Surgical removal of benign, pre-cancerous, and malignant skin lesions, performed with meticulous technique to achieve the best possible functional and cosmetic outcome.
Lesion Excision Surgery Brisbane
Skin lesions are among the most common presentations seen in plastic and reconstructive surgery. A skin lesion is any abnormal area of skin that differs from the surrounding tissue, whether in colour, texture, size, or structure. Lesions range widely in nature, from entirely harmless lumps and bumps that patients choose to have removed for comfort or cosmetic reasons, through to pre-cancerous changes and malignant tumours that require prompt, careful surgical management to protect health.
Australia has one of the highest rates of skin cancer in the world, and living in Queensland, with its high UV exposure year-round, places patients at even greater risk. For this reason, any new or changing skin lesion deserves prompt attention and professional assessment. Most lesions turn out to be benign, but some require excision and histological examination to confirm their nature. The surest way to know what a lesion actually is, and whether it needs treating, is to have it properly checked over by a Specialist Plastic Surgeon.
Dr Perron performs the full spectrum of skin lesion removal, from straightforward excision of benign lumps and cysts under local anaesthetic, through to complex excisions of malignant lesions requiring reconstructive closure with skin grafts, local flaps, or tissue rearrangement. In every case, surgical technique is applied with the dual goals of complete removal and the best possible cosmetic outcome for the surrounding skin.
Patients seek assessment and treatment for skin lesions for a range of reasons, including:
Skin lesions are broadly divided into benign (non-cancerous), pre-malignant (with potential to develop into cancer), and malignant (cancerous) categories. Understanding which category a lesion belongs to is the essential first step in determining the right management.
Most skin lesions are benign and won’t harm your health, but they can still be uncomfortable, get infected again and again, or simply bother you cosmetically. Here are the benign lesions Dr Perron treats most often:
Epidermoid and pilar cysts: People often call these sebaceous cysts, which isn’t quite accurate, and they’re the cysts we see most. Epidermoid cysts grow out of the skin’s surface layer and are filled with a keratin material, while pilar cysts come from hair follicles and usually turn up on the scalp. Both feel like smooth lumps that move under the skin. They don’t cause harm on their own, but if one gets infected it can swell up fast, turn red and sore, and sometimes need draining. Once things calm down, we usually recommend removing the whole cyst wall so it doesn’t come back.
Lipomas: A lipoma is a soft, slow-growing, benign tumour composed of fatty tissue, located just beneath the skin. They are typically soft, rubbery, and painless unless pressing on an adjacent nerve. Most are harmless, but patients seek removal when a lipoma is growing, causing discomfort, situated in a cosmetically prominent area, or when its nature is uncertain and histological confirmation is warranted. Lipomas deeper in the tissue or larger than five centimetres may warrant imaging prior to excision.
Moles (melanocytic naevi): Moles are pigmented spots that come from melanocytes, the cells responsible for skin colour. Most are completely harmless and you can simply leave them be. That said, moles in spots that are hard to keep an eye on, ones that are changing, or ones you’d rather not have for cosmetic reasons can all be removed surgically. If a mole has any features that point to melanoma, it needs checking quickly and should be cut out so it can be examined under the microscope. A handy way to spot moles worth reviewing is the ABCDE checklist (Asymmetry, Border irregularity, Colour variation, Diameter greater than 6mm, and Evolution or change)..
Skin tags (acrochordons): These are little soft tags of skin that hang off a thin stalk. They’re perfectly harmless and tend to crop up where skin rubs together, such as the neck, underarms, groin, and eyelids. People usually have them taken off because they’re annoying, because they catch on clothing or jewellery, or simply for looks. Taking them off is a quick job with a bit of local anaesthetic.
Dermatofibromas: A dermatofibroma is a common, firm, benign dermal nodule, most often found on the lower legs. It feels harder and more fixed than a lipoma and may be slightly pigmented. Dermatofibromas are generally left alone, but excision is appropriate when the diagnosis is uncertain, the lesion is symptomatic, or cosmetic improvement is desired.
