Surgical Treatments

At Carolinas Skin Center, we believe the best way to alleviate concerns that may accompany a surgical procedure is to ensure patient understanding and allow for complete trust in the skill of the surgeon. Effective communication and expert care are our cornerstones.

How will my skin lesion be diagnosed and what can I expect?

Suspicious skin lesions will be examined thoroughly as well as nearby adjacent areas on the body. Typically, an above the waist or a full body skin examination will be performed to ensure that no other worrisome lesions are present. Special magnifying glasses and handheld optical devices such as dermoscopes are utilized for closer in-depth examinations.
Sometimes, skin lesion can be comfortably diagnosed as being benign but others may not be so obvious. In these instances a sampling or biopsy of the skin may be required to obtain a definitive diagnosis.
There are various types of biopsies that may be performed.

Shave Biopsy
Sampling of the outermost superficial or layers of the lesion is obtained with a sharp surgical blade.

Punch or Incisional Biopsy
A deeper, more full-thickness specimen of the skin is obtained while the bulk and majority of the lesion is left behind.

Excisional Biopsy
This technique attempts to remove the lesion completely and allows for a more thorough examination by the pathologist. This information will help determine if additional treatment or surgical intervention is required. The skin defect that remains will most likely require suturing and surgical wound closure.

What happens after a diagnosis is made?

After obtaining a diagnosis and deciding that skin surgery is indicated the surgical reconstructive options are reviewed. Sometimes the repair is done immediately while other times it is temporarily delayed.

Primary Repair
Soft tissue defects can sometimes be repaired primarily by suturing the skin edges together in such a way as to minimize scarring. This may include undermining of the tissue or layered closure technique.

Skin Graft
This technique harvests or shares skin from one area of the body to close over another. The site that the skin was removed is allowed to heal over by itself.

Flap Reconstruction
Removal of skin lesions that leave substantial defects may necessitate a flap reconstruction or closure. This type of closure rearranges and reconfigures or borrows adjacent skin to cover over the soft tissue defect. Design of these flaps requires creativity and artistry. This is where the creativity of Dr. Nowicky shines through and the subtleties and expertise of plastic surgery are optimized.

Typically, these reconstructions are performed conveniently and safely within the office and procedure rooms at Carolinas Skin Center. Our dedicated team of professionals and staff provide for expert and compassionate care.

Will there be a scar?

The human body has an incredible ability to heal itself. The goal is to leave patients happy and pleased with the final appearance of their surgical site. With the passage of time most scars fade and settle quite nicely. But sometimes abnormal healing events such as excessive widening or thickening of the scar such as hypertrophic or keloid formation may occur. Scar revisions or steroid injections may be required. The risks and benefits of any type of skin surgery need to be weighed. For the most part, there is no such thing as an “invisible scar” so the goal becomes one that is well camouflaged and barely noticeable.

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