Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less
CPT4 code
Name of the Procedure:
Excision of a malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less
Summary
This procedure involves surgically removing a small malignant (cancerous) lesion from sensitive areas such as the face, ears, eyelids, nose, or lips. The excision includes a margin of healthy tissue around the lesion to ensure complete removal.
Purpose
This procedure is used to treat skin cancers such as basal cell carcinoma, squamous cell carcinoma, or melanoma. The goal is to completely remove the cancerous cells and prevent the spread or recurrence of the cancer.
Indications
- Presence of small (0.5 cm or less) malignant skin lesions on the face, ears, eyelids, nose, or lips.
- Diagnosed skin cancer requiring surgical removal.
- Patients who do not respond to non-surgical treatments or where surgery is deemed the best option for complete removal.
Preparation
- Patients may be advised to avoid certain medications and supplements that can increase bleeding risk.
- Pre-procedure testing might include a biopsy to confirm the malignancy and imaging to assess the depth and extent of the lesion.
- Fasting is typically not required, but special instructions may be given based on the patient's health and the use of anesthesia.
Procedure Description
- The patient is positioned to allow easy access to the lesion.
- Local anesthesia is administered to numb the area.
- The surgeon uses a scalpel to carefully excise the malignant lesion along with a margin of healthy tissue around it.
- The excised tissue is sent to pathology to ensure all cancerous cells have been removed.
- The surgical site is closed with sutures and may be covered with a sterile dressing.
Duration
The procedure typically takes 30 to 60 minutes, depending on the complexity and location of the lesion.
Setting
The procedure is usually performed in an outpatient clinic or a surgical center.
Personnel
- A board-certified dermatologist or a plastic surgeon performs the excision.
- A nurse or medical assistant provides support during the procedure.
- An anesthesiologist may be present if deeper sedation is necessary.
Risks and Complications
- Common risks include bleeding, infection, and scarring.
- Rare risks involve allergic reactions to anesthesia, incomplete removal of the lesion, or recurrence of cancer.
- Complications are managed with appropriate medical intervention such as antibiotics for infections or follow-up surgeries if cancerous cells remain.
Benefits
- Removal of the malignant lesion minimizes the risk of cancer spread and recurrence.
- Early excision can lead to better cosmetic outcomes, especially in sensitive facial areas.
Recovery
- Keep the surgical site clean and dry as per the provided instructions.
- Stitches are usually removed within one to two weeks.
- Recovery time is generally short, but swelling and discomfort in the treated area may last for several days.
- Follow-up appointments are essential to monitor healing and ensure complete removal of the lesion.
Alternatives
- Non-surgical treatments such as cryotherapy, topical medications, or radiation therapy.
- Each alternative has its pros and cons, such as varying effectiveness, cosmetic outcomes, and side effects.
Patient Experience
- The patient will feel a prick during the injection of local anesthesia but should not feel pain during the excision.
- Mild pain and discomfort at the incision site can be managed with over-the-counter pain relievers.
- Patients may experience some swelling and bruising, which typically subsides within a few days.