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Excision Biopsy

Excision Biopsy

If you’ve been told you might have skin cancer, or if a suspicious spot has appeared on your skin, the next step is often to get more information. One of the most common ways to achieve this is through a medical procedure known as an excision biopsy. This procedure is not only key for diagnosis but also acts as a method of treatment for certain types of skin cancer.

Plastic Surgeon Anca Breahna performs a range of Skin cancer surgery procedures at Cheshire Cosmetic Surgery in Chester UK.

At a glance

Procedure Time
30 to 60 minutes
Procedure Anaesthesia
Local Anaesthesia
Procedure Downtime
A few days

Table of Contents

What Is Excision Biopsy?

Excision biopsy is a surgical procedure aimed at removing an area of abnormal skin, typically for the purpose of diagnosing or treating skin cancer. A dermatologist or plastic surgeon performs the procedure, which involves cutting out the suspicious skin, along with a small margin of surrounding healthy tissue. This tissue is then sent to a lab where a pathologist examines it under a microscope to determine whether cancer cells are present and, if so, what type of skin cancer it is.

  • Diagnosis: A primary reason for undergoing an excision biopsy is to diagnose the type of skin cancer present
  • Treatment: Depending on the type and stage of skin cancer, excision biopsy can also serve as a treatment
  • Certainty: This procedure offers more certainty than other types of biopsies, such as punch or shave biopsies, as it usually removes the entire area of concern

Excision Biopsy candidates

Who Needs Excision Biopsy?

Determining who might need an excision biopsy is a critical step in the diagnostic journey for skin cancer and other skin abnormalities. In this section, we will elaborate on the criteria that make someone a candidate for this surgical procedure, as well as the conditions and symptoms that often lead healthcare providers to recommend it.

Typical Signs and Symptoms

  • Changing Moles: If you notice moles that are growing, changing shape, or altering in colour, these could be signs that warrant an excision biopsy
  • New Skin Growths: Any new growths or lumps on your skin should be taken seriously and could make you a candidate for this procedure
  • Persistent Sores: Sores or skin wounds that don’t heal within a typical timeframe may also be an indicator that an excision biopsy is needed

Previous Biopsy or Tests

  • Inconclusive Results: If you’ve had other forms of biopsies or skin tests and the results were unclear, an excision biopsy may be the next step for a more definitive answer
  • Confirmed Skin Cancer: In cases where a previous test has confirmed the presence of skin cancer, an excision biopsy might be used as a treatment option to remove the cancerous tissue

Age and Risk Factors

  • Older Age: Older individuals are generally at a higher risk for skin cancer, making them more likely candidates for an excision biopsy if any skin abnormalities are noticed
  • Sun Exposure: If you have a history of extensive sun exposure, you may be more susceptible to skin cancer and therefore a candidate for this procedure

Medical History

  • Personal or Family History: A personal or family history of skin cancer significantly increases your chances of needing an excision biopsy
  • Pre-existing Skin Conditions: Certain skin conditions may predispose you to skin cancer or other abnormalities that require this type of biopsy

When Is Excision Biopsy Not Recommended?

  • Location of Lesion: If the lesion is in an area that is hard to operate on or where scarring could be problematic, another form of biopsy may be recommended
  • Small Size: Extremely small lesions may not always be best evaluated with an excision biopsy; other methods may be more appropriate

Benefits of the Excision Biopsy Procedure

When facing a possible skin cancer diagnosis, understanding the benefits of an excision biopsy can provide some peace of mind. This procedure offers a number of advantages over other methods in both the diagnostic and treatment phases.