Seborrhoeic keratoses: These are extremely common benign skin growths that appear as warty, rough, brown or black patches, often with a stuck-on appearance. They are not cancerous and are associated with ageing rather than sun damage. They can look alarming to patients unfamiliar with them, and when uncertain, biopsy or excision provides reassurance. They can also be removed when causing irritation or cosmetic concern.
Ganglion cysts: These are fluid-filled lumps that tend to pop up around a joint or tendon sheath, usually near the wrist or hand. They are covered in more detail on the Hand Surgery pages.
Pre-malignant lesions are not yet cancerous but carry a meaningful risk of progressing to skin cancer if left untreated. Prompt identification and treatment are important.
Solar (actinic) keratoses: Solar keratoses are the rough, scaly patches you get from years of sun exposure, and they’re one of the most common skin complaints we see in Australia. We treat them as pre-malignant because some will eventually turn into squamous cell carcinoma (SCC) if left alone. You’ll usually find them on the bits that catch the most sun, like the face, scalp, ears, hands, and forearms. How we deal with them comes down to how many there are, their size, and where they sit. When a keratosis is thick, growing quickly, or looks like it might be turning cancerous, the best move is to cut it out and send it off for testing.
Dysplastic (atypical) naevi: Some moles show features of cellular abnormality under the microscope without being fully malignant. These atypical or dysplastic naevi sit along the spectrum between ordinary moles and melanoma and warrant careful monitoring or excision with adequate margins. Dr Perron will assess the degree of atypia and advise on the most appropriate management.
Bowen’s disease (SCC in situ): Bowen’s disease is an early, surface-level type of squamous cell carcinoma that hasn’t yet pushed down past the top layer of skin. It usually shows up as a red, scaly patch that just won’t go away. We typically treat it by cutting it out or with a topical therapy, and which route we take depends on how big it is, where it’s located, and your own circumstances.
Malignant skin lesions require prompt diagnosis and treatment. Dr Perron has extensive experience in the surgical management of the three most common forms of skin cancer, addressed in detail on the Skin Cancer Surgery page. A brief overview is provided here:
Basal cell carcinoma (BCC): This is the most common skin cancer we see in Australia. BCCs grow slowly and dig into the tissue around them, but they hardly ever spread elsewhere in the body. Left alone, though, they can do a fair bit of damage locally. The main way we treat them is to cut them out with clear margins. In sensitive areas such as the face, careful reconstructive closure is often required.
Squamous cell carcinoma (SCC): SCC is the second most common type we see SCCs start in the upper layers of the skin and are more likely to spread than BCCs are, especially in people with weakened immune systems or when they crop up in certain high-risk spots. The usual fix is to cut the lesion out with a good margin and have it checked under the microscope to confirm everything’s clear.
Melanoma: Melanoma is the skin cancer to take most seriously. It develops in the pigment-making cells of the skin. Dealing with melanoma takes careful staging and a step-by-step surgical plan. We start with an excision biopsy, then go back for a wider excision once we know how thick the tumour is, and we’ll check the sentinel lymph node if that’s warranted. Catching and treating it early makes a real difference.
Before removing anything, Dr Perron takes a proper look at the lesion. He examines it closely, and where it helps he uses a dermoscope, a magnifier that brings out the pigment and the small blood vessels under the skin. If a lesion runs deep or sits in an awkward spot, he might order a scan such as an ultrasound first.
During your consultation, Dr Perron will discuss:
Every excised specimen that is sent to the pathology laboratory is reported by a pathologist, and Dr Perron will discuss the histological results with you at a follow-up appointment or by phone, depending on the nature of the lesion.
Most simple lesion removals are done under local anaesthetic as a day procedure, either here in the rooms or at a day surgery. For a straightforward excision there’s usually not much to prepare beforehand. The main thing is to let Dr Perron know if you’re on any blood-thinning medications or supplements, since a few of these may need to be stopped for a while before your surgery.
For larger or deeper lesions, or where reconstruction with a skin graft or flap is anticipated, the procedure will be planned as a formal operating theatre case under local anaesthetic with sedation, or under general anaesthetic. Dr Perron will advise on the appropriate setting and anaesthesia at your consultation.
