Question: I have had a mole on my right cheek near my laugh line since I was younger. It has gotten bigger and more elevated as I got older. My Dermatologist suggested for me to see a Plastic Surgeon to get it remove for minimal scarring. I had a pimple on my chest over 20 years ago and had it taken out and biopsied, which was benign, but I developed a Keloid. I'm Asian will I get a Keloid if I get my mole removed on the right side of my cheek?
Dr. A’s Answer: For moles on the face, I always recommend a shave "excision" as a first line of management. A shave only removes the bumped up part and often also removes the darkness (if any is there to start with). With the tissue removed, a diagnosis can be confirmed and if benign, may be left as is. A shaved mole does not typically leave a "scar". It may leave an area of slightly different skin color or texture, but is usually minimal. If done properly, this area will be no larger than the original mole and cosmetically be superior to both leaving it alone or excising it. A shaved mole may grow back. If so, it can be shaved again.
An excised mole will always leave a scar. Sometimes this is preferred to a shave, but not usually. A shaved mole is a "no bridges burned" approach in that the option to excise is still there with no difference in result as compared to excising at first. If a shave proves less than needed (either because the tissue is malignant/pre-malignant or for cosmetic issues), then excision is still available.
A shaved mole will look something like a scratch and take a week or so to "skin over" and a couple months to not be pink. An excised mole will require stitches and leave a pink line for a few months that usually fades to a light colored line.
Regarding keloids, the chest is high risk for keloid, the face is low risk. But it is still probability and a keloid can happen either place. I have never seen a shaved face mole result in a keloid, though I don't doubt that it could happen.