# Surgery & Biopsies > Learn about skin biopsies and surgical excision at Kelowna Private Skin Cancer Clinic, from assessing a concerning spot to discussing treatment and recovery. SURGERY & BIOPSIES Skin biopsies and skin cancer surgery At the Kelowna Private Skin Cancer Clinic, care begins with a clinical assessment, including dermoscopy to examine concerning skin spots in greater detail. If a spot may be cancerous, a biopsy helps confirm the diagnosis and guide treatment. We offer skin biopsies and surgical excision for suitable lesions. We will explain the recommended procedure, what to expect, and whether specialist referral is needed. Contact the clinic Assessment first: examining your skin with dermoscopy Your doctor first examines the spot and makes an initial clinical diagnosis — an assessment of what it appears to be. Dermoscopy uses a handheld instrument with magnification and a special light to reveal details that are not visible to the naked eye. If the assessment suggests a possible skin cancer, a biopsy is usually the next step to confirm the diagnosis. Not every spot needs a biopsy, and being advised to have one does not mean you definitely have cancer. Why do a biopsy instead of removing the whole spot straight away? It is understandable to ask whether a concerning spot can simply be removed in one procedure. Different types of skin cancer need different amounts of normal-looking skin removed around them. This surrounding tissue is called the surgical margin. Cancer cells can extend beyond the visible edge of a spot, so removing only what we can see may not be enough. A biopsy helps establish whether the spot is cancerous and which type of cancer it is. Basal cell carcinoma, squamous cell carcinoma, and melanoma do not all require the same surgical approach or margin. The biopsy may also identify features, such as the cancer’s subtype or depth, that influence treatment. Knowing the diagnosis first helps us plan an appropriate excision, aiming for complete removal while avoiding unnecessary removal of healthy skin. It also helps us decide whether treatment at our clinic or specialist referral is more appropriate. Sometimes the whole visible spot is removed as the initial biopsy. This is called an excisional biopsy and is often the preferred approach when melanoma is suspected. Even then, the laboratory result may show that a further excision with a wider margin is needed. Your doctor will explain the best first step for your spot. Skin biopsies: confirming the diagnosis A biopsy removes a sample of skin, or sometimes the whole visible spot, for examination under a microscope. The area is numbed with local anesthetic, sometimes called “freezing.” The approach depends on the clinical assessment and the spot’s size and location. Punch biopsy A small circular tool takes a sample of skin, including deeper layers. It may sample part of a larger spot or remove a very small spot. Stitches may be needed. Incisional biopsy Only part of a spot is removed for testing. This may be appropriate when removing the whole area is not the best first step. The result helps guide further treatment. Excisional biopsy The whole visible spot is removed for testing, usually with a small margin of surrounding skin. Stitches are usually needed. Further treatment may still be recommended once the diagnosis is known. Punch describes the sampling tool. Incisional and excisional describe whether part or all of the visible spot is removed. These approaches can overlap. Skin cancer surgery and specialist referral Surgical excision at our clinic Surgical excision may be recommended to remove a skin cancer once the diagnosis and treatment plan are established. The area is numbed, then the lesion is removed with a planned margin of surrounding skin. The amount removed depends on the cancer type, relevant biopsy findings, and the lesion’s size and location. The wound is usually closed with stitches. A pathologist assesses the removed tissue, including the edges, to check whether the cancer has been completely removed. If cancer cells are found at an edge, further treatment may be needed. Your doctor will explain the expected scar, wound care, and follow-up. Excision may also be appropriate for other lesions that need removal. Mohs surgery: specialist treatment outside Kelowna Mohs surgery removes skin cancer in stages. The tissue is checked under a microscope during the procedure, and further tissue is removed where needed. The aim is to remove the cancer while preserving as much healthy skin as possible. It may be recommended for selected skin cancers, including some in sensitive locations or with a higher risk of returning. It is usually performed under local anesthetic, and the appointment can take several hours. Mohs surgery is not offered in Kelowna. When this treatment is recommended, we typically refer patients to a Mohs specialist in Vancouver, Calgary, or Edmonton. We will discuss whether referral is appropriate and explain the next steps. Learn about Mohs surgery What to expect before and after your procedure Before your procedure We will explain the procedure, its benefits and risks, and any alternatives. Please tell us about your medicines, including blood thinners, allergies, and any previous problems with bleeding or wound healing. Do not stop prescribed medicines unless your treating clinician tells you to. Do you have an important occasion coming up? Tell both the clinic staff and your doctor before the procedure begins if you have a wedding, anniversary, photo session, special occasion, or an event where your appearance matters shortly afterwards. You will have a healing wound and may have visible bruising, swelling, stitches, or a dressing. We aim to avoid scheduling a procedure immediately before an important event. Let us know in advance so we can discuss recovery and plan the timing with you. Your doctor will also consider whether it is appropriate to delay investigation or treatment of a suspected cancer. During your procedure The numbing injection may sting briefly. Once the area is numb, you may feel pressure or movement, but you should not feel sharp pain. Tell your doctor if you are uncomfortable so they can check the anesthetic. Afterwards Some soreness, bruising, or swelling can occur, and a biopsy or excision can leave a scar. Healing time varies with the procedure and the area of the body. Follow the wound-care instructions provided, including advice about dressings, activity, and stitch removal. Seek medical advice promptly if bleeding does not stop with firm pressure or you develop possible signs of infection, such as fever, increasing pain, or swelling. If you cannot reach the clinic, contact an appropriate urgent-care service. Where your tissue is examined and when to expect results Specimens removed during biopsies and excisions at our clinic are sent to Kelowna General Hospital’s pathology department, where they are evaluated by a pathologist — a doctor who examines tissue under a microscope. Histology results typically take about three weeks after your procedure. The clinic will communicate the results to you and explain whether further treatment or follow-up is needed. Some results may take longer. If you have not heard from us after three weeks, please contact the clinic to check on your results. Do not assume that no news means the result is normal. Optional video: what a skin excision involves Watch an educational overview of a skin excision and what the procedure involves. Content warning: This video contains graphic medical footage. Watching is optional; you do not need to view it before your appointment. Watch the excision video on YouTube Book a skin assessment Have a changing mole, an unusual growth, or a spot that does not heal? Contact the Kelowna Private Skin Cancer Clinic to arrange an assessment and discuss whether a biopsy or treatment is needed. Contact the clinic This page provides general information and does not replace advice about your individual care.