Mole Removal in NYC
Dr. Darren M. Smith removes moles in his Manhattan office, both for appearance and because a lesion needs to be examined under a microscope. Most moles are removed by excisional biopsy, which takes the whole lesion and sends it to pathology, or by shave removal for smaller surface lesions. Where a lesion is better handled by a dermatologist or a Mohs surgeon, he says so and refers, and he performs the reconstruction afterward when one is needed.
Understanding moles
Moles develop when pigment cells called melanocytes grow in clusters underneath the skin. They can appear anywhere on the skin or mucous membranes, alone or clustered together. Their color ranges from pink-tan to dark brown-black, and they may be flat or raised.
| Type of mole | Description |
|---|---|
| Common moles | Round-oval shaped and pink, tan, or brown with a distinct edge. Can have hair and range from flesh-colored to black. Tend to have a stable size and appearance over time. |
| Atypical moles | Tend to be larger than a pencil eraser, irregular or multicolored with hues of brown, black, blue, or pink. Change in size and appearance over time. |
| Congenital moles | Present at birth or appearing in the first two years of life. Vary in size, shape, and color. May be called a congenital melanocytic nevus; larger ones may be called a giant congenital melanocytic nevus. |
| Spitz nevi | Have a dome shape and are generally pink or red, but may be other colors. Tend to occur on the face or legs. |
| Blue nevi | Usually circular and shades of blue or slate gray. They are nodules that appear on the head, arms, legs, or buttocks. |
| Halo nevi | Feature a brown central region surrounded by a pale halo or ring. |
| Dermal nevi | A general term for moles, seen in a wide variety of shapes and colors. |
| Lentigo moles | Flat, dark lesions with well-defined borders. They do not tend to fade in winter months. |
| Dysplastic nevi | Larger lesions with an irregular shape. Tend to have uneven pigment with darker centers and lighter borders. |
Most people have 10 to 40 moles by adulthood, which typically appear in childhood or the first 20 years of life. They frequently form in areas with the most sun exposure, like the scalp and extremities, but can also form in less common places such as between the fingers.
It is worth knowing where your moles are and what they look like, because a change in one is the thing that prompts evaluation.
Why moles are removed
Some patients want a mole removed because of where it sits or how it looks. A mole in an awkward spot can catch on clothing or draw attention, and removing it is a reasonable cosmetic decision.
Other moles are removed because they need to be examined. A lesion that has changed in size, shape or color, or that has an irregular border or uneven pigment, should be assessed rather than watched indefinitely. When Dr. Smith removes a lesion by excisional biopsy, the specimen goes to a pathologist, which is what answers the question definitively.
How mole removal is performed here
Mole removal is an outpatient procedure performed under local anesthesia. After the area is numbed with an injected anesthetic, the lesion is removed by one of two methods in this practice.
Excision, including excisional biopsy
Excision removes the mole and a surrounding margin of skin with a scalpel or surgical scissors. The aim is to take the lesion completely, along with any involved tissue below the surface. Deeper lesions may need layered suturing to close the wound precisely. Because the whole specimen is preserved, a pathologist can examine it under a microscope and confirm whether it has any concerning features. This is how Dr. Smith treats most lesions.
Shave removal
Shave removal uses a scalpel to take the mole off level with the surrounding skin. It suits smaller, superficial lesions that do not extend deeper into the skin, and it usually does not require sutures.
Methods performed elsewhere, and when Dr. Smith refers
Three methods you will read about are not performed in this practice. They are described here so you know what they are and who does them.
Mohs surgery
Mohs is a specialized technique for removing cancerous lesions. The lesion is removed and its edges examined under a microscope during the procedure; if cancer cells reach an edge, a further small excision is taken and examined, repeating until the margins are clear. It removes the smallest amount of tissue necessary. Mohs is performed by a Mohs surgeon. Dr. Smith refers lesions best treated this way, and performs the reconstruction afterward when one is needed.
Laser removal
A laser can be used to destroy certain lesions that have no malignant potential. Because it does not preserve a specimen for pathology, it is only appropriate for lesions that have already been judged benign. It is offered elsewhere rather than in this practice.
Cryotherapy
Liquid nitrogen freezes and removes harmless lesions in small, controlled doses. As with laser removal, no specimen is preserved, and it is offered elsewhere rather than here.
Where the boundary sits
Dr. Smith treats most lesions in the office by excisional biopsy. Lesions he judges to need dermatologic evaluation are referred to a dermatologist. Lesions best treated by Mohs are referred to a Mohs surgeon for excision, and reconstruction can be performed here afterward. For routine mole surveillance and skin cancer screening, see a dermatologist.
Post-procedure care
Proper wound care after mole removal supports healing and helps limit scarring. Some of the things we advise our patients to do while the site heals are included in this table.
| Post-op care instructions |
|---|
| Keep the area dry for 48 hours |
| After 48 hours, gently wash the area with soap and apply plain petroleum jelly to keep it moist, unless your surgical team gives you different instructions. Use an antibiotic ointment only if your clinician specifically recommends it. |
| Avoid picking at the scab or scratching the healing site |
| Keep the area clean and protected from sunlight during recovery. After the initial 48-hour period, follow your surgical team’s instructions for cleaning and moist wound care. |
| Once the wound has fully closed and your surgical team confirms the skin is ready, silicone-based scar gel may help improve the scar’s appearance. Do not apply it to open wounds; follow the team’s product instructions. |
Why choose Dr. Darren M. Smith
Expertise
Dr. Smith is board-certified by the American Board of Plastic Surgery and has completed advanced fellowships in aesthetic and craniofacial surgery, which inform how he approaches mole removal and closure.
Reputation
Vogue, The New York Times and other media outlets have recognized Dr. Smith’s expertise, and patients often comment on the care they receive.
Technique
Closure technique is what determines how a small excision looks a year later. Dr. Smith plans the orientation of the incision and the closure with the resulting scar in mind, and that planning is where he puts the most attention in this procedure.
A personalized approach
Dr. Smith takes the time to understand your goals and concerns, developing a plan tailored to your individual needs and anatomy.
Convenient location
His accredited Manhattan facility at the Ritz Tower, 111 East 57th Street, is straightforward to reach from across the city.
Common questions about mole removal
Is mole removal painful?
The procedure is performed under local anesthesia, so you should feel only the injection of the numbing medicine. Some minor discomfort during healing is normal, and Dr. Smith will tell you how to manage it.
What is the recovery time?
It varies with the size and location of the lesion and the method used. Most patients resume regular activities almost immediately, with wound care continuing for the first couple of weeks.
When should I have a mole looked at?
Any mole that changes in size, shape or color, has an irregular border or uneven pigment, bleeds or does not heal deserves evaluation. For ongoing mole surveillance and skin cancer screening, see a dermatologist.
Will the mole be sent to pathology?
When the lesion is removed by excision, yes. The specimen goes to a pathologist, which is how a diagnosis is confirmed. Shave removal preserves a specimen as well when that is the intent of the procedure.
Will there be a scar?
Any removal leaves a mark. How noticeable it is depends on the size and site of the lesion, how the incision is oriented and closed, and how you care for it afterward. Protect the area from sunlight as directed. Once the wound has fully closed and your surgical team confirms the skin is ready, silicone scar gel may help improve the scar’s appearance.
What does it cost?
Fees depend on the number of lesions and the method used, and are quoted after your consultation. Dr. Smith’s practice is out of network with all insurance plans; where a removal is medically indicated, our team will help you use any out-of-network benefits your plan offers. The consultation fee is $500 and is applied toward any procedure you book, and financing is available through CareCredit and Alphaeon Credit.