Concierge diagnostic surgery · London
Excisional biopsy, complete removal of a lesion for histological diagnosis — skin, lymph node and breast.
An excisional biopsy removes the entire lesion (with a margin) for histopathology. Commonly performed for suspicious skin lesions, lymph nodes and breast lesions. Modern private pathway: same-week appointment, local anaesthesia, one-stop histology and photograph.
Why patients choose us
- 01
The right hands
We route you to a consultant surgeon or dermatologist who both excises the lesion and steers the histology pathway.
- 02
One-stop, same week
Consultation, photograph, excision and dressing in a single appointment — histology to follow.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private excisional biopsy costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A standard skin excisional biopsy in our network: £450–£900, with histology in 7–10 days.
| Procedure | Indicative range | Typical duration | Histology turnaround |
|---|---|---|---|
| Standard excisional biopsy (skin lesion) | £450–£900 | 30 min | 7–10 days |
| Complex or facial excisional biopsy | £700–£1,400 | 45 min | 7–10 days |
| Excisional lymph node biopsy | £1,800–£3,500 | 60 min | 10–14 days |
| Breast excisional biopsy (lumpectomy for diagnosis) | £2,500–£5,000 | 60–90 min | 10–14 days |
| Excision + same-visit dermatology consult | £650–£1,300 | 60 min | 7–10 days |
| Urgent same-week excision | £600–£1,500 | 30–60 min | 7–10 days |
Prices vary by lesion site, complexity, whether closure is direct or a flap/graft is needed, and whether a same-visit consultant opinion is included. We come back with a firm quote within one working day.
The problem
An excisional biopsy is only as good as the surgeon and the pathologist.
The margin, orientation and specimen handling decide whether the histology can answer the question — and whether a second procedure is avoided. We route you to a consultant surgeon and a specialist pathologist, not a generalist.
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Suspicious skin lesion?
We arrange an urgent excisional biopsy with dermoscopy and photograph, and route findings to the skin-cancer MDT.
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A lymph node that has not settled?
We arrange excisional lymph node biopsy for whole-node architecture — essential for lymphoma sub-typing.
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An indeterminate breast lesion?
We fold excisional biopsy into a triple-assessment pathway with breast imaging and specialist pathology.
The journey
From enquiry to histology — what happens, in order.
One clinician from first message to histology — often within a week.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
20–40 minutes under local
Phase 3 · After
Histology and next steps
- 01
Before
You tell us what’s going on
A short, confidential form. Lesion site, duration, changes, prior imaging or dermoscopy if you have them.
- 02
Before
We come back with a recommendation
Within one working day: whether an excisional biopsy is the right step, which clinic, indicative price. If a shave or punch is more appropriate, we say so.
- 03
Before
Specialist consultation
Consultant clinical assessment, dermoscopy or ultrasound as needed, photograph and site marking.
- 04
On the day
Skin cleaned and local anaesthetic
The area is cleaned, marked with a planned margin, and local anaesthetic is infiltrated. You stay awake and comfortable throughout.
- 05
On the day
Lesion excised and closed
20–40 minutes. The lesion is excised with the planned margin, wound closed with dissolvable or non-absorbable sutures, and dressed.
- 06
On the day
Straight home
No general anaesthetic recovery. Written post-op instructions, dressing care and a 24-hour contact number.
- 07
After
Histology and next steps
Histology in 7–10 days, with onward MDT, wide local excision, sentinel node biopsy or radiotherapy pathway if needed.
Typical end-to-end: 7–14 days. Urgent cases: same week.
What it shows
When an excisional biopsy is the right step.
Excisional biopsy answers a specific question — what is this lesion, and are the edges clear. These are the presentations we see most.
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Basal cell carcinoma
The commonest skin cancer — excisional biopsy gives both diagnosis and, often, cure.
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Squamous cell carcinoma
Complete excision confirms diagnosis and clears margins on histology.
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Melanoma
Complete excision with a narrow margin is the standard diagnostic step for suspicious pigmented lesions.
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Benign naevus
Complete removal for symptomatic or cosmetically troublesome moles with definitive histology.
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Lymph node — lymphoma or reactive
Whole-node architecture is essential for lymphoma sub-typing; core biopsy can miss the answer.
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Breast fibroadenoma or phyllodes
Excision biopsy for indeterminate breast lesions where core biopsy is not definitive.
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Soft-tissue tumour
Superficial soft-tissue lumps where imaging is inconclusive and histology is needed.
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Red flag: melanoma or lymph-node lymphoma — urgent MDT pathway
These findings trigger an urgent multi-disciplinary review and staging, not a wait-and-see approach.
Next steps
What happens after the histology.
The histology decides the next move — from reassurance to a full oncology pathway. Every result is explained and routed.
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Reassurance for benign histology
A clear benign result closes the loop — no further treatment, just dressing care and scar aftercare.
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Wide local excision for melanoma
A second, wider excision to clear margins based on Breslow thickness — the definitive treatment step.
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Sentinel node biopsy
Staging procedure for intermediate-thickness melanoma to detect microscopic nodal spread.
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Mohs micrographic surgery (facial BCC)
Tissue-sparing staged excision with real-time margin control — the standard for facial or recurrent BCC.
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Radiotherapy referral
For selected non-melanoma skin cancers, lymphomas or margin-positive lesions where surgery alone is insufficient.
