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Surgical Dermatology

At Pacific Dermatology Institute we are experts in surgical dermatology care.

Surgical Dermatology

Dermatologic surgery deals with the diagnosis and treatment of medically necessary and cosmetic conditions of the skin, hair, nails and veins.

The majority of dermatologic surgeries are now minimally invasive and require only local or regional anesthesia. We are able to provide superior patient safety while reducing the all-important “downtime” and recovery period.

 Skin Cancer

Each year in America almost a million new cases of skin cancer are diagnosed. The most common types of skin cancer are Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC) and Melanoma. Pacific Dermatology Institute provides a wealth of treatment options in order to combat all forms of skin cancer. While each skin cancer is inherently unique, you can rest assured our team of expert providers will take the time to discuss what options best suit you, your skin cancer and specific needs.

Various treatment options include: Mohs Micrographic Surgery (95%+ cure rate), C & D, Wide excision and topical chemo-therapeutic agents.

Our dedication to skin cancer in the communities we serve is simply unparalleled.

Cysts

A cysts is a sac-like growth under the skin which can come from hair, oil gland, sweat gland, or even deeper structures. A cyst is usually filled with fluid, watery or oily, or paste-like material, which can leak to the surface and exude a foul odor. A cyst is not dangerous and it is not cancerous with rare exceptions. Many people have cysts all their life with no harm. Occasionally a cyst can burst and the content leaks into the skin. That will cause a painful boil to form which will need to be drained by a dermatologist or surgeon.

Cryotherapy

Cryo Therapy (LN2) Common procedure performed in office for the removal of pre-cancers, warts and other skin lesions.

Mohs Micrographic surgery

What is MOH’s?

Mohs Micrographic surgery is a technique designed specifically to treat and remove the two most common skin cancers, basal and squamous cell carcinoma. The procedure originated from Dr. Frederic Mohs himself and became the preferred method of treatment with a cure rate of over 98% for new lesions and 95% for recurrent. Mohs is commonly done as an in office procedure under local anesthesia and allows patients to return home the same day. 

When is it Performed?

After a lesion has been biopsied, proven to be malignant and the treating physician or physician assistant recommends Mohs as the best course of action for your condition. Malignant Lesions must meet all Medicare local coverage determinations in order for a patient to have mohs, unless they’re paying cash and have no insurance coverage.

How to schedule and prepare for Mohs?

  • Treating physician or medical assistant will go over pre-op instructions during follow-up visit or by phone once biopsy results have been received.
  • Identify a surgery date that works for you. (Mohs is generally done once or twice a month at each location)
  • Medical assistant or front desk receptionist will request prior authorization from insurance company or medical group.
  • Patient Co-pay, deductibles or co-insurance will be collected before surgical visit. If you do not have the money immediately you will be asked to pay a portion of the amount owed and establish a payment plan with our outside billing company.
  • The procedure can take any where from 2-4 hours and we ask that patients only bring one person with them to their visit because our waiting room space is limited. Patients are encouraged to bring reading material or IPADs to help pass the time.

What to expect on the day of Surgery?

On the day of the procedure you should expect nothing less then the best. You will be greeted at the front desk and asked to sign in and be seated with other patients having the same procedure. We normally complete all the procedures on the same day because we have to have the surgeon, pathologist and Mohs technician on site to complete each surgery. Patients will be brought back according to scheduled surgery times to start the initial treatment process.

Brief overview of how the procedure will be performed.

The medical assistant or surgeon will bring you back into a treatment room, discuss the risks and benefits of each procedure and have you sign a consent stating you understand the procedure and elect to have PDI complete it. After the consent is done the surgeon will go over the pathology results from the biopsy, locate the lesion and draw a circle around it to identify where the initial incision will be made. After the lesion is marked it will be locally anesthetized and you will be asked to wait a few minutes in the exam room until the medication takes full effect and the area is completely numb. After the surgeon has numbed the area he will begin to slowly and precisely remove the cancerous lesion. He will try to remove only what is necessary so he can preserve the most amount of healthy skin and minimize any scarring you may have. After the tissue has been removed the surgeon or medical assistant will transport the tissue to the histopath technician who will then prepare a frozen block of the tissue and prepare a slide for interpretation from the pathologist. The pathologist will review the slide and if he determines there is additional malignancy that needs to be removed the previous steps of the surgeon removing more tissue from the area will be repeated until the your skin is clear of any malignancy. During slide preparation and interpretation it is common for the area to be bandaged and the patient to wait in the comfort of our waiting room. After the lesion has been cleared of malignancy the Plastic Surgeon will determine the best method or technique to close each particular lesion. Please note not all wounds are closed and the area sometimes needs to be left open to granulate and heal on its own.

Post-procedure.

Please refer to post op instructions given at appointment. Your follow-up appointment will be made before you leave the office if one is needed. Try to avoid any strenuous activity that can cause the wound to reopen. If you experience any bleeding that cannot be stopped by applying firm pressure to the area please call our office or go to the nearest immediate or urgent care facility.

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Surgical Dermatology
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