Scar area and cosmetic outcome after circular and elliptical excision of small skin lesions

Background: Cutaneous surgery for removal of small skin tumors is usually performed as elliptical excision. There is some indication that circular excisions could result in cosmetically more favorable scars and should therefore be considered as an alternative method. Objective: The aim of this study was to compare circular and elliptical excisions with respect to scar area and cosmetic result. Methods: Fifty-six operations were performed, 27 elliptical and 29 circular. The cosmetic results were determined as patient's opinion by questionnaire and assessment of photo slides by three independent observers. Also, scar areas were measured by computer program. Results: The scar area was significantly smaller after circular excisions compared with elliptical excisions after 6 and 12 months of observation (p = 0.005 and p = 0.001, respectively). The assessment of cosmetic results by the patients did not differ between the two groups (p = 0.44), while the independent observers slightly favored the cosmetic outcome of elliptical scars (p = 0.03). When analyzing only excisions without complications, there was no difference in cosmetic results between the two groups. Conclusion: Circular excisions seemed to cause smaller scars and equal cosmetic results compared with traditional elliptical excisions and could therefore be an alternative method for small skin excisions on the trunk and extremities.