How Dr Perron approaches the surgery comes down to a few things: what the lesion is, how big and deep it goes, where it sits, and what the area will need afterwards to heal well.
Simple excision and direct closure: For most small to medium benign lesions, and plenty of skin cancers in areas where the skin isn’t under much tension, Dr Perron cuts the lesion out along with a margin of healthy skin around it, using a neatly planned elliptical shape. He then closes the wound in layers with fine stitches. What you’re left with is a thin straight scar, and with good surgical technique and a bit of care while it heals, it keeps fading and settling over time.
Punch excision: Small, discrete lesions, particularly on the face, may be removed using a circular punch biopsy technique followed by fine suture closure. This technique produces a very small, well-healed scar when used appropriately.
Shave excision: Raised, benign surface lesions such as some moles and skin tags can be removed by shave excision, where the lesion is shaved flat at skin level. This avoids a linear scar at the cost of a small, rounded flat scar at the lesion site.
Reconstructive closure with local flaps: Sometimes once a lesion comes out, the gap left behind is too big to simply stitch shut without pulling the skin too tight, or the spot calls for something more refined to look its best. That’s when we turn to a local flap. The idea is to borrow nearby skin to fill the gap while keeping its blood supply intact as it’s moved across. It really comes into its own on the face, scalp, nose, ears, and eyelids, where both how things look and how they work matter a great deal.
Skin grafting: For bigger wounds, especially on the scalp or lower legs, or anywhere there just isn’t enough nearby skin to close things up directly, we may need a skin graft. This means lifting a thin sheet of skin from somewhere else on the body (for small grafts that’s usually the thigh, upper arm, or behind the ear) and laying it over the area we’ve removed. Over the next few weeks, the graft settles in and knits into place.
Wide local excision: For melanoma and certain high-risk malignancies, a wider margin of normal tissue around the primary excision site is required, as determined by NHMRC guidelines and the thickness of the tumour confirmed on histology. Wide local excision may require more extensive reconstructive planning, which Dr Perron will discuss with you once the initial histological results are available.
Recovery varies considerably depending on the size and type of procedure. A simple excision under local anaesthetic in the consulting rooms may require nothing more than a small dressing, and most patients return to normal daily activities immediately. There is typically minimal discomfort, which settles within a day or two.
For more significant excisions or those involving skin grafts or flaps, recovery requires more planning. Some swelling, bruising, and tenderness around the surgical site is expected and will resolve gradually over the following weeks. Any sutures that are not dissolvable will be removed at a follow-up appointment, typically within seven to fourteen days depending on location.
Sun protection of the healing scar is important for the first twelve months following any excision, as new scars are sensitive to UV radiation and can become permanently hyperpigmented if inadequately protected. A physical sunscreen applied daily and protective clothing over the area are both recommended.
Dr Perron will provide clear post-operative care instructions at discharge and will arrange appropriate follow-up to review the wound, discuss histological results, and monitor healing.
Like any surgery, removing a skin lesion comes with some risk. For minor excisions done under local anaesthetic the risk is usually low, but it goes up as the procedure gets more involved. In general terms you’re looking at things like infection, bleeding, a haematoma forming, and reactions to the local anaesthetic (or a general anaesthetic where one is used). On top of those, the more specific risks include:
Dr Perron will take you through all relevant risks during your consultation. For malignant lesions, the risks of surgery are weighed against the risk of the lesion being left untreated, and prompt treatment is almost always clearly in the patient’s best interest.
Every procedure carries some risk, so it’s worth talking things over with your regular GP and a Qualified Specialist Plastic Surgeon before you decide to go ahead. Find more information here.
Most skin lesion removals do attract a Medicare benefit, since taking them off is usually medically needed rather than just cosmetic. Which item number applies comes down to a few things: whether the lesion is benign or malignant, where on the body it sits, and how wide the excision needs to be once you add a safe margin of normal skin around it.
