21012 Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater

Name of the Procedure:

Excision of Tumor, Soft Tissue of Face or Scalp, Subcutaneous; 2 cm or Greater Common Name(s): Soft Tissue Tumor Removal, Subcutaneous Tumor Excision Medical Term: Excision, Tumor, Subcutaneous, Face/Scalp

Summary

This procedure involves the surgical removal of a tumor located in the soft tissue just under the skin on the face or scalp. It is performed when the tumor measures 2 centimeters or larger.

Purpose

Medical Condition or Problem:

The procedure addresses the presence of abnormal or potentially harmful growths in the soft tissue under the skin of the face or scalp.

Goals or Expected Outcomes:

• Remove the entire tumor to prevent growth, spread, or discomfort.
• Obtain tissue for pathology to diagnose the nature of the tumor (benign or malignant).
• Improve physical appearance and function if the tumor is causing disfigurement or functional impairment.

Indications

Symptoms or Conditions:

• Visible lump or mass on the face or scalp.
• Pain, discomfort, or tenderness at the site of the tumor.
• Rapid growth or change in size/shape of the tumor.
• Functional impairment or cosmetic concerns related to the tumor.

Patient Criteria:

• Tumor 2 cm or larger.
• Tumors suspected to be malignant based on clinical assessment or previous biopsy.
• Patient in overall good health and suitable for minor surgical procedures.

Preparation

Pre-Procedure Instructions:

• Fasting may be required for a few hours before the surgery if general anesthesia is used.
• Adjustments to medications, such as blood thinners, may be necessary.
• Preoperative blood tests or imaging studies (e.g., MRI, CT scan) may be conducted.

Diagnostic Tests:

• Biopsy to determine the nature of the tumor.
• Imaging tests for tumor assessment and surgical planning.

Procedure Description

1. The patient is positioned comfortably, and the surgical site is cleaned and sterilized.
2. Local anesthesia or sedation is administered to ensure the patient is pain-free.
3. The surgeon makes a precise incision over the tumor site.
4. The tumor is carefully excised, along with a margin of surrounding healthy tissue to ensure complete removal.
5. The surgical wound is closed with sutures or staples, and a sterile dressing is applied.

Tools and Equipment:

• Scalpels and surgical scissors.
• Sutures or staples for wound closure.
• Surgical drapes, sterilization equipment, and anesthesia equipment.

Anesthesia/Sedation:

• Local anesthesia for small, controlled excisions.
• General anesthesia or sedation if the procedure is extensive or patient preference.

Duration

The procedure typically takes around 30 minutes to 1 hour, depending on the size and complexity of the tumor.

Setting

The procedure is usually performed in an outpatient clinic, surgical center, or hospital operating room.

Personnel

• Surgeon (typically a plastic surgeon or dermatologist).
• Surgical nurse or assistant.
• Anesthesiologist or nurse anesthetist (if sedation or general anesthesia is used).

Risks and Complications

Common Risks:

• Bleeding and infection at the surgical site.
• Scarring or changes in skin sensation around the surgical area.

Rare Risks:

• Adverse reactions to anesthesia.
• Incomplete removal of the tumor, requiring additional surgery.
• Damage to underlying structures (e.g., nerves).

Management:

• Prompt treatment of infections with antibiotics.
• Monitoring and follow-up care to manage any complications.

Benefits

Expected Benefits:

• Complete removal of the tumor, reducing the risk of recurrence.
• Relief from symptoms such as pain or discomfort.
• Improved cosmetic appearance.

Realization Timeline:

• Immediate improvement in appearance post-surgery.
• Symptom relief shortly after the procedure.

Recovery

Post-Procedure Care:

• Keep the surgical site clean and dry.
• Follow wound care instructions provided by the healthcare team.
• Take prescribed pain relievers and antibiotics if necessary.

Recovery Time:

• Initial recovery within a few days.
• Full healing may take several weeks.

Restrictions and Follow-Up:

• Avoid strenuous activities that may affect the surgical site.
• Attend follow-up appointments for wound assessment and suture removal (if non-dissolvable).

Alternatives

Other Treatment Options:

• Observation and monitoring of smaller, asymptomatic tumors.
• Non-surgical treatments such as radiation or chemotherapy (for malignant tumors).

Pros and Cons:

• Surgery provides immediate removal but involves risks and recovery time.
• Non-surgical options may be less invasive but could require longer treatment periods and may not be as definitive.

Patient Experience

During the Procedure:

• Patient will feel minimal to no pain due to anesthesia.
• Mild pressure or tugging sensations may be noticed.

After the Procedure:

• Some soreness, swelling, and bruising around the surgical site.
• Over-the-counter or prescribed pain relief can be used to manage discomfort.
• The healthcare team will provide detailed post-operative care instructions to ensure a smooth recovery.