Treatments / Skin / Melanoma treatment
Melanoma & sentinel node biopsy
Melanoma Treatment in Kent, Surrey, Sussex and London
Expert, reassuring care for melanoma
Wide local excision and sentinel lymph node biopsy with Mr Siva Kumar, Consultant Plastic Surgeon and skin cancer MDT lead. Clear explanations at every step.
At a glance
About melanoma
Treating melanoma thoroughly
Melanoma is a type of skin cancer that starts in the cells that give skin its colour. Found early, it is very treatable, but it needs prompt, careful management because it can spread.
The main treatment is a wide local excision: removing the area where the melanoma was, with a margin of normal skin, to reduce the chance of it coming back. The wound is usually closed directly, or with a skin graft or local flap.
For some melanomas, a sentinel lymph node biopsy is offered at the same time. A tracer is injected near the site to find the first lymph node the cancer would reach, which is removed and checked. This tells us whether the melanoma has spread and guides any further treatment.
Treatment aims to
- Remove any remaining melanoma cells
- Reduce the risk of the melanoma coming back
- Stage the melanoma accurately (with sentinel node biopsy)
- Close the wound with the best possible appearance
Treatment
What your treatment may involve
Wide local excision
Removes a margin of skin around the original melanoma scar. The width depends on how deep the melanoma was.
- Best for: all invasive melanomas
Sentinel lymph node biopsy
Finds and removes the first draining lymph node, using a blue dye and a radioactive tracer.
- Best for: melanomas above a certain thickness, after discussion
Reconstruction
Larger wounds can be closed with a skin graft or a local flap of nearby skin.
- Best for: larger or awkwardly placed wounds
Read more about skin grafts and local flaps
Local flaps
A local flap moves nearby skin, still attached to its own blood supply, into the wound. Because the skin comes from right next to the wound, it matches the colour, texture and thickness of the surrounding skin very well. This is why flaps are often the first choice on the face, for example on the nose, cheek, lip or forehead.
The skin is advanced, rotated or transposed into place, and the scars are planned to sit in natural creases and lines where possible. The final scar is usually longer than the original wound, but often less noticeable.
Skin grafts
A skin graft is a thin layer of skin taken from another part of the body and placed over the wound, where it picks up a new blood supply over the following week.
- Full-thickness graft: taken from an area with spare skin, such as in front of or behind the ear, the neck or above the collarbone. The donor site is stitched closed. Used for smaller wounds, especially on the face.
- Split-thickness graft: a very thin shaving of skin, usually from the thigh, for larger wounds. The donor site heals like a graze over about two weeks.
Which is right for you?
Mr Kumar chooses the best option based on the size and position of the wound, your skin and your general health, and explains the plan before your operation. Reconstruction is usually done at the same operation as the removal, or on the same day after Mohs surgery.
Recovery
- A padded dressing protects a graft for 5 to 7 days and must be kept dry.
- Stitches are usually removed after 5 to 14 days, depending on the area.
- Swelling and redness settle over several weeks, and scars keep improving for 12 to 18 months.
- Please avoid smoking, which reduces the blood supply and increases the risk of a graft or flap not healing.
Specific risks
These include bleeding, infection, part of a graft or flap not surviving, a difference in colour or contour, a raised or puffy appearance of a flap, and occasionally the need for further treatment such as scar massage, a steroid injection or a minor revision.
Watch & read
Everything you need to know, in one place
Patient guide
Melanoma: your patient guide
A detailed booklet written by Mr Kumar. It explains the procedure in depth, how to prepare, every risk and complication, and how to look after yourself afterwards.
Opens as a booklet you can flick through. Your copy is also given to you at consultation.
Videos
Mr Kumar explains
Your journey
Your step-by-step journey
Your journey starts the moment you get in touch. From your first enquiry to your final check-up, you deal with the same small team, and you will always feel listened to, informed and never rushed.
Get in touch
Call, email or send an enquiry, or ask your GP or dermatologist to refer you. We aim to see you quickly.
If you are worried about a skin cancer, tell us when you book so we can prioritise your appointment.
Assessment
Mr Kumar examines the area, reviews any biopsy results or scans, and explains your options clearly.