If the lesion isn’t malignant (think cysts, lipomas, moles taken off for a clinical reason, and pre-malignant spots), the relevant MBS item numbers sit between 31357 and 31370, sorted by where the lesion is and how wide the excision is. For the malignant ones (BCC, SCC and melanoma), the numbers run from 31356 to 31388, depending on the type of tumour, its location and the size of the excision. If the wound needs rebuilding with a local flap or skin graft, that brings in extra item numbers where it applies.
Purely cosmetic removal of benign lesions without a clinical indication, such as removal of a skin tag that is asymptomatic and not causing any functional concern, may not attract a Medicare rebate. Dr Perron’s team will clarify the Medicare position relevant to your specific lesion and clinical circumstances at your consultation.
Where private health insurance is held, in-patient or day-surgery procedures may also attract a contribution from your insurer depending on your level of cover and the item numbers applicable.
Choosing a Specialist Plastic Surgeon for skin lesion removal matters. While simple excisions are within the scope of many practitioners, the combination of accurate lesion assessment, precise surgical technique, and skilled reconstructive closure in anatomically complex or cosmetically sensitive areas requires a level of training and experience that specialist plastic surgery provides.
Dr Justin Perron is a Specialist Plastic and Reconstructive Surgeon holding the Fellowship of The Royal Australasian College of Surgeons (FRACS, Plastics), the highest surgical qualification in Australia for this specialty. He is registered with the Australian Health Practitioner Regulation Agency (AHPRA) under registration number MED0000959827, verifiable at the AHPRA public register.
Dr Perron’s training encompasses the full breadth of plastic and reconstructive surgery, including extensive experience in skin cancer surgery, complex wound reconstruction, flap and graft repair, and the meticulous approach to wound closure that minimises scarring. He completed his Fellowship training across major hospitals throughout Queensland and Western Australia, from Townsville to Brisbane, Redcliffe, Caboolture, the Gold Coast, and Perth. Skin lesion removal and reconstruction is a core component of the work he performs daily.
He is an active member of the leading professional bodies in his field:
Dr Perron presents at surgical conferences and has published in peer-reviewed journals. He stays current with the latest NHMRC guidelines for skin cancer management and the evolving evidence base for reconstructive techniques.
He operates from his consulting rooms at Herstellen Clinic in Spring Hill, Brisbane, and holds surgical privileges at Wesley Hospital, St Andrews War Memorial Hospital, Brisbane Private Hospital, and Spring Hill Specialist Day Hospital.
Herstellen Clinic 490 Boundary Street Spring Hill, Brisbane, QLD 4000 Phone: 07 3861 8800
Every patient presenting with a skin lesion receives a careful, thorough clinical assessment from Dr Perron, an honest explanation of what the lesion is most likely to be, and a clear recommendation for management tailored to their individual clinical circumstances and goals.
Any new or changing skin lesion should be assessed by a qualified medical professional. While the majority of new skin lesions are benign, some require urgent evaluation, particularly if they are changing rapidly, bleeding, itching persistently, or have features suspicious for melanoma. The sooner a concerning lesion is assessed, the better the outcome if treatment is required. If in doubt, book a consultation.
The ABCDE rule is a useful framework for identifying moles that should be assessed promptly. A stands for Asymmetry (one half does not match the other). B stands for Border (irregular, ragged, notched, or blurred edges). C stands for Colour (variation in shade from one part to another, including brown, black, red, white, or blue). D stands for Diameter (larger than 6mm, roughly the size of a pencil eraser). E stands for Evolution (any change in size, shape, colour, or a new symptom such as bleeding or itching). Any mole showing these features should be assessed without delay.
These terms are often used interchangeably by patients and are sometimes confused even in clinical settings. An epidermoid cyst is the most common type and arises from the skin surface layer, typically presenting as a smooth lump with a small central punctum. A pilar cyst arises from hair follicles and is most commonly found on the scalp. Neither is a true sebaceous cyst, though they are colloquially called that. All three can become inflamed or infected and all benefit from complete surgical excision (including the cyst wall) to prevent recurrence. Partial removal or drainage alone is associated with a high recurrence rate.