Diagnostic Accuracy

  • Clear Results: One of the primary benefits of an excision biopsy is that it often provides very clear and definitive results. A sizable sample is taken, making it easier for pathologists to analyse the tissue
  • Early Detection: By providing a comprehensive tissue sample, this procedure helps in the early detection of skin cancer, which is often more treatable

Dual Function: Diagnosis and Treatment

  • Removal of Abnormal Tissue: Not only does an excision biopsy serve a diagnostic purpose, but it can also act as a treatment by removing the lesion entirely
  • Reduced Number of Procedures: Since it can serve both as a diagnostic and treatment tool, you may need fewer surgical procedures in the long run, reducing both time and cost

Comprehensive Evaluation

  • Wide Area: Because a margin of healthy tissue is also removed around the lesion, an excision biopsy allows for a thorough evaluation of the area surrounding the abnormality
  • Cancer Spread: This comprehensive approach helps doctors assess whether the cancer has spread to nearby tissues, aiding in more targeted treatment plans

Minimal Invasion

  • Local Anaesthesia: The procedure usually only requires local anaesthesia, reducing the risks associated with more potent forms of sedation
  • Short Duration: Typically, an excision biopsy doesn’t take long to perform, often lasting less than an hour

Post-Procedural Benefits

  • Follow-Up Care: The procedure generally involves straightforward follow-up care, making it easier to manage post-operation
  • Future Monitoring: Successful removal of a lesion provides a baseline for future skin checks, facilitating easier monitoring for any new abnormalities

Psychological Benefits

  • Peace of Mind: Knowing definitively whether or not you have skin cancer can relieve a lot of worry and uncertainty, helping you to better focus on next steps
  • Informed Decisions: The detailed results can provide you and your healthcare team with the information needed to make informed decisions about further treatment or monitoring


  • Widespread Availability: Excision biopsies are commonly performed and the procedure is usually available at most hospitals and specialised clinics
  • Covered by Insurance: In many cases, the procedure is covered by insurance plans, especially if it is deemed medically necessary by your healthcare provider

Excision Biopsy Shave

Types of Procedures

Excision Biopsy

  • Complete Removal: Excision biopsy aims to remove the entire lesion along with some surrounding healthy tissue
  • Diagnostic and Treatment Value: It can serve both diagnostic and treatment purposes, offering the ability to not just diagnose but also potentially treat skin cancer in one step

Punch Biopsy

  • Circular Sample: A special circular blade is used to take a cylindrical sample of skin tissue
  • Partial Analysis: This type often only removes part of the lesion, making it primarily diagnostic but not usually a treatment option

Shave Biopsy

  • Surface Layer: In a shave biopsy, only the surface layers of the skin are removed using a surgical blade
  • Less Invasive: Because it only involves the surface layer, it’s less invasive but also less comprehensive than an excision biopsy

Incisional Biopsy

  • Partial Removal: This type removes only a portion of the tissue of interest, making it useful for larger lesions that can’t be entirely removed
  • Limited to Diagnosis: It’s primarily diagnostic in nature, with treatment requiring further procedures

Fine Needle Aspiration (FNA) Biopsy

  • Needle-Based: A thin, hollow needle is used to extract cells from a lesion or lump
  • Least Invasive: This is the least invasive type of biopsy but also provides the least amount of tissue for examination, making it less definitive

Core Needle Biopsy

  • Larger Needle: A larger needle is used to take a ‘core’ or cylindrical sample from a lesion
  • More Tissue: This provides more tissue than FNA but less than other types, serving as a middle-ground option for diagnosis

Biopsy with Imaging Guidance

  • Ultrasound or CT: Sometimes, biopsies are done with the aid of imaging techniques like ultrasound or CT scans
  • Targeted Approach: This is often used when the lesion is hard to locate or lies deep under the skin

How is the Excision Biopsy Procedure Performed

An excision biopsy is generally a straightforward procedure. Here are the general steps:

  1. Local Anaesthesia: A local anaesthetic is applied to numb the area
  2. Surgical Removal: Anca uses a scalpel to remove the lesion and some of the surrounding skin
  3. Stitching: The wound is then stitched up
  4. Lab Analysis: The removed tissue is sent for lab testing

The whole procedure takes about 30 to 60 minutes, depending on the complexity.

Recovery after Excision Biopsy Procedure

Recovery after an excision biopsy is usually straightforward. Here’s what to expect:

  • Immediate Care: A dressing is applied to the wound immediately after the procedure
  • Rest and Elevation: Rest and keeping the area elevated can help minimise swelling
  • Pain Management: Over-the-counter pain medication is often sufficient for managing any discomfort

Anca and her team will give you instructions on how to care for the wound and when to come in for a follow-up appointment.


