The role of surgery in dermatology

Author: A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, February 2016.

What is dermatologic surgery?

Dermatologic surgery is the treatment of medically necessary and cosmetic skin, nail, and hair conditions by various surgical methods. It is also called dermatological surgery.

Dermatologists are all trained in basic dermatologic surgery. Some dermatologists undergo additional training in advanced dermatologic surgery procedures. Non-dermatologists that may also perform skin surgery include plastic and reconstructive surgeons, otolaryngologists, ophthalmic surgeons, general surgeons and general practitioners.

What is dermatologic surgery used for?

Surgery is essential for removal of skin cancers and suspected skin cancers, including:

Mohs micrographic surgery is used to remove mid-facial skin cancers, especially if their margins are unclear or they are recurrent lesions.

Surgery is also used to remove benign growths that are causing a nuisance or are unsightly, such as large moles and seborrhoeic keratoses.

Cosmetic surgical procedures include:

Dermatologic surgeons also employ non-surgical cosmetic techniques, such as:

How is skin surgery carried out?

In most cases, dermatologic surgery can be undertaken using local anaesthetic in a side room at the doctor’s office.

The most common procedure is a simple ellipse excision of a skin tumour, described here.

Sometimes an additional procedure is necessary to close the wound, such as a skin flap (skin taken from an adjacent area and moved to fill the surgical defect) or skin graft (skin taken from a distant area and placed on the surgical defect).

What are the possible complications of skin surgery?

Immediate complications include:

Delayed complications may include:

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