Medical Oncologist
CION Cancer Clinics
Wide excision for skin cancers | CION Cancer Clinics
Wide excision is the standard operation for basal cell and squamous cell skin cancers. The growth is cut out with a rim of normal skin around it, called the margin, and the whole piece goes to the laboratory to confirm the edges are clear. For most people it is one visit under a local anaesthetic, home the same day. This page explains how the type changes the plan and how healing goes. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What is wide excision surgery for a skin cancer?
- How does the type of skin cancer change the operation?
- Words on a skin cancer report, in plain language
- What does healing look like, from the day of surgery onward?
- Four things families tell us about skin cancer surgery, and what is true
- Who is excision not right for, and what this page cannot tell you
- Common questions about skin cancer excision
The short answer
What is wide excision surgery for a skin cancer?
Wide excision is the usual operation for the two common skin cancers, basal cell cancer and squamous cell cancer. The surgeon cuts out the growth with a rim of normal-looking skin around it, called the margin, and sends the whole piece to the laboratory to confirm that the edges are clear. For most people it is a single visit, done under a local anaesthetic, and you go home with a dressing the same day.
Why it is different from melanoma surgery
Basal cell and squamous cell cancers usually grow slowly and stay where they start, so the margin is a few millimetres rather than the centimetre or two a melanoma needs. So the operation can often be finished in one sitting, with no second, wider operation unless the report shows a problem at the edge.
When a second step is needed
If the report says the cancer reaches or sits very close to the cut edge, a small further excision is planned, or radiotherapy is offered for the spot instead. Some squamous cell cancers are treated as higher risk because of their size, depth or site, and those get a wider margin from the start.
"Skin cancer" on its own does not tell you which kind. Ask, because the plan differs.Which kind is it?
How does the type of skin cancer change the operation?
Basal cell cancer (BCC)
The most common and the slowest. It almost never spreads to other parts of the body but can eat into skin and bone if left. A small margin under local anaesthetic is usually enough.
Needs more care when it is
- On the nose, eyelid, ear or lip
- Of the infiltrative or morphoeic type
- Coming back in an old scar
Squamous cell cancer (SCC)
Faster growing, and a small number do spread to the lymph glands. The margin is a little wider than for BCC, and the surgeon will feel the nearby glands before and after the operation.
Treated as higher risk when
- Large, deep or growing along a nerve
- On the ear or lip
- In someone with a weakened immune system
Rarer skin cancers
Merkel cell cancer and a few others need wider margins and often a lymph gland check or radiotherapy as well. If your report names one of these, ask to be seen by a team that treats them regularly.
Not sure whether this applies to you?
Ask an oncologistOn your report
Words on a skin cancer report, in plain language
- Completely excised
- The cancer came out with clear skin around it on every side and underneath. Usually nothing more is needed apart from check-ups.
- Peripheral and deep margin
- The distance from cancer to the cut edge at the sides and the underside, given in millimetres.
- Well, moderately or poorly differentiated
- How much the cells still resemble normal skin. Poorly differentiated means less like normal, and for SCC it raises the risk.
- Perineural invasion
- Cancer growing along a nerve. It makes the team more cautious and often means radiotherapy is discussed.
- Infiltrative or morphoeic
- Types of BCC with poorly defined edges that spread wider under the skin than they look. They need a larger margin or edge-checked surgery.
- Bowen's disease
- Squamous cells that are abnormal but confined to the top layer of skin. Not yet an invasive cancer, and treated with a smaller excision or a cream.
Afterwards
What does healing look like, from the day of surgery onward?
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The first day
Numbness wears off over the evening and the wound becomes sore. Ordinary pain tablets, as your surgeon advised, are usually enough. Keep the dressing dry and the area still.
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The first week
Some bruising and a small amount of blood on the dressing are expected. A graft, if you had one, is checked at a dressing clinic and must not be disturbed until then.
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Stitches out
Stitches on the face come out sooner than stitches on the back or leg. Your clinic will give you the date, and often the pathology result at the same visit.
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The scar settles
Red and raised at first, then paler and flatter over many months. Sun protection on the scar matters during this time, and a simple moisturiser helps it soften.
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Check-ups
Because one skin cancer makes another more likely, your team will want to check your skin at intervals. Learn what the first one looked like so you can spot a new one early.
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Commonly believed
Four things families tell us about skin cancer surgery, and what is true
"It is only a skin cancer, so it can wait."
BCC and SCC are much less dangerous than melanoma, but they keep growing. A spot that needs a small stitch line this year can need a graft next year. An SCC left long enough can reach the lymph glands.
"A cream or a burning treatment is the same as surgery."