Patient satisfaction is the top priority for Anca. You can find how patients feel about her work below.

Further Reading



Frequently asked questions

The procedure takes less than an hour to perform. However, the duration can vary depending on the size and location of the lesion being removed. Anca will be able to give you a more accurate estimate during your consultation.

The area being biopsied is usually numbed with local anaesthesia, so you should not feel pain during the procedure itself. You may experience some discomfort or mild pain in the days following the biopsy, but this is generally manageable with over-the-counter pain medication as recommended by your medical team.

Recovery after an excision biopsy is generally straightforward. You might experience some swelling, redness, or mild discomfort, but these symptoms usually subside within a few days. Your plastic surgeon will give you specific instructions on how to care for the biopsy site, including how to clean the area and when you can return to normal activities.

The timeline for receiving biopsy results can vary, but it generally takes between several days to a couple of weeks. The tissue sample needs to be sent to a lab for examination under a microscope. Once the analysis is complete, your healthcare provider will discuss the results with you and recommend any further treatment or monitoring that may be necessary.

Yes, there are several other types of biopsies such as punch biopsy, shave biopsy, and fine-needle aspiration, among others. The choice of procedure depends on various factors, including the size and location of the lesion, your medical history, and the suspected type of skin abnormality.

While excision biopsy is generally considered safe, it’s not without risks:

  • Infection: Any surgical procedure carries a risk of infection
  • Scarring: Scars are a common side effect but are usually minor
  • Incomplete Removal: There’s a possibility that not all cancerous cells are removed, necessitating further treatment

About Anca Breahna – Consultant Plastic Surgeon at Cheshire Cosmetic Surgery

Ms Anca Breahna, PhD, MSc, FEBOPRAS, FRCS (Plast) is a highly regarded Consultant Plastic Surgeon specialising in the field of Aesthetic and Reconstructive Plastic Surgery.

Anca performs a wide range of Hand Surgery & Skin Surgery and Aesthetic Breast, Body and Face Surgery,

Anca Breahna - Female Plastic Surgeon in Chester UK

As one of the very few female Plastic Surgeons in the region, she is able to offer that unique female perspective, with empathy, attention to detail and personalised care. It is Anca’s true dedication and commitment to her field, that sets her aside from her peers. Her extensive surgical training means that you are in safe hands. She is renowned for providing exceptional care, support and helping achieve realistic goals for her patients.

Anca Breahna’s surgical training has mainly been undertaken within the United Kingdom. She began a rigorous training programme in Plastic and Reconstructive Surgery in 1999, after achieving her medical degree from the University of Bucharest. Miss Breahna attained her PhD degree at the same university in 2007 for her medical research. She then relocated to the UK and has worked Internationally to further extend her qualifications and training.

The team at Cheshire Cosmetic Surgery looks forward to meeting you and will treat you with respect, consideration, and empathy.

Your Next Steps

Do your Research

  • Please read our website pages and blogs to learn more about your intended procedure.
  • All Surgery has risks and potential complications. Please read more about the risks of your surgery.

Get a Medical Referral before your consultation at Cheshire Cosmetic Surgery

  • A Referral from your Doctor is not essential, however it is recommended to have one

Making The Most Of Your Consultation

  • Please arrive slightly early for your in-person consultation with Anca – Car parking is usually available on-site
  • You are welcome to bring a friend or relative to help consider the information and discuss your options
  • Please be aware you may need to undress for a physical exam so wear simple clothes
  • Ensure you also take a lot of notes during the consultation and thoroughly read all the documents provided

Want more information before scheduling your consultation?

  • Please call to find out more about availability, pricing and medical payment plans
  • Request more information about the procedure – call us or email us

How to Book your Consultation with Anca Breahna – Plastic Surgeon

  • You can book your consultation with Anca by paying the £150 cosmetic consultation fee when you make your appointment. This fee covers further consultations about the same concern.

Contact Anca’s Team

Call Claire or Joedy on 03332 244111 to arrange your consultation or email us for more information.

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