The skin is the largest organ of the body. It is susceptible to a wide variety of diseases, disorders, discolorations, and growths, as well as damage from the environment and the aging process. There are many reasons for the need for Dermatologic Surgery; however, skin cancer removal is the number one reason for Dermatologic Surgery in our office. Skin cancer can vary according to the location, extent, and aggressiveness of the skin cancer and the patient’s general health. In most cases, our Dermatologists will take a small piece of the abnormal tissue – called a biopsy. The tissue is then examined under a microscope by a Dermatopathologist to determine whether it is malignant.
Malignant tumors require more treatment such as curettage, surgical excision, cryosurgery, Mohs’ microscopically controlled surgery, topical chemotherapy, and laser surgery or radiation therapy. Most of these procedures are performed right in our office under local anesthesia or at an outpatient facility.
Cancerous Growths
Curettage and electrodesiccation involve scraping away the malignant tissue with a sharp surgical instrument called a curette. An electrosurgical unit may then be used to stop bleeding and remove a zone of normal tissue.
Surgical excision i nvolves cutting into the skin, removing the growth, and then closing the wound with stitches.
A biopsy means to remove a small piece of the skin for examination under the microscope and diagnosis.
Cryosurgery involves the use of a machine that sprays liquid nitrogen directly onto the skin, or contacts the skin with an instrument, which freezes the cancerous tissue. Freezing can destroy cancer cells, and wound healing will occur with minimal scarring.
Mohs surgery is a way of removing a tumor where each bit of tissue is examined under the microscope to determine the site and extent of malignant cells before more tissue is removed. While the procedure is time-consuming, it yields a very high cure rate and is indicated for recurrent tumors and tumors located in areas of high risk for recurrence, such as on and around the nose.
Topical chemotherapy involves the application of a chemical, which destroys precancerous growths and sometimes cancerous tissue.
Radiation therapy can also destroy cancerous tissue and is useful in certain types of skin cancer, as well as in selected individuals for whom surgery is not possible.
Non-Cancerous Growths
Many blemishes that occur on the skin, such as age or “liver” spots, birthmarks, moles, warts, wrinkles, and scars, can be eliminated or at least improved by an appropriate dermatological surgical procedure.
Age or liver spots are large freckles which develop on sun-exposed areas. They can be minimized by using a sunscreen and respond well to treatment with chemical peeling, cryosurgery, or laser removal.
Moles are common skin growths which are usually small and tan or brownish, are sometimes raised, and may occasionally change shape or color. Dermatologists remove moles to improve appearance, to prevent the mole from enlarging, or to prevent cancer. They are usually removed by cutting.
Warts are caused by a virus and consist of piled up layers of skin. Warts may develop on people of all ages anywhere on the skin. Some warts require cryosurgery, curettage, electrosurgery, injections with chemicals, or laser surgery.
Broken blood vessels on the skin can be eliminated by electrosurgery, microinjection or laser surgery.
Scars resulting from acne, chickenpox, accidents, or previous surgery may be improved by dermabrasion. The skin is frozen with a spray medication, after which a high-speed rotary abrasive wheel is used to remove the outer layers of skin and soften the irregular edges of the scar. Dermal Fillers can be injected into the skin. Raised scars can be surgically leveled or flattened with corticosteriod injections. Any operation results in some scar formation; however, a dermatologic surgeon places incisions so that the resulting scar will be minimal. In addition, soft tissue augmentation in the form of injectable Dermal Fillers or collagen-enhancers may raise depressed scars to normal levels.
Wrinkles can be improved with dermabrasion, laser surgery, or topical chemical peeling with dilute acids. These methods can also be used on discolored skin, resulting in a more youthful appearance.
Actinic keratoses are thick, warty, rough, reddish growths which appear on the sun‑exposed areas of the body. They sometimes develop into squamous cell cancer and are usually treated with cryosurgery, curettage, dermabrasion, laser, or chemical peeling to prevent the change to cancer.
Seborrheic keratoses are raised, tan or brown growths. They often become itchy and irritated by clothing. They may be removed by cryosurgery or cutting.
Cysts are small closed sacs that contain fluid or solid material. Infection often means that the dermatologist must drain the contents and sometimes surgically remove the cyst. The site may or may not be closed with stitches.
Baldness can be corrected by transplanting hair-bearing grafts or strips from the back and sides of the scalp to balding areas on the top or front. The dermatologist uses a special knife to remove the hair, which is then inserted into spaces on the bald scalp. There is a three to six week waiting period between transplants so that healing and new growth can take place. Within six months, transplanted hair grows to one half inch in length. Removal of large areas of bald skin by scalp reduction will improve the balding area with less need for hair transplants. This can be combined with hair transplantation.
Unwanted Fatty Deposits may be removed by dermatologic tumescent liposuction. This can be done as an office procedure with local anesthesia, insignificant blood loss and exceptional safety.
Dermatologic Surgery Procedures
Dysport®
Dysporte is a dermatologic prescription injection that temporarily improves the look of moderate to severe frown lines between the eyebrows. It’s intended for less than 65 years of age.
Belotero Balance
Belotero Balance is an FDA-approves dermal injection used to correct mid-to-deep facial wrinkles and folds. Belotero delivers natural results that don’t look stiff or emotionless.
For more information, please visist www.belotero.com
Xeomin®
What is Xeomin®?
XEOMIN (1ncobotulinurntoxinA) is an intramuscular prescription injection used to temporarily soften the appearance of moderate to severe frown lines between the eyebrows.
How Does Xeomin® Work?
Xeomin® works by relaxing wrinkle-causing muscles fibers. Every time you frown or squint, muscles in your brows contract. The surrounding skin folds, and over time these repeated contractions cause persistent frown lines as the skin ages and loses elasticity. Xeomin® acts on these muscle nerve endings and keeps them from contracting.
Sculptra Aesthetic
Sculptra Aesthetic is a long-term facial injection designed to give you results over time. Made from poly-L-lactic acid, Sculptra Aesthetic rejuvenates skin by replacing lost collagen. It’s designed to give you a more natural appearance by correcting both shallow and deep facial wrinkles and folds. An average session consists of three injections spread out over a few months but produces results that can last for more than two years.
Juvederm Voluma®XC
Juvederm Voluma XC is a dermal injectable that adds volume to sagging cheeks for a more youthful appearance. Volume XC works by creating contour and contrast to lift the apples of your cheeks for up to two years.
Additionally, Juvederm Voluma®XC is used to smooth moderate to severe facial wrinkles. Inserting this injectable gel into precise areas of facial tissue will alleviate wrinkles to give the appearance of smoother skin.
Juvederm Voluma®XC may be used in adults over the age of 21.