Creams, freezing and scraping have their place for very thin or early lesions, but they leave nothing for the laboratory to check, so no one can confirm the edges were clear.
"Dark skin does not get skin cancer."
It gets it less often, but it does happen, and it is often found later because nobody was looking. On darker skin, SCC tends to appear in old scars, burns and long-standing sores.
"Once it is cut out I never need to think about it again."
The one that was removed is dealt with. The skin that grew it is the same skin, and new cancers are common in people who have had one. Regular skin checks and sun protection are part of the treatment, not an optional extra.
!
After you go home: what should not wait
Bleeding that soaks through the dressing and does not stop after firm pressure, spreading redness or warmth around the wound, pus or a bad smell, a graft that has lifted, or a fever in the days after surgery all need a same-day call to the clinic. At night, go to the nearest emergency department. Do not take the dressing off to look, and do not start antibiotics from a chemist on your own.
Being straight with you
Who is excision not right for, and what this page cannot tell you
Excision suits most skin cancers, but not all. A large or badly placed BCC on the nose, eyelid or ear may be better served by surgery that checks every edge under the microscope as it goes, so that less normal skin is lost. Someone who is very frail, or on blood thinners that cannot be paused, may be offered radiotherapy instead. A cancer that has spread to the glands needs a wider plan.
What to ask before you agree
Which type of skin cancer it is. What margin is planned and why. Whether the wound will close with stitches or need a graft or a flap. Whether the surgeon has felt the lymph glands. Who you call if there is a problem after hours.
What this page cannot tell you
It cannot tell you which type you have, whether your margin will be clear, or whether you will need anything further. Those answers come from the pathology report and from your surgeon reading it with you. If the report has arrived and the appointment has not, call the helpline and someone will go through it with you.
Questions we are asked
Common questions about skin cancer excision
Does the operation hurt?
The numbing injection stings for a few seconds. After that you feel pressure and tugging but not pain. When the numbness wears off in the evening the wound is sore, and ordinary pain tablets as advised by your surgeon are usually enough.
Will I need a general anaesthetic?
Usually not. Most BCC and SCC excisions are done awake under local anaesthetic, including on the face. A general anaesthetic is used for very large lesions, some flaps and grafts, when a lymph gland is being removed, or when someone cannot lie still comfortably.
Can it be done the same day as my first appointment?
Sometimes, for a small and obvious lesion. More often the surgeon wants a biopsy result first, so that the margin and the closure are planned for the right diagnosis.
Why is the scar longer than the spot was?
Because a circle does not close flat. The surgeon removes an oval roughly three times as long as it is wide so the edges meet without puckering. On the face the oval is placed along a natural line so the scar fades into it.
What is Mohs surgery, and do I need it?
Mohs is excision in thin layers, each checked under a microscope before the next is taken, so the least skin is removed. It is valuable for certain BCCs on the face. It is not needed for most skin cancers and is available at only a few centres in India.
I am on blood thinners. Do I stop them?
Do not stop or change any medicine on your own. Tell the surgeon exactly what you take, including aspirin. For many small skin excisions the tablets are continued and the wound is managed with pressure. Where a pause is needed, the surgeon and your prescribing doctor set the timing together.
What happens if the margin is not clear?
A small second excision is usually planned to take a little more skin from the involved edge. For some sites, or for someone who cannot have more surgery, radiotherapy to the area is offered instead. It is common and not a sign of a poor operation.
Is skin cancer surgery covered by Aarogyasri or insurance?
Cancer surgery is generally covered as part of an approved treatment plan. Aarogyasri, CGHS, ECHS and EHS are accepted at CION, and most cashless insurers are empanelled. Cover for a day-case skin procedure can differ from an in-patient stay, so call the helpline with your card details and we will check.
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Dr. C. Raghavendra Reddy
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Dr. Vinay Mamidala
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Dr. Vajja Sandeep Kumar
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Sources
- NHS — Non-melanoma skin cancer
- Cancer Research UK — Surgery for skin cancer
- American Cancer Society — Surgery for Basal and Squamous Cell Skin Cancers
- National Cancer Institute — Skin Cancer Treatment (PDQ) - Patient Version
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Mohs Surgery: Is It Available in India?The edge-checked alternative for BCC on the faceWide Local Excision Under Local AnaestheticWhat being awake for the operation is actually likeWide Excision on the Face: Cosmetic OutcomeHow the scar is planned on the nose, eyelid and earFollow-Up and Skin Surveillance After ExcisionWhy the skin checks continueWound, Stitches and ScarsLooking after the wound at home
Talk to us
Found a spot that will not heal?
Send us a photo and any report, or call the helpline. A surgical oncologist will tell you whether it needs a biopsy or an excision and help you reach the right clinic. One helpline serves every CION centre.