I came across a young female patient with a facial pigmented nevus who came to the clinic and was given a routine surgical procedure to remove it. It was lucky that the surgery was done and not frozen or laser. Patients may ask, “Should I use laser, freezing, or surgery for this nevus? Now I summarize the experience of the cases I encountered in the clinic as follows: those less than 2mm can be treated non-surgically if the possibility of malignancy can be excluded. The defects of freezing and laser are: 1) stimulating the degeneration of pigmented nevus and cancer; 2) leaving specimens for pathological examination; 3) easy to remove incompletely. Therefore, the indications should be strictly controlled. If the nevus recurs after cryo-laser treatment, surgery is necessary. If the nevus is larger than 2mm and affects the beauty, it needs to be removed surgically. Recent changes in pigmented nevus, such as: 1) rapid increase in size; 2) deepening of color; 3) breaking and bleeding; 4) itching; 5) appearance of satellite nevi; 6) irregular edges and unclear borders; 7) other possible malignant changes cannot be excluded. In these cases, surgical treatment is necessary, and the specimens are routinely examined by pathology. Pigmented nevi in areas prone to friction, such as palms of hands, feet, and external genitalia, should be treated surgically, and the specimens should be routinely examined pathologically. Surgical scars are not necessarily larger than non-surgical scars. Cryo laser leaves a depressed pit type scar, surgery leaves a linear scar, surgical incisions are often designed inside the skin lines or wrinkles and sutured with cosmetic techniques and materials, the scar is very inconspicuous after a 3 month recovery period. My surgical requirement is that the marks are invisible from a social distance.