taking the rest of the day off. Some people may need to arrange a few days off work afterwards. Please discuss with the team any concerns you have regarding returning to work.

Some treatments may only take half an hour, others are longer, so please be prepared to be in the department for up to around 2 hours.

The method of skin closure to be undertaken which is likely to be best for you, will be discussed with you before you sign any consent form for your operation.

What happens once the affected area has been removed?

This will depend on the size and position of the area that is removed and will be discussed with you prior to your treatment. There are 3 ways to repair the area:

1. For small lesions, the area will be simply closed together using a row of stitches.
2. If there is not enough loose skin in the area to allow the edges to be stitched directly, a ‘flap’ of skin will be moved in from the adjacent skin, and rotated round to cover the defect. This will then be stitched in place.
3. If a larger area has been removed, a piece of skin can be taken from somewhere else to cover the defect. This is called a graft, and is often taken from the skin on your neck, or behind your ear. Once placed over the area, the graft will be stitched into place and then have a dressing stitched over the top. Therefore this dressing will remain in place until your follow up appointment, usually 10 – 14 days later. The area where the graft was taken from will be closed with a row of stitches

What should  I expect afterwards?

Once the numbing injection wears off, it is normal to feel some discomfort and / or tightness in the area. The team will advise you about appropriate pain relief medication to take.

Bruising and swelling in the area is also to be expected, and can become more obvious over the first few days before it starts to get better.

Scarring tends to fade over time. The surgeon will aim to place the scar in such that a way that it can fade in with the natural skin creases.

Will I need a follow-up appointment?

Most patients will need to have their stitches removed 7 – 14 days after the treatment. This can be arranged either in the Maxillofacial department where you had your treatment, or with your own doctor’s surgery (often the practice nurse will do this). The best option and timing for this will be discussed with you if you do need to have stitches removed.

When the lesion is removed, it is routinely sent to the lab for testing. This will tell us exactly what type of skin lesion it is and whether it has all been removed. Sometimes these results can be sent to you or your doctor via letter, so you will not need to come back to the department. For other patients, it may be necessary to return to discuss the results or to monitor the area.

Some of information included in this leaflet has been provided by the https://www.baoms.org.uk/patients/procedures/

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Maxillofacial Unit (01482) 463218

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.