Wide local incision on skin - did it really need to be so big?

[Mustardfan]

The mole that I had removed was about 6mm squarish. The wide incision seems to be about 4cm in diameter. They told me they were taking 1cm around the original site. I’ve started wondering if the surgeon who did the wide local incision actually knew the size of the original melanoma. My mum has also had melanoma surgeries and one time the surgeon had to cancel the surgery as he didn’t know what he was supposed to be taking off. I didn’t realise I’d be left with this crater.

I’m sure the surgeon won’t have removed any skin they didn’t think it necessary to remove. Could you contact Pals at your hospital to ask/have a debrief of the op?

Or this info might be included in the letter the surgeon sent to your GP after the op.

My wound was about an inch long for a 1.5mm mole.

They take a circle out around the mole, then slightly more at the top and bottom to make an oval shape, and then fold over the shorter side and stitch it. The oval makes it heal much nicer.

Now that it's all healed there is just a tiny dint less than 1cm wide that looks very similar to the scar on my other arm from my TB vaccination.

I'd just be grateful they got it out and hopefully got clear margins.

It’s the depth into the skin. So yes they did need to take as much as they did. Would you have preferred them to just wing it and let it spread to your lymph nodes then have to have targeted immunotherapy to stop it getting to stage 4?

For confirmed melanoma the margins depend on the breslow score. It can be quite large, but better that they have it all.

They look horrendous at first but they heal better than you’d expect.

Thanks, it does look horrendous, thanks for your encouragement that it will heal.

You can hardly see mine now, it's on the back of my hand so very visible for a long time. Actually the scar on my arm from where they took the graft is worse! I wouldn't have cared how much they took as long as they got rid of the cancer tbh.

It sounds like you have a lot of faith in the medical profession. My health and life would be very different now if I’d had different treatment in the past (for other things) and that may be one reason why I don’t have so much faith. I’m imagining that the scenario for my surgery may have been this: busy, overworked, caring doctor, has a quick look at my notes, looks at the scar on my leg from the removal of the melanoma, and takes a guess as to where the original melanoma was and how big it was. I had three procedures, it wasn’t until the third one, two weeks after the wide local incision, that a third doctor did the skin graft. The third doctor began his consultation with me on the day of the operation by saying: ‘so, I’m going to do a wide local incision today’. I had to correct him.

Now I’m just wishing I’d taken a more proactive stance before the wide local incision, discussing with the doctor how much he was taking off/ how much needed to be taken off.

I’m very grateful for my treatment, but my recovery and regaining my mobility is also important for my wider health. I don’t yet know whether the skin graft will be a success or will fail. If the wound had been smaller, I’m imagining the recovery would have been easier.

It was a shock to me, my first one was at the top of my back between spine and shoulder blade and due to the location they had to do a flap - I only just avoided a graft. It had to be revised as the scar was really raised on the ends where it was very tight so it is even longer now. It’s looking much better after 3 years.