Well... if you want to know the nature of the lesion, only a pathology finding from a biopsy could tell you that. So, in that sense, a biopsy is necessary.
I've had both surgical/ excisional and stereotactic/ needle biopsies. So, I could tell you about both... but since you ask about the surgical procedure, I can honestly say that mine wasn't nearly as bad as I had expected.
I was fully sedated for the duration of the procedure, which lasted about a half an hour. Soon after I awoke, I was off on my way along with instructions to follow and a prescription for Vicodin. I was left with an overall groggy feeling for the remainder of the day due to the after effects of the sedative. Anyway, I didn't need to use the Vicodin script. Pain thresholds and discomfort levels vary and, my pain was rather minimal. On a scale of 1-10, I’d say that my pain level was probably at a 4. If anything, I felt more soreness and sensitivity than true pain... but, that was easily managed with extra-strength Tylenol. Ice packs worked wonders for reducing the swelling and overall achyness. And, there was a significant amount of bruising... it was kinda scary to look at. But, it didn’t take long for the bruising to disappear along with the swelling and achy feeling. As a precautionary measure, I was instructed to avoid heavy lifting and getting into hot tubs. Sleeping, I'd say, presented the major challenge as I'm unaccustomed to sleeping on my back... but, I somehow managed it.
Complete healing took a couple of weeks. And, I was left with a fine, inch and a half, hairline scar... which is now, very faint and barely visible.
All in all, I would say that the toughest part of the entire ordeal was the waiting period to hear the pathology results. I received mine in about 3 days and thankfully, it returned with benign findings... as I'm hoping that yours will. Take care... good luck with the biopsy and if you want more input/ advice or just need some emotional support with this, please feel free to PM me.
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