Surgical Dermatology

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Questions & Answers

How long will the surgery take?
Most excisions take between 15 and 30 minutes, and we ask that you arrive 10 minutes prior to your scheduled appointment time.

Will it hurt?
No. You will be given a local anesthesia to ensure that you are comfortable during the procedure.

Do I have to limit my activity after the procedure?
Yes. You will need to limit your activity level and take care to not strain the incision site. You will want to avoid swimming, hot tubs, and physical activities such as tennis, golf or biking which may place tension the surgery site and cause it to open. Once the sutures are removed, typically within 7-10 days you may resume your regular activities.

Keith Llewellyn MD, and Sean Fisher PA-C perform numerous cutaneous surgical procedures in both our Santa Barbara and Santa Ynez offices. All surgical procedures are performed in a comfortable out-patient setting.
If you have been diagnosed with skin cancer, have a mole, cyst or other unwanted skin growth, and need or want to have it removed call today to schedule your appointment.

How It Helps

Numerous surgical procedures are performed on a daily basis by both Keith Llewellyn MD and Sean Fisher PA-C to remove premalignant, malignant and unwanted growths. Below is a sampling of some of those procedures.

What to Expect

PreCancers (actinic keratosis): While treatment recommendations may vary, these lesions are usually frozen off with liquid nitrogen at the time of your visit. It takes only seconds to freeze a lesion. Afterwards the treated area tends to turn red and swell up similar to a bug bite. Sometimes a blister may form. The area eventually turns dark, scabs and peels off. The healing process takes around 7 days if performed on the face, other areas of the body can take between 10-14 days to fully heal.

Warts: While treatment recommendations vary, these lesions are usually frozen off with liquid nitrogen at the time of your visit. It takes only seconds to freeze a lesion. Afterwards the treated area tends to turn red and swell up similar to a bug bite. Sometimes a blister may form. The area eventually turns dark, scabs and peels off. The healing process takes around 7 days if performed on the face, other areas of the body can take between 10-14 days to fully heal.

Biopsies: If a concerning lesion, atypical mole or skin cancer is found during your visit, a skin biopsy will be recommended to sample the lesion and confirm a diagnosis. The procedure takes only a few minutes. The area is anesthetized with a local injection of lidocaine and then a portion of the lesion is shaved off, the tissue is then sent to a lab for evaluation. Patients are notified of results within 10 days via a phone call or our secure Patient Portal.

Excisions: Excisions are frequently performed to remove biopsy proven skin cancers and atypical moles. They are also performed to remove unwanted benign growths like lypomas and cysts. The time required to perform an excision varies depending on the lesion size and site, but typically takes between 10-30 minutes to perform. The area is anesthetized with a local injection of lidocaine. Most lesions are removed using an elliptical incision and then closed with stitches in a straight line. The tissue is then sent to a lab for evaluation. Patients are notified of results within 10 days via a phone call or our secure Patient Portal. Stitches are typically removed 7-10 days after the excision.

EDandC (Electrodessication and Curretage): This procedure may be used to treat some superficial basal cell carcinomas and, more rarely, squamous cell carcinoma in situ. The procedure only takes a few minutes. The area is anesthetized with a local injection of lidocaine and then the cancer is scraped off with a small round curette, the base is then cauterized and the scraping is repeated 2 more times. The area then heals like a scrape over the next 7-21 days. The cure rate for this procedure is somewhat lower than the cure rate obtained by excision and the area may take longer to heal than an excision. EDandC, however, is less invasive than an excision, takes less time to perform and is not as expensive. No sutures are used and, hence, there are typically not restrictions to your activities post procedure.

Mohs Surgery: Please refer to the Mohs Dermasurgery dedicated page for information regarding this procedure.

 

 

How to Prepare

Make sure to check your social and athletic calendar before scheduling any surgical appointment. All procedures have a healing period in which you may not look your best and procedures involving stitches will require a reduced activity to avoid tension on the surgical site for several weeks.

You will need to arrive 15 minutes prior to your scheduled surgery time. This will allow you time to have any questions you may have addressed, to review and sign the consent form and have the surgical area prepped. Ideally, your surgery will start at your scheduled appointment time.

 

Post-Care Instructions

If you had a procedure which required stitches, please keep our bandage on and dry until the following day. You may shower after 24 hours, but you may not submerge the stitches in water (no baths, hot tubs, pools, lakes or ocean). After the initial 24 hours, you may remove the bandage and let soap and water run across the area. Pat dry and then reapply an ointment (Neosporin, Polysporin, or aquaphor) and cover with a band-aid. You can repeat this process twice a day until the stitches are removed.

Take it easy and do not perform activities that put a lot of tension on the surgical wound. If you have questions about a particular activity please contact our office.

If you experience any discomfort, you may take Tylenol (avoid ibuprofen, Motrin and Aleve as they may increase the risk of bleeding) or use ice packs. If you take a narcotic pain reliever do not drive.