Informed Consent – Skin Biopsy or Lesion Removal
You can read the consent wording before arriving. Reading this page does not constitute consent to the procedure. Consent is signed only at the clinic.
General Information
A skin biopsy or lesion removal is a procedure performed for diagnosis, treatment, cosmetic improvement or comfort. Lesions may be benign or potentially malignant. The method of removal depends on the size, shape, appearance, body location, and suspicion of malignancy. The extent of the biopsy or excision is chosen according to the lesion characteristics, risk of malignancy, and need for pathological examination. A wound remains after the procedure, and it leaves a mark or a scar of varying degree.
Possible Treatment Methods
Biopsy: superficial (shave) or deep (e.g., punch). Removal: surgical excision or alternative methods such as curettage, electrocautery, radiofrequency, radiotherapy, liquid nitrogen, laser, acid, a topical chemotherapy cream, and more. Certain malignant lesions are suitable for removal by Mohs surgery, in which the margins of the excision are checked under the microscope during the operation itself.
Anesthesia
The procedure is usually performed under local anesthesia using injection or topical anesthetic cream.
Recovery
After a biopsy, sutures are usually not required, except in certain cases such as scalp biopsy for hair loss evaluation. After surgical excision an open wound remains. It can be left to heal on its own (secondary healing), which usually takes several weeks, or closed with stitches, by moving nearby skin (a flap), or by grafting skin from another area (a graft). Avoid strenuous activity in the first few days, prolonged sun exposure until the wound closes, and swimming until fully healed. Smoking may slow healing.
Post-Procedure Care
Biopsy without stitches: Leave the initial dressing on for 24 hours. Then wash once a day with soap and water. Apply a thin layer of the prescribed antibiotic ointment and cover with an adhesive bandage, not gauze, until the wound has closed. Scalp biopsy with dissolving stitches: Leave the first dressing on for 24 hours. Then change it once or twice a day. Apply a thin layer of the prescribed antibiotic ointment, with Vaseline on top. On the scalp where there is hair, use a non-stick pad held by a hat. Do not put adhesive bandages or tape on the hair. If stitches remain after two weeks, a nurse at your health fund clinic (Kupat Holim) can remove them. Antibiotic ointment: If two antibiotic ointments are prescribed, one is enough, depending on availability at the pharmacy. What is normal? Mild redness around the wound and mild tenderness or discomfort that settles within a few days. Mild bleeding: Apply gentle pressure with dry gauze for 10 minutes. If bleeding continues, repeat in rounds of 10 minutes. If bleeding does not stop despite pressure, go to an urgent care center. When to contact the clinic: Severe pain not relieved by painkillers, spreading redness, pus or a bad smell, severe worsening swelling, a fever above 38°C, or bleeding that does not stop despite pressure. In an emergency: Go to an urgent care center. For excision with sutures, a flap or a graft: instructions for wound care and suture removal will be provided separately, and you must follow them.
Possible Results and Risks
Based on pathological results, re-excision or alternative treatment may be required. Scar appearance depends on the type of repair, individual response, and treated area. The resulting scar may be up to five times the size of the original lesion (with sutured closure) or larger with complex closure. Common effects: redness, swelling, pain, discomfort, and scarring. Possible complications: local bleeding, infection, suture dehiscence, flap or graft failure, prominent scarring, pigmentation changes, prolonged sensory disturbance, and, rarely, nerve injury that may cause muscle weakness in the area. Allergic reaction to the local anesthetic, or a feeling of weakness or fainting (vasovagal reaction) during the procedure. Additional side effects or complications, rare or unforeseen, not listed above, may occur.
Treatment Alternatives
The alternatives are monitoring the lesion, or complete excision instead of a sample. Not performing a biopsy on a suspicious lesion may delay the diagnosis of a malignant tumor, including melanoma.
Payment and Insurance Reimbursement
A private payment for treatment at the clinic is not conditional on any reimbursement being received. The clinic cannot undertake that a private or supplementary insurance policy will reimburse you, nor for how much. That decision rests with the insurer and the terms of the policy alone, and for aesthetic treatments most policies provide no cover at all.
Use of Injectable Medications
Vials of injectable medications used at the clinic contain doses sufficient for multiple patients but are labeled by the manufacturer for single-patient use. Every withdrawal from a vial follows strict sterility standards, using a new sterile single-use needle and syringe for each patient. If you prefer a dedicated vial reserved for your treatment alone, please inform the physician or clinical staff. In that case, we will be happy to issue a prescription for you to purchase a personal vial from a pharmacy, or to refer you to another clinic for the procedure.
Consent Declaration
I declare that I received a detailed explanation from Dr. Yehonatan Kaplan and/or the clinic staff regarding the procedure, outcomes, treatment options, risks, and alternatives. I hereby give my consent to the procedure and local anesthesia, after having been informed of the possible risks. I was given the opportunity to ask questions and received answers to them. I understand that no particular result has been guaranteed to me, and that I may withdraw my consent at any time before the treatment.
Photography Consent
I consent to photography of the treated area for medical and legal purposes, as well as use of close-up images for research (subject to the approvals required by law) or for professional presentation without personal identification.