Wide Local Excision in Singapore
What Is a Wide Local Excision
A wide local excision (WLE) is a surgical procedure in which a skin lesion is removed together with a defined margin of clinically normal surrounding tissue. The purpose of taking this wider margin is to improve the probability of complete removal – that is, to ensure that no residual abnormal cells remain at the edges of the excised specimen.
Wide local excision is a more extensive procedure than a standard lesion excision, and the size of the margin taken is determined by the type and characteristics of the lesion being removed.
When Wide Local Excision Is Used
Wide local excision is most commonly indicated in the management of skin cancers and atypical lesions where clear margins are a clinical priority.
Melanoma
Wide local excision is the standard surgical treatment for primary melanoma. The margin of normal tissue removed is guided by the Breslow thickness of the tumour, as established by international clinical guidelines. For thin melanomas, a margin of 1 cm is typically recommended; for thicker tumours, wider margins may be required.
Squamous Cell Carcinoma
High-risk or locally advanced SCC may be managed with wide local excision to improve the likelihood of clear histological margins.
Atypical or Recurrent Lesions
Lesions that have previously shown incomplete excision, dysplastic features, or uncertain characteristics on histology may be managed with wider surgical margins at re-excision.
Dr Ang will discuss the planned margins with you in full, with reference to the histological findings and relevant clinical guidelines.
What to Expect
Wide local excisions at Skincodes are performed under local anaesthetic in-clinic for suitable cases. Where the lesion size, location, or complexity warrants a different setting, Dr Ang will discuss the appropriate referral pathway with you.
The procedure involves precise surgical removal of the lesion and its surrounding tissue margin. Wound closure may involve direct suturing or, for larger defects, a local flap or skin graft – the method will be discussed with you in advance. The excised specimen is sent for histopathological analysis, and Dr Ang will review and communicate the results with you directly.
Recovery depends on the size and location of the excision. You will receive clear wound care instructions and a structured follow-up plan. Most patients resume normal activity within one to two weeks, with the wound continuing to mature over the months that follow.
Long-term surveillance is an important part of post-excision care, particularly for melanoma. Dr Ang will guide you on an appropriate monitoring plan based on your individual circumstances.
Why Choose Specialist Surgical Care
Dermatological surgery performed by a specialist offers distinct advantages:
- Accurate pre-surgical diagnosis with dermoscopy. Lesions are assessed carefully as appearances can be misleading without specialist evaluation
- Appropriate margin assessment for cancer excisions based on lesion type and guidelines
- Histological analysis of all removed tissue to confirm diagnosis and clear margins
- Minimally invasive techniques selected to optimise cosmetic outcomes
- Structured follow-up and surveillance for ongoing skin health