Melanoma Treatment in Edinburgh
Melanoma treatment at Waterfront Private Hospital begins with a consultant-led assessment and surgical excision in Edinburgh. Care is delivered by Mr Ben Aldridge — chair of the South East Scotland Melanoma MDT and the UK’s only consultant dual-qualified in dermatology and plastic surgery — and by Mr Kazem Nassar, consultant plastic and reconstructive surgeon. Both are on the GMC Specialist Register and sit on the South East Scotland Melanoma MDT, treating melanoma in their NHS practice as well as at Waterfront. Every confirmed melanoma is discussed at the MDT; sentinel lymph node biopsy and any systemic treatment are delivered through the NHS pathway.
Content
Overview
- Consultants: Mr Ben Aldridge or Mr Kazem Nassar — both on the South East Scotland Melanoma MDT.
- Pathway: excisional biopsy of the suspicious lesion at Waterfront, MDT review of histology, then wide local excision and reconstruction at Waterfront if indicated.
- Anaesthetic: local anaesthetic, or general anaesthesia, where the lesion site or reconstruction requires it.
- Hospital stay: outpatient day case.
- Excisional biopsy: from £1,495.
- Wide local excision with reconstruction: from £2,195. Final pricing is set after assessment.
- Time from booking to consultation: typically 1-2 weeks.
How melanoma is diagnosed and treated at Waterfront
Melanoma is diagnosed by histology: a suspicious lesion is removed in full by excisional biopsy under local anaesthetic, with results normally within two weeks. Confirmed melanomas are discussed at the South East Scotland Melanoma Multidisciplinary Team — which Mr Aldridge chairs and on which Mr Nassar sits — and for most early melanomas the next step is a wide local excision, with reconstruction performed by the same consultant where required.
Sentinel lymph node biopsy and any systemic treatment are arranged through the MDT and delivered in the NHS pathway by the same consultants, preserving continuity across both settings.
What to expect from melanoma treatment
The most common pathway is excisional biopsy under local anaesthetic, followed — after MDT discussion — by wide local excision with or without reconstruction. Most early melanomas are managed with this two-stage surgical pathway alone.
Outcomes depend on stage at diagnosis. Melanomas detected early (thin melanomas, Breslow under 1.0mm, no ulceration) have very good long-term survival after wide local excision. Thicker melanomas, ulcerated melanomas, or those with positive sentinel lymph nodes require staging and surveillance, and may require systemic treatment through the NHS oncology pathway.
Where reconstruction is needed, the goal is to restore the contour of the affected area while keeping the wound under tension low enough to support healing and minimise scarring. Reconstruction is planned at the same time as wide local excision by the consultant performing the surgery.
When to seek a melanoma assessment
Patients commonly book a melanoma assessment when they have noticed one of the following.
- A new pigmented mole appearing in adulthood.
- An existing mole that has changed in size, shape, colour, or behaviour — particularly asymmetry, irregular borders, multiple colours, or a diameter increasing beyond 6mm.
- A mole that has started to bleed, itch, or crust.
- A pigmented lesion that looks different from the rest of your moles.
- A family history of melanoma, particularly in a first-degree relative.
- Multiple atypical moles or a personal history of skin cancer.
Most pigmented lesions assessed by a consultant are benign. The purpose of the assessment is to identify the small proportion that need a biopsy and to start the diagnostic pathway promptly where it is required.
Risks and considerations
Surgical risks of excisional biopsy and wide local excision include bruising, infection, scarring, and altered sensation around the wound. The site of the lesion influences the appearance of the final scar; your consultant will discuss this in detail at the assessment.
Margin reassessment is occasionally required. If histology shows that the melanoma extends to the edge of the initial excision, a further excision may be needed to achieve clear margins. This is part of standard melanoma management.
