Melanoma surgery: what to expect and how it works

Finding a melanoma diagnosis throws a lot at you fast. Surgery is the main treatment for most early melanomas. This page explains common procedures, how margins matter, what recovery looks like, and key questions to ask your surgeon. Read this if you want clear, practical steps before your operation.

Common surgery types

Wide local excision removes the tumor plus a rim of normal skin. The margin size depends on how deep the melanoma is. For very thin melanomas the margin may be 0.5 to 1 cm; for thicker tumors it can be 1 to 2 cm or more. Sentinel lymph node biopsy checks whether cancer reached nearby lymph nodes. A radioactive dye and blue dye find the first node that drains the tumor. If that node has cancer, your team may recommend a larger lymph node surgery called lymphadenectomy.

Mohs micrographic surgery is sometimes used when preserving tissue matters, like on the face. Not all melanomas are suitable for Mohs; your surgeon will decide based on tumor type and location. Skin grafts or local flaps may be needed to close larger wounds after excision. Reconstructive choices aim to balance appearance and function.

Before, during, and after surgery

Before surgery you’ll get a clear plan: the procedure type, margin size, and whether a sentinel node biopsy is planned. Stop certain blood thinners if your doctor tells you. Expect local anesthesia for small excisions and general anesthesia for complex procedures.

During the operation the surgeon removes tissue and may send samples to pathology. If margins are positive, a second surgery to widen the excision is common. Sentinel node results sometimes arrive days later and can change follow up plans.

After surgery you’ll manage a wound with simple care instructions: keep the area clean, change dressings, and avoid heavy lifting until the surgeon says it’s safe. Pain is usually mild and controlled with over-the-counter meds. Scars fade over months but may take a year to settle. Ask your team about scar care and sun protection.

Know the risks: infection, bleeding, numbness, and rarely restricted movement depending on the site. If you notice growing redness, fever, severe pain, or unusual drainage, contact your provider right away.

Follow-up includes regular skin checks and, for higher-risk melanoma, periodic scans and blood tests. Immunotherapy or targeted therapy may be recommended if melanoma has spread. Keep a record of any new moles and practice sun-safe habits to lower future risk.

Questions to ask your surgeon: What margin do you recommend and why? Will I need a sentinel node biopsy? What are the possible complications? How will the wound be closed and what will recovery look like? Who do I call with concerns after hours?

Good communication and a clear plan reduce anxiety and improve outcomes. If you want help preparing for an appointment, jot down symptoms, medications, and any prior skin biopsies. That simple prep helps your team make the best decision for your care.

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