You will receive the plan in writing. Where relevant, your case is discussed with the skin cancer multidisciplinary team (MDT) that Mr Kumar leads.
Your procedure
Wide local excision alone is often done under local anaesthetic. With a sentinel node biopsy you will have a general anaesthetic, usually as a day case.
You will have clear wound-care instructions and a number to call if anything worries you.
Results
Anything removed is examined in the laboratory, usually within 2–3 weeks.
Mr Kumar goes through the results with you and explains what, if anything, needs to happen next.
Follow-up
A wound check and, where needed, regular skin checks to keep you well in the future.
You will also be shown how to check your own skin and what changes to look out for.
Recovery
Healing, step by step
Everyone heals at their own pace. This is a typical recovery, and Mr Kumar will give you a personal plan.
Go home the same day in most cases. Keep dressings dry.
Stitches out or dissolving. Avoid strenuous activity.
Results are discussed with you.
Regular follow-up and skin checks.
Patient reviews
In their own words
194 verified reviews on Doctify
90 verified reviews on Top Doctors
90 reviews on Top Doctors
Following my melanoma diagnosis I contacted Mr Kumar to discuss the treatment available. I was informed clearly about the options and any associated risks. He took time to address all my questions. I went ahead with the agreed procedure. I felt very confident I was in good hands. The procedure went well and I made a full recovery.
From the outset Mr Kumar explained in great detail both verbally & in writing my options, this really helped me with my decision making. Throughout the process I felt confident in the outcome, by this I mean the surgery & the aftermath. A very positive experience & thankfully a positive outcome.
My experience was excellent with Mr Kumar, he reassured me and explained everything about my operation. Thank you I would also like to thank Julie, Mr Kumar’s secretary for being so helpful. Thank you
Safety
Risks and staying safe
All surgery carries some risk. Mr Kumar will go through these with you in detail, and the patient guide covers them in full, so you can make an informed decision.
Possible risks
- Infection
- Bleeding
- Wound opening or delayed healing
- Scarring
- Fluid collection after sentinel node biopsy (seroma)
- Swelling of the limb (lymphoedema), uncommon after sentinel node biopsy
- Temporary blue colour in the skin or urine from the dye
- Numbness around the scar
Lowering your risk
- Check your skin every month and report any changes
- Protect your skin from the sun
- Tell us about all medicines and supplements, especially blood thinners
- Stop smoking and vaping well before and after your procedure
- Follow your aftercare plan and attend every follow-up
- Call us at any time if something does not feel right
Fees
Guide price from£850
Self-pay consultations £250.
One package price. No hidden surprises.
If you go ahead, you receive a single package price covering your whole journey, so you know exactly what you are paying before you commit. It usually includes:
- Your surgeon’s fee
- Procedure room or theatre fees
- Laboratory analysis where needed
- Follow-up and wound check
- Support whenever you need it
- A clear written quote
FAQs
Your questions, answered
Why do I need more surgery after my melanoma was removed?
The first operation confirms the diagnosis. The wide local excision removes a safety margin of skin to reduce the risk of the melanoma coming back.
Do I need a sentinel lymph node biopsy?
It depends on the thickness and features of your melanoma. Mr Kumar will explain the benefits and risks so you can decide together.
Can I have this privately?
Yes. Most private insurers cover it, and you can also self-fund. Being seen privately can mean faster appointments and continuity with one consultant.
What happens if the lymph node contains melanoma?
Your case is discussed at the specialist skin cancer MDT, and you will be offered further scans and treatment options, which may include drug treatments.
Melanoma treatment: what is the guide price?
The guide price starts from £850. Your final fee depends on your treatment plan and choice of hospital, and is confirmed in a written quote after consultation. Self-pay consultations cost £250.
Is it covered by insurance?
Treatment for a medical concern is usually covered by private medical insurance, subject to your policy. Your insurer will need Mr Kumar’s full name, Siva Kumar Veeramani, and GMC number 6114710. Self-pay is also available.
Ask the expert
Questions answered
Longer answers from Mr Kumar to questions patients often ask about this treatment.
Thinking about melanoma treatment?
Start with an unhurried consultation with Mr Siva Kumar at The Ü Clinic in Sevenoaks or Oxted. Self-pay consultations cost £250.