There are several reasons that patients sometimes decide to undergo the removal of a large nevus. Most of the time, the overriding reasons to remove a congenital pigmented nevus are first to reduce melanoma risk and second to improve appearance which can be fundamental to improving a patient’s overall psychosocial state. Other reasons to remove a nevus may be to improve the strength, texture, sensation, and sweat gland activity of the affected area.
Is Removal Possible?
Small nevi can be removed by simple surgical excision. The nevus is cut out, and the adjacent skin stitched together leaving a small scar. Removal of a large congenital nevus, however, requires replacement of the affected skin. While it is almost impossible to remove every cell of a large nevus, the goal is to remove as many cells as possible while at the same time preserving function and minimizing scarring.
How is Nevus Removal Performed?
When small nevi are removed, the surrounding skin is simply pulled together and stitched up. Removal of a large nevus involves the replacement of the affected skin. Skin can be transferred from another area of the body (grafting), or adjacent skin can be stretched, then used to cover the area where the nevus was removed (tissue expansion). There are many details about the surgery you should consider and it is best to consult a surgeon experienced in the treatment of giant nevi.
There are limits to skin grafting and tissue expansion procedures. You can only harvest so much additional skin from one person. Can another person donate skin? Not as easily as you might think. This is not commonly done and presents many risks and challenges. Can’t they just grow some artificial skin like I saw on TV? No, sorry. That skin does not have all the other tissue underneath it that the patient needs like muscle, fat and blood vessels. Artificial skin can keep a burn victim alive, but it is usually not a viable option for nevus removal.