Recurrence risk depends on the stage at diagnosis. Early melanomas have very low recurrence rates after wide local excision. Higher-risk melanomas — thicker, ulcerated, or with positive sentinel lymph nodes — have higher recurrence rates and require longer follow-up. Recurrence, whether local, regional, or distant, remains possible across all stages and is the reason for the structured surveillance schedule described below.
Clinical and dermoscopic assessment is the most accurate way to identify a suspicious lesion without biopsy. Where there is any doubt, the consultant will recommend an excisional biopsy, because histology is the only way to confirm what a pigmented lesion is.
Aftercare and follow-up
After excisional biopsy or wide local excision at Waterfront, a nurse reviews the wound at one week, and more often if needed in the early healing period. Your consultant reviews you at around six months once the result has settled. Between then, your consultant is always available — if anything concerns you, they will respond directly and arrange to see you as soon as needed.
Long-term surveillance after melanoma is set by stage and follows national guidelines. Early melanomas are typically reviewed every three to six months for the first two years, then less frequently, with most schedules extending to five years. Thicker melanomas may be followed for longer.
Surveillance is normally delivered through the NHS pathway by the same consultants who treat you at Waterfront. Where preferred, ongoing surveillance can also be arranged at Waterfront.
What does melanoma treatment cost?
Pricing depends on the stage of the pathway.
- Consultation with a consultant: £200.
- Excisional biopsy: from £1,495.
- Wide local excision with reconstruction: from £2,195. Final pricing is set after consultation, based on the lesion site, the size of the wide local excision, and the type of reconstruction required.
Each price covers the surgeon’s fee, the anaesthetist’s fee where applicable, the hospital and theatre fee at Waterfront Private Hospital, and all post-operative reviews until you are fully discharged. Histology fees are included where a specimen is sent for analysis.
Sentinel lymph node biopsy and any systemic treatment are not delivered at Waterfront and are not part of these prices. They are arranged through the MDT and the NHS pathway. The full price of any onward treatment delivered at Waterfront is confirmed in writing before the procedure is booked.
Our melanoma consultants
Melanoma diagnosis, excisional biopsy, wide local excision, and reconstruction at Waterfront are performed by Mr Ben Aldridge — the UK’s only consultant dual-qualified in dermatology and plastic surgery, with a PhD in skin lesion diagnostics, co-author of national skin cancer guidelines, and chair of the South East Scotland Melanoma Multidisciplinary Team — and by Mr Kazem Nassar, consultant plastic and reconstructive surgeon. Both consultants are on the GMC Specialist Register and sit on the South East Scotland Melanoma MDT. Both treat melanoma in their NHS practice — including sentinel lymph node biopsy and lymph node clearance — providing continuity between Waterfront and NHS care.
Frequently asked questions
Will the same consultant handle my full melanoma pathway?
How quickly can I be seen?
How long does histology take?
What happens if histology confirms melanoma?
What is a wide local excision?
Will I need a sentinel lymph node biopsy?
Where does sentinel lymph node biopsy happen?
What if my melanoma needs systemic treatment?
How much does melanoma treatment cost?
What is the recurrence risk after wide local excision?
How long is the follow-up for melanoma?
Which consultant will I see?
Page authors
Mr Kazem Nassar, MBChB, FRCS (Plast), GMC 7131999, is a Plastic and Reconstructive Surgeon Consultant with over 10 years of experience. He practices at St John’s Hospital and the Western General Hospital in Edinburgh, specialising in melanoma, skin cancer treatments, breast surgery, and post-cancer reconstructive surgery. Mr Ben Aldridge, MB ChB, MSc, PhD, MRCP, FRCS (Plast), GMC [6049481], is a Consultant Dermatologist and Plastic Surgeon at Waterfront Private Hospital in Edinburgh. He is the UK's only consultant dual-qualified in dermatology and plastic surgery, holds a PhD in skin lesion diagnostics, is a co-author of national skin cancer guidelines, and chairs the South East Scotland Melanoma Multidisciplinary Team.
