Skin surgery covers the removal of common benign lumps and lesions — moles, cysts, lipomas, skin tags and similar growths — as well as the revision of scars and the management of keloids. At her Harley Street practice in London, Ms Anna De Leo brings the precision of a plastic surgeon to these everyday procedures, so that each lesion is removed safely and completely, sent for analysis where appropriate, and closed with a scar designed to heal as discreetly as possible.
Many people live for years with a lump that catches on clothing, a mole that is repeatedly nicked while shaving, or a cyst that becomes inflamed. Others simply want a reliable professional opinion on whether a lesion is harmless. Minor skin procedures may be small, but on the face, neck and other visible areas the quality of the result matters greatly. A careful assessment, honest advice and meticulous technique make the difference.
01What Is Skin Surgery?
Skin surgery, sometimes called dermatosurgery or minor skin surgery, refers to procedures that remove or reshape lesions in the skin and the fatty layer directly beneath it. Most are performed under local anaesthetic as outpatient procedures. The guiding principles are always the same: confirm the diagnosis, remove the lesion completely, and close the wound in a way that leaves the finest scar possible.
Common benign lesions treated
- Moles (naevi): removed because they are raised and catch on clothing or jewellery, are repeatedly irritated, or are unwanted for cosmetic reasons.
- Epidermoid and pilar cysts: often called sebaceous cysts; smooth lumps under the skin that may become infected or discharge.
- Lipomas: soft, slow-growing lumps of fat beneath the skin, frequently on the back, shoulders, arms or thighs.
- Skin tags: small, soft, hanging growths, common on the neck, armpits and eyelids.
- Seborrhoeic keratoses: warty, "stuck-on" lesions that are harmless but can be unsightly or itchy.
- Other lesions: dermatofibromas, xanthelasma around the eyelids and benign vascular lesions.
If a lesion has features that raise concern for skin cancer — a changing mole, a non-healing sore or a growing lump — it is managed differently, with appropriate margins and multidisciplinary input. Please see our dedicated skin cancer surgery page.
02Scar Revision and Keloid Treatment
Scars from previous surgery, acne, injuries or piercings can be wide, raised, tethered or uncomfortable. Scar revision uses plastic surgery techniques to improve them: excising a stretched scar and re-closing it in layers, re-orientating it along natural skin creases, or breaking up a straight line with a Z-plasty or W-plasty so that it blends more naturally.
Keloid scars are different. They grow beyond the boundaries of the original wound, can be itchy or painful, and are more common on the earlobes, chest, shoulders and upper back, and in people with darker skin types or a family history. Because keloids tend to recur after simple excision, they need a combined approach, which may include:
- Silicone gel or sheeting and pressure, for example pressure earrings after earlobe keloids.
- Corticosteroid injections to flatten and soften the scar.
- Careful surgical excision in selected cases, followed by further steroid injections or other adjuvant treatment to reduce the risk of recurrence.
For scars resulting from more significant injuries or burns, see our page on trauma reconstruction.
03Your Consultation on Harley Street
Your appointment takes place at 64 Harley Street in Marylebone, central London. Ms Anna De Leo will ask how long the lesion has been present, whether it has changed, and whether it causes symptoms such as pain, itching, bleeding or infection. She will examine it closely, often using dermoscopy for pigmented lesions, and assess the surrounding skin tension and natural lines of the area.
She will then explain whether the lesion appears benign, whether removal is advisable or optional, and how the scar is likely to look. Many patients — particularly women seeking removal of lesions on the chest, abdomen or intimate areas — tell us they feel more at ease being examined by a female surgeon. In many cases, the option of simply leaving a harmless lesion alone is entirely reasonable, and you will be told so honestly.
Where a procedure is requested purely for cosmetic reasons, a cooling-off period of at least two weeks between consultation and treatment is observed, in line with GMC guidance. Factors that influence the cost of a personalised plan include the number, size and site of lesions, the complexity of closure, whether histology is required and any follow-up scar therapy.
