This re-pigmentation side effect is particularly problematic for patients with olive skin or dark eyes and hair. Because of these limitations in shave excision of moles, excision of moles with the skin underlying them is sometimes recommended. This technique is often referred to as elliptical mole excision because the mole is usually removed in an ellipse of skin that allows for a flush closure without puckers. Elliptical excision may be recommended if there is a high suspicion of melanoma. It is also useful when the risk of mole regrowth, re-pigmentation or uneven skin contours with shave excision make it a better choice.
Elliptical excision is more time and resource intensive than shave excision.
It entails more risk of bleeding and infection. Just as in shave excision, results with elliptical excision depend up on good surgical judgment and careful execution of the finer points of surgical technique. Elliptical excision invariably results in a linear surgical scar that can vary from virtually undetectable to more noticeable than the original mole. In younger patients, elliptical excisions often heal with wide and sometimes unsightly scars due to the tug of surrounding elastic skin. Careful patient selection is a prerequisite for obtaining good mole removal results.