Yes. Lipomas are benign and pose no health risk. Many patients choose to leave them alone indefinitely, particularly if they are small, not growing, and not causing discomfort. Removal is recommended when a lipoma is enlarging, causing pain or pressure on surrounding structures, is cosmetically bothersome, is in a functionally limiting location, or when its nature is uncertain and histological confirmation is needed. Any soft tissue lump greater than five centimetres in diameter warrants careful assessment to exclude the rare possibility of a liposarcoma.
A GP referral is recommended and is required for Medicare benefits to apply to the consultation. If you are concerned about a skin lesion, your GP can assess it first and refer you to Dr Perron for specialist evaluation and surgical management where appropriate. If you have private health insurance and are seeing Dr Perron as a private patient, your insurer may also require a valid referral. Please contact Herstellen Clinic to discuss your individual circumstances.
This depends on the size and location of the lesion and the extent of the excision required. Most small to medium lesions can be removed and the wound closed directly without the need for grafting or flap repair. In some locations, particularly the face, scalp, nose, ear, and lower leg, the skin has limited laxity and a reconstructive technique is needed to achieve a good functional and cosmetic result. Dr Perron will discuss the planned closure approach at your consultation so you know what to expect.
All excised lesions are sent to a pathology laboratory where a pathologist examines the tissue under the microscope and produces a histological report. This report confirms the exact nature of the lesion and, for skin cancers, confirms whether the excision margins are clear. Dr Perron will discuss the histological results with you and advise whether any further treatment is needed.
If the pathology report indicates that a malignant lesion has not been completely excised (that is, cancer cells are present at or close to the cut edge of the specimen), a further excision will be required to achieve clear margins. Dr Perron will discuss this with you as soon as the result is available and arrange the appropriate follow-up procedure. Clear surgical margins are essential to minimise the risk of local recurrence.
Most skin lesion removals attract Medicare benefits because the procedure is clinically necessary. The applicable item numbers (in the range MBS 31356 to 31388 for excisions, with additional items for reconstructive closure) are determined by the nature of the lesion (benign, pre-malignant, or malignant), the body location, and the excision size. Purely cosmetic removal of asymptomatic benign lesions without a clinical indication may not attract a Medicare rebate. Dr Perron’s team will clarify the Medicare position relevant to your specific lesion at your consultation.
The cost depends on the nature and size of the lesion, the complexity of the excision, the type of closure or reconstruction required, whether the procedure is performed under local anaesthetic in rooms or in a day surgery or hospital setting, and any applicable Medicare rebate. An accurate and fully itemised quote will be provided following your consultation with Dr Perron. Many patients will have a significant portion of the surgeon’s fee offset by Medicare and private health insurance where applicable.
Figures listed are Surgeon’s fees only. Other fees may include anaesthetic fees, hospital fees, assistant fees, and pathology fees. All patients are different and require different treatment approaches. An accurate individualised quote will be provided after an in-depth consultation with Dr Perron.
The wound itself will heal over the first few weeks following surgery, and sutures (where not dissolvable) are typically removed at around seven to fourteen days depending on location. The scar will then continue to mature and improve for twelve to eighteen months. During this period it will fade from initial redness, soften, and flatten. Sun protection of the healing scar throughout this period is important to achieve the best possible final appearance.
If you have a skin lesion that is causing concern, or if you have been referred by your GP or dermatologist for specialist assessment and surgical management, the first step is a personal consultation with Dr Perron at Herstellen Clinic.
To book your consultation, contact Herstellen Clinic on 07 3861 8800 or use the enquiry form on this website.
Herstellen Clinic 490 Boundary Street, Spring Hill, Brisbane QLD 4000
Disclaimer: Please be advised that all procedures carry risks. We encourage patients to consult with their regular GP and a Qualified Specialist Plastic Surgeon before considering surgery. Find more information here.
Page written in accordance with Australian Health Practitioner Regulation Agency (AHPRA) guidelines for the advertising of regulated health services. Individual patient outcomes will vary. Specific results are not guaranteed.
Have a question about one of our procedures? Simply enter your details in the form below and one of our friendly team members will be in touch ASAP.
490 Boundary Street
Spring Hill QLD 4000
