A congenital nevus is a darkly colored mole that’s either present at birth or appears in the first year of life. They can range in size, from very small to very big, covering large areas of the body.

Giant congenital nevi measure 20 centimeters or more, and the color and texture can vary. Because excess hair growth is common, they’re sometimes referred to as giant hairy nevi. 

Wake Forest Baptist Health's plastic surgeons are experienced in advanced techniques to remove giant congenital nevi from all parts of the body. Different surgical methods are available, and our team spends time discussing the options with each patient to help them determine which techniques will provide the best outcome.

Congenital Nevus Treatment

The large size of these lesions often means that they can’t be removed all at once. The goal of surgery is to eventually remove the mole in its entirety, or at least as much as possible. Techniques for removal include:

  • Serial excision, which involves the removal of one portion of the lesion with closure of the wound, followed by a similar additional surgery or surgeries to remove the remaining lesion. This technique allows the skin to soften and stretch without placing too much tension on the scar.
  • Excision and grafting removes the lesion and places a skin graft on the wound. This technique allows for larger areas of excision, but may also leave more scarring.
  • Tissue expansion is a technique that slowly stretches normal skin, and then uses it to reconstruct the excised giant nevi. During tissue expansion, one or more silicone balloons are placed under the skin, and then over several weeks are inflated with water, until the desired growth of skin is reached. 

Patient Resources

American Society of Plastic Surgeons: Giant Nevi Removal