Minor Skin Surgery

Skin surgery is the treatment of medically necessary and cosmetic skin conditions by various surgical methods. It is also called dermatological surgery. Skin surgery is often used to remove benign growths that are causing a nuisance or are unsightly, such as lipoma, sebaceous cyst and large moles. Surgery is also essential for removal of skin cancers and suspected skin cancers.

Common skin conditions for surgical removal：

Lipoma

A lipoma is a non-cancerous tumour that is made up of fat cells. It is usually a dome-shaped lump that slowly grows under the skin in the subcutaneous tissue. Lipomas can occur in people of all ages and affect both sexes equally. The cause of lipomas is unknown, it is possibly genetic involvement as many patients with lipomas come from a family with a history of these tumours. People are often unaware of lipomas until they have grown large enough to become visible and palpable. They are most common on the shoulders, neck, trunk and arms, but they can occur anywhere on the body where fat tissue is present.Most lipomas are symptomless and require no treatment, but some are painful on applying pressure. Lipomas that are symptomatic, large (5cm), tender or interfere with the movement of adjacent muscles and suspect of malignant change may require surgical removal. Several methods are available：

Simple surgical excision was the mainstay treatment of lipoma, burdened with scaring and risk of complications.
Minimal invasive surgery for lipoma with squeeze technique (a small incision is made over the lipoma and the fatty tissue is squeezed through the hole).
Liposuction assisted lipoma removal is a good alternative to simple surgical excision and is recommended its use in selected cases.

Surgical Removal

Lipomas that are symptomatic, large (5cm), tender or interfere with the movement of adjacent muscles and suspect of malignant change may require surgical removal. Several methods are available：

Simple surgical excision was the mainstay treatment of lipoma, burdened with scaring and risk of complications.
Minimal invasive surgery for lipoma with squeeze technique (a small incision is made over the lipoma and the fatty tissue is squeezed through the hole).
Liposuction assisted lipoma removal is a good alternative to simple surgical excision and is recommended its use in selected cases.

Sebaceous Cyst

Sebaceous cysts are common noncancerous cysts of the skin. They are filled with cheese-like matter and usually are painless. Sebaceous cysts form out of your sebaceous gland. The sebaceous gland produces the oil (called sebum) that coats your hair and skin.

Sebaceous cysts are mostly found on the face, neck, or torso. They grow slowly and aren’t life-threatening, they are typically not painful. Sebaceous cysts are normally only painful if they become inflamed or infected. Infections sometimes occur because the cyst has burst. If a cyst has burst or there is an infection under the skin and may need to lance and drain it. A course of antibiotics may also be needed. Sebaceous cysts can be removed by conventional wide excision but can leave a long scar, or they can be removed by minimal excision or laser with punch biopsy.

Moles

Moles are growths on the skin that usually are flesh-colored, brown or black. Moles can appear anywhere on the skin, alone or in groups. Moles occur when cells in the skin grow in a cluster instead of being spread throughout the skin.

Moles can be hereditary, or they can develop due to a reaction to strong UV light, during the teen years and during pregnancy. Whatever the cause, it’s a good idea to know the difference between a stable mole and an unstable one – i.e. one that has the potential to become malignant. If a mole exhibits potentially cancerous changes, surgical excision or a biopsy may be performed.

A surgical excision is typically utilized when moles are large and have cells that have grown beneath the top layer of skin. With this method, the mole is cut out with a scalpel, along with a small amount of skin surrounding the area (0.2-0.5cm). Cutting out these moles usually requires a few stitches, resulting in a small scar that fades over time. Any differences in a mole’s color, size, or shape could be a warning sign of skin cancer. If the mole looks suspicious, or is worried it could be a form of skin cancer, they will remove it and send it to pathology to have it examined. Surgical excisions are especially vital in diagnosing aggressive types of skin cancers.

Skin Cancer

A skin cancer is a tumour in which there is uncontrolled proliferation of any of the skin cells, whereas the normal process of regeneration of skin involves replication of the cells in a controlled fashion. These are the risk factors of skin cancer：

A lighter natural skin color, blue or green eyes.
Family history of skin cancer.
Exposure to the sun through work and play.
A history of sunburns, especially early in life.
Skin that burns, freckles, reddens easily, or becomes painful in the sun.
Blue or green eyes.
Certain types and a large number of moles and freckles.

Skin cancers generally appear as a lump or nodule, an ulcer, or a bleeding and changing lesion. It can usually be treated and cured before complications occur. Skin cancers are generally diagnosed clinically by a dermatologist, the lesion will be inspected carefully, and a full skin examination will also be conducted. Dermatoscopy (a special magnifying light) may be used to confirm the diagnosis, to detect early skin cancers, and to exclude benign lesions. A skin biopsy may be taken in cases of suspected skin cancer to confirm the diagnosis.

The most common forms of skin cancer are：

Basal cell carcinoma (BCC)
Squamous cell carcinoma (SCC)
Melanoma

Care of Skin After Surgery

In most cases, skin surgery can be undertaken in out-patient operation room. Stitches are special threads that are sewn through the skin at the surgical site to bring the edges of a wound together. Optimal management of post-operative wounds is important to prevent potential complications. Care for your stitches and wound as follows：

Skin surgery is usually done under local anaesthetic and full skin sensation should be return one to two hours after surgery. Pain at the wound site is a normal occurrence and in general, it is minor and slowly improve each day after surgery.

We recommend applying a sterile dressing gel on open wounds 1 to 2 times daily, to create an optimal environment for faster wound healing and prevention of abnormal scarring.

Examine the wound closely, keep the site clean and dry to protect the wound from germs and reduce the risk of infection. On the second day after surgery the wound can be cleaned with antiseptic solution and using of low level laser therapy for wound healing. If there was a bandage over the stitches, replace it with a new clean bandage everyday two days or change it sooner if it becomes wet or soaked with blood or other fluids.

Keep the area dry for the first 48 hours after stitches have been placed. After 3 days, remove the bandage and allow the wound to be exposed to the open air.

Don’t put soap or any other bath products directly onto your wound while it’s still healing. After you shower, gently pat the area dry with a clean towel.

Avoid rubbing the stitches directly and avoid putting tension on the area. If your wound is on your leg, it is important to keep your wound elevated by placing a pillow or two under it while you lie down, to improve circulation and reducing swelling.

We will tell you when to come back to get the stitches removed, usually within 7-14 days. The patient will be given instruction regarding care of the wound, removal of sutures, and follow-up.

One or more layers of stitches are applied to hold the edges of the wound together, to reduce wound tension and prevent wound breakdown. Sutures can be either absorbable or nonabsorbable. Absorbable sutures are intended to be broken down by the body over time and eventually dissolve completely. It’s not unusual for a dissolvable stitch to poke out from under the skin before it has completely dissolved. Please ask our doctors to remove it for you if this happens.