04Skin Surgery Techniques
The right technique depends on what the lesion is, where it is and how deep it extends.
Elliptical excision
The most common method: the lesion is removed within a lens-shaped piece of skin, oriented along Langer's lines — the natural lines of minimal skin tension — so that the wound closes neatly in a straight line. Fine sutures in layers reduce tension on the surface and help the scar settle finely.
Shave excision
Some raised, benign-appearing moles and seborrhoeic keratoses can be shaved flush with the skin, avoiding stitches. This is only appropriate when the diagnosis is clear, as it does not remove the deeper part of a lesion.
Cyst removal
A cyst is removed with its lining intact wherever possible, as leaving part of the wall behind increases the chance of it returning. An actively infected cyst is usually treated first and removed once the inflammation has settled.
Lipoma removal
Lipomas are removed through an incision planned to be as short and well placed as possible. Larger lipomas may need a slightly longer incision or, in selected cases, a liposuction-assisted technique.
Skin tag removal
Small tags are removed quickly by snip excision under local anaesthetic, with minimal or no stitches.
Healing by first or second intention
Most wounds are closed immediately (first intention). In selected small, concave areas, allowing the wound to heal naturally with advanced dressings (second intention) can give an excellent result.
Histology
Lesions removed by excision are generally sent for histological examination. This confirms the diagnosis and provides reassurance, and occasionally identifies something unexpected that needs further attention.
No lesion is too small to deserve a careful diagnosis and a well-planned scar — that is the plastic surgery difference in skin surgery.
ADLSynergy · Harley Street
05Recovery After Skin Surgery
Skin surgery is usually straightforward to recover from. You will be awake throughout and can go home shortly afterwards. Procedures are carried out in a CQC-registered London facility, and most people return to desk work the same or the next day. A follow-up appointment on Harley Street is arranged to check healing and discuss histology results.
- Keep the dressing clean and dry for 24–48 hours, then follow the wound care advice provided.
- Stitches are usually removed after five to seven days on the face and ten to fourteen days on the body; some wounds are closed with dissolvable sutures.
- Avoid strenuous exercise and stretching the area for one to two weeks, especially on the back and shoulders.
- Once healed, gentle scar massage and silicone help the scar soften.
- Protect the scar from the sun for at least a year to reduce darkening.
Ms Anna De Leo and the ADLSynergy recovery team, including Tika, our theatre practitioner with more than thirty years in plastic surgery and particular expertise in scar massage, can support your scar care. Red light therapy and other options within our recovery and longevity programme may also be discussed.
06Risks and Realistic Results
Although minor, skin surgery is still surgery. Possible risks include bleeding and bruising, infection, wound opening, a scar that stretches, thickens or becomes keloid, temporary or permanent numbness, changes in skin colour around the scar, and recurrence — for example of a cyst whose lining was not fully removed or of a keloid. Rarely, histology may reveal an unexpected diagnosis requiring further treatment.
Results vary from person to person. Every excision leaves a scar; the aim is a fine, well-placed line that fades over time, not an invisible one. Healing depends on age, skin type, location and aftercare. Before and after photographs of similar procedures can be discussed at consultation to give you an honest sense of typical outcomes.
07Why Choose Ms Anna De Leo on Harley Street
Ms Anna De Leo is a GMC-registered Plastic, Reconstructive and Aesthetic Surgery Consultant with more than twenty years of experience, a Fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery (FEBOPRAS) and a member of BAPRAS. She trained and worked within NHS plastic surgery departments in London and Oxford, where skin surgery is a core part of everyday practice.
As a female plastic surgeon, she understands that even a small lesion on the face or body can matter a great deal, and she gives the same attention to a skin tag as to a complex reconstruction. If you are looking for mole, cyst or lipoma removal in London, or a skin surgery specialist near Marylebone, please book a consultation on Harley Street.
