Surgical Dermatology in Danville, CA
Skin Surgery in Danville, CA
Surgical dermatology uses office-based procedures to diagnose or remove skin lesions, repair certain skin injuries and improve selected scars. Depending on the problem, care may include biopsy, standard excision, mole removal, scar revision, earlobe repair, laceration repair or skin-tag removal. The first step is an accurate diagnosis, especially when a growth could be skin cancer, followed by the least extensive procedure that safely addresses the medical or cosmetic goal.
This is the part of dermatology that involves procedures: taking a sample or removing a growth, repairing certain injuries to the skin, and improving certain scars. Depending on the problem it can mean a biopsy, cutting something out, removing a mole, improving a scar, repairing an earlobe, closing a cut, or removing a skin tag. The first step is always a proper diagnosis, especially where a growth could be a skin cancer. Then the smallest procedure that safely does the job.
Surgical Dermatology: the essentials
The short version
Office-based diagnosis and surgical treatment of selected skin lesions, scars and injuries.
Diagnosing and surgically treating selected growths, scars and injuries, here in the office.
Biopsy, standard excision, mole removal, scar revision, earlobe repair, laceration repair and skin-tag removal.
Taking a sample, cutting something out, mole removal, improving a scar, earlobe repair, closing a cut, and skin tag removal.
Many dermatologic procedures are performed with local anesthesia while the patient remains awake.
Most of these are done with the area numbed, while you stay awake.
Suspicious or medically indicated tissue may be sent for microscopic examination.
Anything suspicious, or anything where the diagnosis matters, is sent to a laboratory.
Varies from a few days of wound care to several weeks of activity or scar maturation depending on procedure and site.
Anything from a few days of wound care to several weeks of restrictions while the scar settles, depending on the procedure and where it is.
Mohs surgery, complex reconstruction, melanoma staging or oncology care may require another specialist.
Mohs surgery, complex reconstruction, melanoma staging, or cancer care may need a different specialist.
What is surgical dermatology?
What is skin surgery?
Surgical dermatology is the procedural side of dermatologic care. It ranges from diagnostic biopsies and small lesion removals to planned excisions and repairs, usually with careful attention to diagnosis, tissue preservation, wound closure and scar placement.
It is the procedural side of skin care. It ranges from taking a small sample for testing, and removing small growths, through to planned removals and repairs. Throughout, the attention is on getting the diagnosis right, keeping as much healthy tissue as possible, closing the wound well, and putting the scar where it will show least.
- A procedure may be medically necessary, cosmetic, or both.
- The diagnosis determines whether tissue should be destroyed, shaved, excised or sent to pathology.
- Technique differs by body location, skin tension, lesion size and the patient’s tendency to scar.
- A procedure may be medically necessary, cosmetic, or both.
- The diagnosis decides whether something should be destroyed, shaved off, cut out, or sent for testing.
- The technique changes with the part of the body, how tight the skin is there, the size, and how you tend to scar.
Which surgical dermatology services may be included?
What procedures are there?
Each of the main procedures has its own page. This hub keeps the overlapping ones connected.
Each of the main ones has its own page, and this page keeps the overlapping ones connected.
| Mole removal | Bothersome, cosmetically unwanted or suspicious mole | Mole Removal |
|---|---|---|
| Excisions | Complete removal of selected benign, atypical or malignant lesions | Excisions |
| Scar revision | Improve scar contour, symptoms, function or appearance | Scar Revision |
| Earlobe repair | Repair stretched, split or torn earlobe | Earlobe Repair |
| Laceration repair | Clean and close selected acute cuts | Laceration Repair |
| Skin tag removal | Remove symptomatic or unwanted skin tags after diagnosis | Skin Tag Removal |
Mole removal For a mole that is bothering you, that you do not like, or that looks suspicious.
Cutting something out Complete removal of certain harmless, unusual or cancerous growths.
Improving a scar Changing its shape, its symptoms, how it works, or how it looks.
Earlobe repair For a stretched, split or torn earlobe.
Closing a cut Cleaning and closing certain fresh wounds.
Skin tag removal Removing tags that are catching, or that you do not want, once we know what they are.
Diagram showing examination, biopsy or excision, pathology and follow-up
A diagram of the process: examining, taking a sample or removing, testing, and following up.
What happens before a skin procedure?
What happens before a procedure?
The dermatologist confirms what is being treated, reviews medications and medical history, discusses the expected scar and decides whether biopsy or pathology is needed. The safest plan may be different from the procedure a patient originally expected.
The doctor confirms exactly what is being treated, goes through your medicines and your medical history, talks about the scar you can expect, and decides whether a sample needs testing. The safest plan is sometimes not the procedure you came in expecting.
- Tell the office about blood thinners, bleeding disorders, allergies, implanted devices and prior problems with local anesthetic.
- Mention any history of keloids or thick scars.
- Do not stop prescription blood thinners unless the prescribing clinician and procedural dermatologist specifically advise it.
- If cancer is possible, cosmetic destruction should generally not replace a diagnostic plan.
- Tell the office about blood thinners, any bleeding disorder, allergies, implanted devices, and any past problem with local anaesthetic.
- Mention any history of keloids or thick scars.
- Never stop a prescribed blood thinner unless both the doctor who prescribed it and the doctor doing the procedure tell you to.
- If cancer is possible, destroying something for cosmetic reasons should not replace finding out what it is.
Illustration of local anesthesia for an office skin procedure
An illustration of the area being numbed for a skin procedure.
What happens on the day of an office procedure?
What happens on the day?
Many dermatologic surgeries use local anesthetic. The area is cleaned and numbed, the procedure is performed, bleeding is controlled, and the wound is closed with stitches or allowed to heal naturally depending on the site and treatment.
