Interview Outline
Hello, Director Liu, first of all, thank you for agreeing to help answer questions. I have a case at hand. A 7-year-old boy had a palm-sized mole on his face from birth, which was initially treated with laser surgery several times in the local area, but after a few setbacks, it was not cured. I’m currently working on a manuscript about “black moles on children’s faces” and would like to ask you some questions about it, please answer them in detail. Liu Lin, Plastic Surgery Department, Zhengzhou University First Affiliated Hospital
1 Could you please tell us which method to choose for a child with a mole on the face, laser, implant or excision, and whether there are any characteristics that suggest which method to use (such as visual and tactile sensation)? Why should I choose this way, or why is this choice more effective than other methods?
A: For facial moles that are “palm-sized”, only excision and skin grafting can be chosen as the surgical method. The choice of treatment method depends on various factors such as the location, size and age of the mole. Generally speaking, if the mole is smaller than a green bean, we can consider non-surgical methods such as laser and freezing, while those larger than a green bean should be removed surgically. Specific options are excision, split excision or repair by skin implant after excision.
2 There is a folk saying that moles should be cut when they are “mature”, what is the concept of “mature” and is there any basis for this saying? If there is no basis for this saying, why? What are the consequences of delaying the removal of a mole?
A: I have not heard of the term “ripe” or “not ripe”. Mole is a kind of congenital benign tumor, there is no relationship between “ripe” and “unripe”, many factors decide whether to cut it or not. On the contrary, there is the term “mother wart (mother mole)”, which means that a new mole appears on the side of a large mole or at a slightly distant place. Generally speaking, this is a benign metastasis. After the “mother wart” is removed, no new moles will be born.
3 Are there any cases that you have contacted where you have been approached after a failed procedure, and why was it done wrong before? Please tell us what precautions patients should take to prevent misdiagnosis by blindly seeking medical help.
A: There are some cases where the resection was not clean and they sought medical help again. The main reason is that some doctors in primary care hospitals are worried that the excision is too large and not easy to close, or there are too many skin grafts and the lesion is not completely removed, resulting in some residuals that need to be operated again. You should “get rid of the evil” and just remove a little normal skin on the side. Of course, inappropriate use of laser, freezing and other non-surgical methods is also considered “mis-treatment”.
4 How can I tell if a mole will grow or not? What are the methods of identification during your consultation? We know that some moles are benign and some may be malignant, so please tell us how to tell?
(For example, some children want to wait until they are older before cutting, but if it is malignant, does it need to be surgically removed immediately, and do they need to continue treatment after removal? (If it is benign, can we wait until we are older?)
A: My experience is to use the “shoe-like method” to decide the timing of treatment. Cut a “shoe sample” of the mole out of a piece of plastic and take it out at regular intervals to compare. Generally speaking, if the mole is not very special, if it grows at the same time as a person or slower than a person, we can wait until the person grows up a bit before operating. On the contrary, if a mole grows faster than a person, it should be operated as soon as possible. Generally speaking, benign malignancy should be judged by pathologists. If it is malignant, comprehensive anti-tumor treatment is definitely needed after removal.
5 If patients are sure they want to have surgery in this area, what is the approximate price of the three methods: laser, implant and excision? Are there any seasonal restrictions? Do you have anything else to remind our readers?
A: The treatment methods are different, the charges are different. The hospital level is different, the charges are different. There are not many seasonal restrictions. What I want to remind is to try to choose a good and regular medical institution.
6 You mentioned that surgery cannot be “seamless”, so what kind of effect will the surgery achieve? Is there anything more to the surgery than aesthetics? If the mole is only the size of a green bean and the patient does not care about the aesthetics, is it not necessary to do it?
A: Surgery can achieve the effect of “mole removal”. Mole is a kind of congenital benign tumor, but it has the chance to become malignant, but not every mole becomes malignant. A variety of factors determine whether it should be treated or not. It varies from person to person, from site to site, and from nature to nature. In short, the decision to treat or not to treat should be made by the patient and the doctor, as well as the nature of the lesion.