Patients with body surface masses are common in plastic surgery and a significant number require surgical treatment. Previously, the volume of general surgery procedures was high, but as the standard of living and aesthetic awareness has increased, more and more patients are coming to plastic surgery. However the diagnosis of seemingly routine conditions is not easy. There is a wide variety of common body surface masses (lesions), including tumors, inflammation, hyperplasia, developmental abnormalities, degenerative changes, metabolic disorders, foreign bodies, visceral tissue expansion, etc. Their pathological origins can occur in the skin, skin-affiliated structures, connective tissues, muscles, nerves, bones, blood vessels and superficial lymph nodes. Common benign body surface skin soft tissue swellings and lesions Various skin lesions such as pigmented nevus, lipoma, sebaceous cyst (acne), congenital dermatoid cyst, fibroma, neurofibroma, dermatofibroma, nodular conjunctivitis, hemangiomas and lymphangiomas, keloid scar and keloid scar, and so on. Common malignant tumors of body surface skin and soft tissues are basal cell carcinoma, squamous cell carcinoma, sweat adenocarcinoma, malignant melanoma, bulging cutaneous fibrosarcoma, fibrosarcoma, and Merkel cell tumor. The superficial location of the swelling on the surface of the body can be initially diagnosed by the experienced professional doctors through visual examination and palpation (texture, size, boundary, mobility, whether there is any pressure pain, etc.), and combined with ultrasound, CT, MRI examination if necessary, but some swellings are still difficult to be diagnosed after such examinations, and need to be combined with preoperative or postoperative pathological examination to confirm the diagnosis, and sometimes even need a variety of more specialized pathological examination means and multidisciplinary doctor consultation to confirm the diagnosis. Sometimes even need more specialized pathology and multidisciplinary consultation with doctors to confirm the diagnosis. Case 1 An elderly patient was admitted to the hospital because of the ulceration of the “pigmented nevus” on his face, and asked for cosmetic excision. After the interview, the doctor of our department thought that it was basal cell carcinoma, and carried out the local enlargement excision surgery, as well as repairing and reconstructing the defect, and then the previous judgment was confirmed by the pathologic examination. Patients with basal cell carcinoma are more common in our department, and the misdiagnosis rate is relatively high because of its similarity in appearance with pigmented nevus. Basal cell carcinoma, pigmented nevus Case 2 A patient who was diagnosed as “lipoma of cheek” by other departments according to ultrasound imaging was referred to our department. Combining with manual diagnosis and rich experience, our doctors thought that it was “parotid gland tumor”, which was a very dangerous part of the body, and would cause damage to the face if operated according to lipoma. Lipoma for surgery will have the risk of damage to the facial nerve, after further hospitalization and examination confirmed as parotid adenoma. Parotid adenoma Lipoma Case 3 A patient was admitted with a back mass and imaging suggested a lipoma. The doctor’s experience suggests that it may be a low-grade malignant bulging dermatofibrosarcoma, and further pathology confirms the doctor’s diagnosis. The principles of treatment and surgical options for benign and malignant masses are very different, and the patient will benefit greatly from a correct diagnosis. The recurrence rate is very high if not excised cleanly and disposed of properly. Bulging dermatofibrosarcoma is also often misdiagnosed as a benign mass such as a scar or fibroma, delaying treatment. Lipoma Case 4 Recently, a patient with a periorbital mass was diagnosed as “lipoma” in an outside hospital, and came to the hospital to seek an outpatient surgery to remove it with little loss of appearance. The doctor diagnosed it as a dermatoid cyst caused by congenital developmental abnormality, which is a kind of teratoma, and it needs to be arranged for inpatient surgery on an elective date. Because lipoma and periorbital dermatoid cysts are completely different in nature, dermatoid cysts are close to the bone, its surgical difficulty in depth, level, etc. is much higher than lipoma surgery, if the diagnosis is not clear, it will increase the risk of surgical injury and damage, and the removal is not clean, there will be the risk of recurrence and infection. Dermatoid cyst Case 5 60 years old female patient was diagnosed as “lipoma” and underwent excision surgery because of the swelling on the upper part of the breast close to the sternum, and then came to our hospital because the wound never healed, and was diagnosed as breast cancer after pathological examination. We have even encountered cases in which inflammation-induced lumps have been misdiagnosed as “lipomas”. ………. In the current media atmosphere, the public often think that plastic surgery is to cut double eyelids, only with good-looking or not, many patients are also in order to cut a better look to find a plastic surgery, in fact, plastic surgeons are also doctors to treat the sick and save lives, also need to undergo the unimaginable learning and refinement, in order to guard the life of each patient, to bring the greatest benefit to the patient.