11446 Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm

Name of the Procedure:

Excision of Other Benign Lesion Including Margins (Excised Diameter Over 4.0 cm), Face, Ears, Eyelids, Nose, Lips, Mucous Membrane

Summary

This procedure involves the surgical removal of a benign (non-cancerous) lesion along with a margin of surrounding healthy tissue from areas such as the face, ears, eyelids, nose, lips, or mucous membranes. The lesion removed should have a diameter greater than 4.0 cm.

Purpose

The primary goal is to remove benign lesions that may cause functional or cosmetic concerns. Excising these lesions aims to prevent potential complications such as growth, infection, or discomfort, and to confirm the benign nature of the growth via pathological examination.

Indications

• Presence of a benign lesion over 4.0 cm in diameter.
• Lesions causing cosmetic concerns or disfigurement.
• Lesions causing functional issues (e.g., obstruction, discomfort).
• Recurrent infections or irritations associated with the lesion.

Preparation

• Patients may need to fast if general anesthesia will be used.
• Review of medical history and medications.
• Possible discontinuation of blood-thinning medications.
• Pre-operative diagnostic tests (e.g., blood tests, imaging studies).

Procedure Description

1. Anesthesia: Local anesthesia for small lesions; local anesthesia with sedation or general anesthesia for larger lesions.
2. Incision: A scalpel is used to make an incision around the lesion, including margins of healthy tissue.
3. Excision: The lesion and surrounding tissue are carefully removed.
4. Closure: The incision is closed with sutures, and a sterile dressing is applied.
5. Pathology: The excised tissue is sent to pathology to confirm the benign nature.

Duration

The procedure typically takes 45 minutes to 2 hours, depending on the lesion's size and location.

Setting

Performed in an outpatient clinic, surgical center, or hospital.

Personnel

• Surgeon (usually a plastic surgeon or dermatologist)
• Surgical nurse
• Anesthesiologist or nurse anesthetist (if sedation or general anesthesia is required)

Risks and Complications

• Infection
• Bleeding or hematoma
• Scarring
• Nerve damage (rare)
• Anesthetic risks

Benefits

• Removal of the lesion and associated symptoms.
• Improved cosmetic appearance and function.
• Assurance through pathology that the lesion is benign.

Recovery

• Keep the surgical site clean and follow wound care instructions.
• Attend follow-up appointments for suture removal and monitoring.
• Most patients can return to regular activities within a week, avoiding strenuous activity for a few weeks.
• Pain and discomfort are typically managed with over-the-counter or prescribed pain medications.

Alternatives

• Monitoring the lesion for changes.
• Non-surgical treatments (e.g., laser therapy, cryotherapy).
• Pros and cons: Non-surgical treatments may have less immediate risk but might not completely remove the lesion and could require multiple sessions.

Patient Experience

• Mild discomfort or pain during and after the procedure, usually managed with medications.
• Swelling and bruising around the site, which typically resolve within a few days to weeks.
• Post-procedure scar management to minimize cosmetic impact.