Most of these use a local anaesthetic. The area is cleaned and numbed, the procedure is done, any bleeding is stopped, and the wound is either stitched or left to heal on its own, depending on the site and the treatment.
- You remain awake for most local-anesthetic procedures.
- A pressure dressing or simple bandage may be applied.
- If tissue is sent to pathology, results are reviewed before final follow-up decisions.
- You stay awake for almost all of these.
- You may go home with a pressure dressing or a simple plaster.
- If anything is sent for testing, we go through the results with you before deciding anything final.
How long does recovery take?
How long does recovery take?
Recovery depends more on the size, depth and location of the procedure than on the word “minor.” Most patients need wound care, temporary activity restrictions and follow-up if stitches are placed or pathology is pending.
It depends far more on how big and how deep the procedure was, and where it is, than on the word minor. Most people need to look after the wound, avoid certain activities for a while, and come back if there are stitches or a result to discuss.
| Pain | Usually manageable with the plan provided by the clinician | Pain that is rapidly worsening or not controlled |
|---|---|---|
| Bleeding | Small spotting can occur early | Bleeding that does not stop with firm pressure as instructed |
| Swelling/bruising | Varies by location and procedure | Rapidly increasing swelling or other concerning symptoms |
| Wound appearance | Mild redness/tenderness can be normal early | Spreading redness, pus, fever or increasing warmth |
| Scar | Every cut through the dermis creates a scar; it typically changes for months | Scar that becomes markedly raised, painful or restricts movement |
Pain Usually manageable with what you are given. Ring us if it is getting rapidly worse, or not controlled.
Bleeding A little early on is normal. Ring us if firm pressure, as instructed, does not stop it.
Swelling and bruising Varies with the site and the procedure. Ring us if the swelling is increasing quickly.
How the wound looks Mild redness and tenderness early on is normal. Ring us for spreading redness, pus, a fever, or increasing warmth.
The scar Any cut through the deeper skin leaves one, and it keeps changing for months. Come back if it becomes markedly raised, painful, or starts restricting movement.
Visual overview of mole removal, scar revision, excision, earlobe repair, laceration repair and skin-tag removal
A visual overview of mole removal, scar revision, excisions, earlobe repair, closing a cut, and skin tag removal.
When is a different specialist needed?
When would I need a different specialist?
Some conditions should be referred rather than forced into a routine office-excision pathway. Mohs surgery, complex reconstruction, sentinel lymph-node biopsy, advanced cancer care or procedures requiring deeper anesthesia may need another specialist or facility.
Some things should be referred on rather than squeezed into a routine office procedure. Mohs surgery, complex reconstruction, testing a lymph gland, advanced cancer care, or anything needing deeper anaesthesia, may need a different specialist or a different setting.
- Referral is not a failure of care; it is part of choosing the safest setting and expertise.
- Some procedures may require referral or a different surgical setting depending on the diagnosis, complexity and safety needs.
- Being referred is not a failure. It is part of choosing the safest place and the right expertise.
- Whether something can be done here depends on the diagnosis, the complexity, and what is safest for you.
Everything under Surgical Dermatology
Everything in this section
Questions patients ask
Are dermatology surgeries done under general anesthesia?
Will I be put to sleep?
Many office-based dermatologic procedures use local anesthesia while the patient remains awake. More complex procedures may require another setting.
Almost never. Most of these are done with the area numbed while you stay awake. More complex procedures may need a different setting.
Will every removed growth be sent to pathology?
Does everything removed get tested?
Not necessarily. Pathology decisions depend on the diagnosis, procedure and medical need. Suspicious or diagnostically important tissue should be managed according to the clinician’s judgment.
Not necessarily. It depends on the diagnosis, the procedure and whether it matters medically. Anything suspicious, or anything where the answer matters, is handled accordingly.
Will I have a scar?
Will I have a scar?
Any procedure that cuts into the deeper skin can leave a scar. Technique, location, genetics, wound care and tension all affect how visible it becomes.
Any procedure that cuts into the deeper skin can leave one. How visible it ends up depends on the technique, where it is, your genes, the wound care, and how much the skin there is pulled.
Can I exercise after skin surgery?
Can I exercise afterwards?
Activity restrictions depend on the wound location and closure. Strenuous exercise can increase bleeding or pull on stitches, so follow the specific instructions provided.
It depends where the wound is and how it was closed. Hard exercise can make it bleed, or pull on the stitches, so follow the instructions you are given.
What if the pathology shows skin cancer?
What if the test shows a cancer?
The next step depends on the cancer type, margins, location and risk features. Additional excision, Mohs surgery, melanoma-specific surgery or specialist referral may be recommended.
What happens next depends on the type, whether the edges were clear, where it is, and how risky it is. It may mean a wider removal, Mohs surgery, melanoma surgery, or a referral to a specialist.
Can I request a cosmetic removal without an examination?
Can I just ask for something to be removed?
An examination is important first because some lesions that look cosmetic can mimic skin cancer or require a different removal method.
It needs examining first. Some things that look purely cosmetic can turn out to be a skin cancer, or need removing a different way.
If this is a medical emergency, call 911. For an urgent skin problem during office hours, call the practice on (925) 820-3376 rather than using a form, messages are not monitored continuously.
Talk it through with a physician first.
Every plan starts with an assessment of your skin, your anatomy and what you actually want to change.
This page is general health information, not medical advice. It cannot tell you whether a treatment is right for you. Approved uses, risks and results differ from person to person, and product labelling changes. Ask us at Dermatology and Laser Centre about your own situation, or make an appointment, and seek urgent care for any serious symptom.
