Skin surgery

What is skin surgery?

Skin surgery is a general term for procedures that remove, repair or treat problem areas of your skin. It ranges from removing a small growth, such as a mole or cyst, to larger operations that remove areas of loose or excess skin from your body.

What conditions does skin surgery treat?

Skin surgery covers a wide range of conditions, from small growths to larger areas of loose skin, including:

• moles, cysts and skin tags
• skin cancers and other lesions your doctor wants to check or remove
• seborrhoeic keratosis (rough, raised patches of skin) and warts
• lipomas (fatty lumps under the skin) and keloid scars (scars that keep growing bigger than the original wound)
• xanthelasma (yellow, fatty patches around your eyelids) and drooping upper eyelids
• loose or excess skin left after major weight loss, pregnancy or the natural ageing process, including a hanging fold of skin over your tummy, sometimes called a pannus.

What are the benefits of having skin surgery?

If there's any doubt about a growth such as a mole or cyst, removing it means the tissue can be sent for testing to confirm what it is. This can settle any worry and, where needed, treat the problem directly.

If you have loose or excess skin, for example after major weight loss, it can rub and cause soreness, skin infections or difficulty moving around. Removing it can ease these problems and make everyday movement more comfortable.

Many people also find that surgery improves how they feel about their body and boosts their confidence, whether that's from clearer skin or a smoother body shape.

Are there different types of skin surgery?

For smaller growths, such as moles, cysts or skin tags, your surgeon might cut, freeze or scrape the area away. For some skin cancers that need extra care to remove fully, a specialist technique called Mohs surgery may be used instead.

For loose or excess skin, the three main operations are a panniculectomy, an abdominoplasty (tummy tuck) and a brachioplasty (arm lift). A panniculectomy removes the hanging fold of skin and fat from your tummy and is usually carried out because the skin is causing health problems, such as infections.

An abdominoplasty also removes excess tummy skin, but goes further by tightening the muscles underneath, and is usually chosen for how it changes your appearance rather than for medical reasons. A brachioplasty removes loose skin from your upper arms.

What happens before skin surgery?

Before any skin surgery, you'll have a consultation with your surgeon so they understand what you want treated and can plan the operation around you. This is likely to include:

• your surgeon examines the area and discusses your goals and concerns
• together, you agree a plan, including where any cuts will be made and what your recovery might look like
• for operations to remove loose or excess skin, you'll usually need to have reached a stable, healthy weight and kept it stable for at least six months
• you'll be asked whether you smoke. If you are undergoing a major skin excision operation, you ideally must completely stop smoking, vaping, and using all nicotine products for a minimum of 6 weeks before and 6 weeks after your surgery
• you should be in good general health and understand the risks and recovery time involved before you go ahead.

What happens during skin surgery?

The exact steps depend on what is being removed. Smaller procedures to remove a mole, cyst or other growth are usually quick and are often done under a local anaesthetic (a numbing injection) alone, without putting you to sleep.

For larger operations to remove loose or excess skin, the process usually follows a similar pattern:

1. You're given anaesthetic, either a local anaesthetic with sedation, or a general anaesthetic that puts you fully to sleep, depending on how much skin is being removed.
2. Your surgeon makes cuts in the areas agreed before your operation, such as low across your tummy or along the inside of your arm, so any scarring is easier to hide.
3. The loose or excess skin is removed, and your surgeon stretches and tightens the remaining skin.
4. The cuts are closed with stitches.

What does recovery from skin surgery look like?

In the first few days after a larger operation, it's normal to have some swelling, soreness and bruising. Your surgeon will prescribe pain relief to keep you comfortable, and you may be given a compression garment to wear, which supports the area and helps with swelling.

Most people need 10–14 days off work and away from heavy lifting or strenuous exercise. You're likely to see the full results within 2–6 weeks, though healing completely can take up to 8 weeks depending on how much skin was removed.

Any cuts will leave some scarring, but your surgeon plans their position carefully, for example low on your tummy or along the natural crease of your arm, so it's easier to hide under clothing. Avoiding scratching the area and keeping it out of direct sunlight helps scars fade over time.

What are the risks and complications of skin surgery?

Every operation carries some risk, and it's important you understand these before deciding to go ahead. Cutting the skin will always leave some scarring, though your surgeon aims to place cuts where they're least noticeable.

Results can also vary between individuals, so your surgeon cannot guarantee an exact outcome. Your surgeon can talk you through the risks and possible complications that apply to your specific procedure.