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Adjuvant therapy for high-risk lesions
Systemic therapy — immunotherapy or targeted agents — for high-risk melanoma or aggressive histology.
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Multi-disciplinary team review
Cancer diagnoses are reviewed by a skin, breast or haematology MDT to agree the definitive plan.
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Structured follow-up
Scheduled clinical review, dermoscopy or imaging surveillance calibrated to the histological risk.
Our vetted London network
A small panel of clinics, we picked them.
Partners across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every clinic in our network.
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Consultant dermatological, plastic, breast or head-and-neck surgeons
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Standardised margins per BAD, NICE NG7 and RCPath minimum datasets
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Histology reported by a specialist consultant pathologist
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Onward MDT, wide local excision or sentinel node pathway if malignancy is found
Safety and red flags
A very safe minor operation — with a few things worth knowing.
Excisional biopsy under local anaesthetic is a low-risk day procedure. Red flags include melanoma > Breslow 1.0 mm, lymphoma on a lymph node, a suspicious pigmented or ulcerated lesion, rapid growth, post-op infection, recurrence at the scar, positive margins on histology, and any new lesion in an immunosuppressed patient.
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Local anaesthetic, awake procedure
Almost all excisional biopsies are performed under local anaesthetic — no fasting, no general anaesthetic, no overnight stay.
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Small risk of bleeding or bruising
A small amount of oozing is normal in the first 24 hours. Firm pressure for 10 minutes usually settles it.
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Infection is uncommon
Wound infection affects a small minority of excisions — redness, heat, pus or fever needs review.
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You will have a scar
Every excision leaves a linear scar along the planned line, usually 3× the lesion diameter. Scars mature over 6–12 months.
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Anticoagulants and antiplatelets
Bring a current medication list. Most patients continue their blood thinners; some are adjusted for larger excisions.
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Positive margins are managed
If histology shows tumour at the edge, a further excision or Mohs is planned — this is not a failure of the biopsy.
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Dressing and suture care
Keep dry for 48 hours; sutures removed at 5–14 days depending on site; dressing changes as instructed.
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Melanoma is a red flag
Any suspicion of melanoma routes into the urgent skin-cancer MDT — not a wait-and-see follow-up.
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Bring prior photographs and imaging
Serial photographs, dermoscopy images and ultrasound reports materially sharpen the histology interpretation.
Reading your report
A histology report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Clinical details and specimen
Your details, the lesion site, size, orientation and how the specimen was received in the laboratory.
- 02 Macroscopy
Naked-eye description of the specimen
Dimensions, appearance and how the specimen was inked and blocked for microscopy.
- 03 Microscopy
Cellular findings and margin distances
Cell of origin, sub-type, invasion depth (Breslow for melanoma) and distance to the nearest peripheral and deep margins.
- 04 Conclusion
Diagnosis, staging and the next step
The final diagnosis, TNM or Breslow stage, margin status and the concrete recommendation — read this first.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about excisional biopsy.
Quick answers on pain, procedure length, histology turnaround, scars and what happens if the result comes back as cancer.
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What does an excisional biopsy involve?
The complete surgical removal of a lesion, with a planned margin of surrounding tissue, under local anaesthetic. The whole specimen is sent for histopathology — which gives both a diagnosis and, for many benign or early malignant lesions, definitive treatment in a single step.
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Will it hurt?
The local anaesthetic stings briefly as it is injected, and then the area is completely numb. You will feel pressure and tugging but no pain. Aching for 24–48 hours afterwards is normal and controlled with paracetamol.
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How long does the procedure take?
A standard skin excisional biopsy takes 20–40 minutes from local anaesthetic to dressing. Facial, lymph node and breast excisions take longer — 45–90 minutes — and require a longer appointment slot.
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When will I get my histology result?
Standard turnaround is 7–10 days for skin, 10–14 days for lymph node and breast. Urgent or MDT cases can be prioritised. We chase the report and route it to you and your onward clinician.
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Will I have a scar?
Yes — every excision leaves a linear scar, typically about three times the diameter of the lesion along the planned line. Scars mature and fade over 6–12 months; silicone gel and sun protection meaningfully improve the final appearance.
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What if the histology shows cancer?
A malignant result triggers an urgent MDT review, and the surgeon and pathologist agree the next step — wide local excision, sentinel node biopsy, Mohs surgery, radiotherapy or systemic therapy. We coordinate the onward pathway with you and your insurer.
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In practice, in London
How excisional biopsy tends to unfold when you go private
With excisional biopsy, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. The wait for excisional biopsy on the NHS depends heavily on where you live and how urgently the referral is graded. Central and West London private clinics can normally book within a week, with imaging or a procedure slot to follow shortly after. It’s worth being honest about the reason for going private: usually it’s time, not a fundamentally different test.
In practice, a private excisional biopsy appointment in London means a named consultant, a proper hour in the room (or the equivalent on a video call), and a report you can actually read. Most of the imaging suites and endoscopy units we use sit within a mile of Harley Street or in Chelsea and Fulham, and turnaround on findings is measured in days, not weeks. For excisional biopsy specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
We’re careful about what a private pathway for excisional biopsy can and can’t promise. It can compress a wait, put you in front of a subspecialist quickly, and get a proper report in your hands within a week. It can’t rewrite what the imaging or the bloods say. Setting that expectation up front tends to make the whole experience less stressful.