What are the steps of a giant nevi removal procedure?

Step 1 – Anesthesia

Medications are administered to ensure comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you or your child.

Step 2 – The incision

The removal of a giant congenital nevus requires incisions around the edge of the visible lesion, including a small rim of normal tissue to help ensure complete removal. The involved skin will be removed full-thickness through the skin and into the subcutaneous tissues. The lesion will be sent for pathology review to ensure the lesion was benign at the time of excision. If a serial excision is planned, often the central portion of the lesion is removed initially followed by the edges at a later date.

Step 3 – Closing the incisions

Nevus excisions can be closed with removable or absorbable sutures or staples. Typically several different layers of stitches will be used so only a portion of them may be visible at the end of the surgery, while the rest are hidden beneath the skin. The incision sites will be covered at the end with glue and/or tapes or bandages. Elastic wraps or a splint may be used as needed to further protect the incision sites.

Step 4 – See the results

Surgery to remove a congenital nevus will ultimately result in a normal or near-normal contour area without the presence of the large brown lesion. Over time the associated scars will fade. Based on preoperative planning, scars should be placed in such a way as to promote normal growth and function of the involved area.