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In general, children who are born with congenital melanocytic nevi are recommended to be followed regularly by a dermatologist who can monitor the lesion for concerning changes. Dermatologists may subsequently refer a patient to a plastic surgeon for a consultation regarding removal of the lesion. Removal is usually recommended for symptomatic lesions that ulcerate or are excessively itchy. Lesions with atypical changes in size, shape, appearance or texture are also recommended for excision to prove the lesion is still benign and to prevent further risk of malignant degeneration. Families may also not like how the lesion looks and desire removal for cosmetic reasons as well.
Removal of a congenital nevus is a highly individualized procedure due to the variable shape, size and location of these types of lesions. Typically surgery is started sometime during childhood to promote healing and avoid natural enlargement as the child grows and the potential for malignancy changes over time.
In general, your child may be a good candidate for giant nevi removal surgery if:
If you're considering surgery for your child to remove a congenital nevus, spend time reviewing any available before and after photos and learning about what to expect during recovery. Preparation ahead of time helps parents and their children have reasonable expectations and a smoother recovery.