Fellows of the Australasian College of Dermatologists have all been trained in skin cancer surgery and where appropriate can employ plastic surgical repair techniques to minimise the cosmetic impact resulting from surgery.
This is the removal of a sample of your skin to confirm or exclude a diagnosis of skin cancer or to accurately diagnose a skin disorder. The biopsy technique chosen is determined by the type of sample your dermatologist feels will provide the best information for pathological examination. Techniques include – punch biopsy, shave biopsy or incisional biopsy. In general, taking a biopsy will necessitate the infiltration of the sample area with a local anaesthetic to minimise discomfort and bleeding at the biopsy site. Depending on the technique chosen a suture may be necessary to close the wound and minimise the risk of post procedure bleeding.
This is the most used technique to remove both benign skin tumours such as cysts and moles as well as for skin cancers including basal cell carcinomas, squamous cell carcinomas and malignant melanoma. The suspect lesion is cut out with a margin of normal tissue to ensure adequate clearance, the resulting wound is closed in layers, usually with dissolvable deep sutures and surface nylon sutures that need removal between 7 to 14 days following the procedure. The area removed is elliptical in shape to minimise puckering at the 2 ends of the scar.
Serial curettage and cautery
This is a tried and trusted technique to remove low-grade skin cancers and some benign lesions. The spot to be removed is anaesthetised, an instrument called a curette is used to scoop or scrape the tissue away. The tissue can be sent for pathological analysis. The wound is then cauterised to stop bleeding before the process of curettage is repeated between 2 and 3 times to ensure that all the abnormal tissue is removed. The residual wound is left to heal like a deep graze. You will be provided with instructions in how to look after the wound.
Skin flap surgery
Flap surgery are surgical techniques utilizing adjacent normal skin to close wound defects resulting from surgery (most commonly on the face, occasionally on other areas of the body where there is insufficient laxity of the skin), where simple closure would provide a less functional or cosmetic outcome. Dermatologists are trained in these techniques and can perform them or refer to a plastic surgical colleague for further treatment.
These are employed where the surgical defect is too extensive for local flap(s) to cover the wound. Grafts may be full thickness or partial (split) thickness depending on the size and location of the wound. The donor site of the skin graft is not near the surgical wound so in essence the surgery requires the creation of a second wound or defect that will also require aftercare.
Mohs micrographic surgery
This is a specialised technique which some dermatologists have undergone additional training to perform. Its indication is primarily for recurrent skin cancers on the head and neck, especially in high-risk areas near the eyes, nose and ears. Your dermatologist can discuss this surgical option with you and refer if appropriate.
Dermatologists providing consultative and procedural services at Eastern Suburbs Dermatology are all Fellows of the Australasian College of Dermatologists.
Practising individual dermatologists at Eastern Suburbs Dermatology have sub-specialisation interests in paediatric dermatology, surgical dermatology, and women’s and cosmetic dermatology.