Definition and Overview

Dermatology surgery focuses on the surgical treatment of various cosmetic conditions affecting the skin, hair, nails, and veins. These may include skin growths, skin imperfections, hair loss, or malignancy. Nowadays, there are many types of surgical procedures used for this purpose, with some making use of advanced technology to improve results and reduce side effects as well as complications.

Who Should Undergo and Expected Results

Dermatology surgery can benefit people with:

  • Wrinkled and sagging skin
  • Benign and malignant skin growths
  • Damaged skin
  • Disorders involving the vein, such as spider veins
  • Disorders affecting the skin, such as psoriasis and rosacea
  • Other cosmetic problems, such as acne and skin tags

The goal of dermatologic surgery is to either improve aesthetic appearance or treat a disease or disorder. With surgery, patients can expect skin cancers and growths to be removed and their skin disorders (and related symptoms) to be resolved.

How the Procedure Works

Various dermatology surgeries are carried out differently depending on the technology used, the goal of the treatment, and the specific condition that the patient is suffering from.

  • Laser - Dermatologic procedures using laser technology are some of the most popular treatments in use today. Continuous improvements in the field of laser technology promise better patient outcomes. The best thing about laser surgery, however, is its non-ablative or non-wounding nature because the laser light penetrates the skin’s inner layers and target the veins and hair follicles without requiring any incision. There is now a long list of dermatologic procedures that make use of laser energy, which are used in different wavelength peaks and durations of exposure to obtain the desired results. Some treatments require high-energy laser beams applied in short pulses, while some use constant and prolonged application laser energy at moderate levels. Most of these procedures can now be performed on an outpatient basis at the doctor’s office or specialty dermatologic clinics, eliminating the need for prolonged hospital stay. Of all available techniques in dermatology surgery, laser is the most versatile, and is now being used for skin and vascular lesions treatment, psoriasis plaques removal, tattoo removal, hair removal, skin imperfections and scars removal, warts removal, and skin growth vaporization, among others. Although some laser-based treatments cost more than other available options, their reduced risks and shorter recovery downtimes make them worth the price.

  • Traditional surgery - Traditional scalpel surgery is still used to treat dermatologic diseases and disorders. It is most commonly used for the removal of benign and malignant skin growths and cancers, moles, cysts, birthmarks, melanomas, and lipomas. While laser surgery and electrosurgery can also be used, conventional surgery is generally less expensive, and is sometimes more feasible and efficient, such as in the treatment of surface lesions, which are simply shaved or snipped off using a scalpel or surgical scissors.

  • Electrosurgery - Electrosurgery refers to the use of electrical energy to treat dermatologic disorders and diseases, either by dehydrating, coagulating, or vaporizing them. These procedures work by applying high-frequency electric currents to the affected tissue, which results in thermal tissue damage. Another type of electrical surgery is electrocautery, which is performed by applying a heating element directly on the affected tissue. These procedures are most useful for the removal of skin tags and the treatment of basal cell carcinoma and other benign and malignant skin growths.

  • Cryosurgery - Cryosurgery refers to the application of extreme cold, using liquid nitrogen at up to -346 degrees Fahrenheit, on any abnormal tissue growth on the skin to instantly freeze it. Doing so instantly kills or destroys the cancerous cells. This type of dermatology surgery is best used for removing warts and tumors that are outside the body.

  • Photodynamic therapy - Photodynamic therapy is a procedure that combines light energy and the use of photosensitizing drug. Photosensitizers are highly effective in removing cancerous growths because they are designed to stay longer in cancerous cells. While they can leave normal cells untouched within the first 72 hours after application, they remain in cancerous cells longer. When the photosensitizer is activated by light energy at the correct wavelength, it produces a type of oxygen capable of destroying abnormal cells. Photosensitizers alone can shrink tumors by damaging the blood vessels leading to the tumors, restricting the flow of blood, depriving them of nutrients.

  • Liposuction - Liposuction is a specific type of dermatology surgery used for fat removal purposes. Mostly used for cosmetic purposes, this procedure sucks unwanted fat deposits from various parts of the body. It is most commonly performed on the thighs, hips, buttocks, abdomen, and the arms. The procedure can be performed in conjunction with other cosmetic or plastic surgery procedures, such as breast augmentation, facelift, tummy tuck, and many others.

  • Blepharoplasty or cosmetic eyelid surgery - Performed alone or combined with traditional facelift, blepharoplasty is a cosmetic dermatologic procedure intended to improve the appearance of the eyelid area. Its goal is to give the eyelids a lift either by removing eye bags, smoothing out wrinkled and sagging skin, firming up drooping eyelids, and removing excess skin and fat deposits around the eyes.

  • S-lift or minimally invasive facelift surgery - S-lift is the minimally invasive version of the traditional facelift. Due to its less invasive nature, it is now more widely used to give facial skin a subtle lift to rejuvenate a person’s appearance. Its name is derived from the S-shaped incisions that the surgeon makes in performing the surgery. Less expensive, less invasive, and less painful, an S-lift is the most beneficial option for patients who wish to tighten and lift facial skin, remove jowls and sagging jawline skin, and those who heal slowly, such as diabetics.

  • Fat transfers - Going by alternative names such as fat grafting or fat injection, fat transfer surgeries are procedures wherein fat from certain parts of the body is removed and transferred to body parts that lack volume. It can rejuvenate the entire appearance by resolving creasing and the hollow, sunken appearance caused by the aging process.

  • Mohs micrographic surgery - Mohs micrographic surgery is a specialized technique used to ensure complete excision of skin cancers. The surgery is especially effective because it is guided by a complete microscopic image of all the tissues in the affected area, allowing the surgeon to selectively remove only malignant cancer cells while protecting the normal, healthy tissues; this makes Mohs the top choice for cancers on the face and other sensitive areas of the body. This highly advanced technique even allows surgeons access to even the smallest cancerous root cells and boasts of a high rate of success even with cases where other techniques have failed. Mohs surgeries can only be performed by surgeons who have received an additional year of specialty training in Mohs surgery on top of their existing dermatology credentials.

Possible Risks and Complications

Surgeries performed for dermatological reasons have been linked to some risks and complications, including:

  • Bleeding
  • Allergic response to medications or anesthetics used during the procedure
  • Bacterial infection of the wound
  • Incomplete excision of skin growths and tumors
  • Delayed wound healing
  • Persistent inflammation

Bleeding complications have a higher rate of occurrence in surgeries involving the forehead, scalp, and eyelids, and when certain medications are involved such as warfarin, aspirin, and heparin.

The following symptoms, however, may be expected as a normal but passing effect of the procedure, as long as they occur moderately:

  • Bruising
  • Swelling
  • Discomfort

In addition, there is also a risk that the surgery will not yield the results the patient desired or expected, especially with cosmetic procedures.

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