Surgical Services

Fair Winds Dermatology offers a comprehensive range of surgical services to address various skin conditions with precision and care. Our skilled dermatologic surgeon is double board certified in both Dermatology and Micrographic Surgery and Dermatologic Oncology (also known as Mohs.) We specialize in procedures such as mole removal, skin cancer surgery, cyst removal, and other minor skin surgeries. All procedures are performed under local anesthesia (with the patient awake.) We prioritize patient safety, comfort, and optimal outcomes, ensuring you receive the highest standard of care throughout your treatment. Fair Winds Dermatology prides itself on making any surgical process as relaxing, painless, and uneventful as possible.

What We DO?

Skin Biopsy

A skin biopsy is a procedure in which a sample of skin is removed, processed, and examined under a microscope. Several different methods may be used to obtain a skin sample, depending on the size and location of the abnormal spot of skin, called a skin lesion. The skin sample is placed in a solution, such as formaldehyde. At the lab the skin is processed and then examined under a microscope. All biopsies performed at Fair Winds Dermatology are analyzed by board certified dermatopathologists, who are doctors that specialize in the pathology of the skin.

Skin biopsies are done most often to diagnose skin cancer, but also to diagnose certain rashes. Skin cancers are the most common type of cancers. Early diagnosis of a suspicious skin lesion can help identify skin cancers leading to earlier treatment and better outcomes.

How Do You Prepare?

You will be provided written wound care instructions following the biopsy, which can also be found here will provide you with weblink to be inserted here. Before a skin biopsy, please tell your doctor if you:

Are allergic to any medicines
Are taking any blood-thinning medications, including over-the-counter medications like aspirin

Excision

Surgical excisions are performed to remove a wide variety of skin lesions ranging from benign growths such as moles, cysts and lipomas to skin cancers. A margin of normal appearing skin is removed around the lesion to ensure complete removal; narrow margins for benign growths and wider margins for skin cancers.

Typically an elliptical shape of skin is removed. The resulting wound is repaired by loosening the surrounding skin and then closed in straight line using layers of deep and superficial sutures. The incision line will be longer than you may expect, as the final length is usually three times as long as the diameter of the wound. Surgical Excision is performed under local anesthesia.

We suggest that you eat your normal breakfast. PLEASE TAKE ALL MORNING MEDICINES AS USUAL

What can I expect with the surgery?

Anxiety
We understand that having a surgical procedure can be an anxiety-provoking experience. Every effort is made to decrease stress throughout the process. If you experience high anxiety with procedures, please inform our staff, and we will work with you to generate a plan to suit your needs.

Pain
Most people will experience very little discomfort after surgery. Usually, acetaminophen (Tylenol) is sufficient to control the pain, and the dosing regimen is written out in our post operative instructions link. Our surgeon will discuss pain management during your visit particularly if greater post-operative pain is anticipated.

Bruising and Swelling
Bruising and swelling are common following surgery and usually last for several days. Procedures around the eye can result in significant eyelid swelling the following day that typically resolves two to three days after the procedure.

Infection
The infection rate at Fair Winds Dermatology is less than 1%, which is far less than the national average. Your surgeon will review your chart ahead of time and may recommend a pre- or post-operative antibiotic. It is normal to develop some redness along the suture line, but if it becomes more extensive or if you develop increasing pain, swelling, or drainage, please notify us immediately.

Bleeding
The risk of significant post-operative bleeding is low. Upon completion of the procedure a pressure bandage will be placed on the wound. Direct and firm pressure for 15 minutes is typically adequate to stop bleeding if it occurs. For any bleeding that is not controlled with pressure, we need to be notified immediately. All patients undergoing a surgical procedure will be provided an after-hours call number in case of persistent bleeding or other urgent post-operative concerns.

Numbness
At times, the area surrounding your operative site will be numb to the touch. This area of numbness may persist for several months or longer. In some instances, it may be permanent.

Scar
Although every effort will be made to offer the best possible cosmetic result, you will be left with a scar. The scar will often be longer than what you may anticipate, particularly with skin cancer removal, in order to allow for an adequate margin of healthy tissue. In some skin types, scars can stay red or darkened for six months or longer.

Activity and Follow-up
You should plan on decreased activity and restrict travel for 1 week, and in some cases longer. We will discuss this after the surgery depending on the case.

Activity and Follow-up

Avoid vigorous activities (exercise, hiking, yardwork, etc.) and lifting objects heavier than ten pounds for 48 hours after a surgical procedure.

Typically, the site can get shower-wet in 48 hours unless otherwise advised by your surgical team.

If you have stitches, avoid submerging the wound (e.g., bathtub, hot tub, pool, ocean, lake, or river) until the stiches come out.

Unique limitations will be discussed during your appointment if applicable.

Please tell your doctor if you

You will be provided written wound care instructions following the procedure, which can also be found here. Before a skin procedure, please tell your doctor if you:

Are taking any blood thinning medications, including over-the-counter aspirin
Have an artificial heart valve
Have a pacemaker, defibrillator, nerve stimulator, or cochlear implant
Have a history of viral hepatitis (hepatitis B or C) or human immunodeficiency virus (HIV)
Have leukemia, lymphoma, or are actively undergoing treatment for cancer elsewhere

Mohs Surgery

Mohs is a surgical technique that is used to remove skin cancer. Most frequently it is used for cancers located on the face, hands, genitals, shins, or feet. It is also utilized for recurrent, large, or otherwise high risk skin cancers anywhere on the body. Mohs surgery is a tissue-sparing procedure and offers the highest cure rates for the most common types of skin cancer (basal cell carcinoma and squamous cell carcinoma.) Mohs is not an acronym; it is named after Dr. Fred Mohs who developed the technique in the 1930’s.

The process begins with numbing the area. The tumor is then removed and sent to the lab located inside Fair Winds Dermatology. The Mohs surgeon then examines the surgical margins under the microscope. Unlike a regular surgical excision or the biopsy, 100% of the surgical margin is evaluated during a Mohs surgery. If necessary, additional tissue is removed and re-examined until the tumor is completely gone.

Once the tumor is clear, the reconstruction begins. Our goals of reconstruction are excellent cosmetic appearance and rapid wound healing. Reconstruction typically involves stitches and may include secondary intention (granulation or natural healing), linear repairs, skin flaps, tissue grafts, or a combination thereof. Your surgeon will discuss the options with you prior to starting the reconstruction.

The entire Mohs process can take between 2-4 hours. Please bring a book or other entertainment, water, and snacks for yourself.

Expectations for Mohs surgery are similar to those for an excision listed above. We suggest that you eat your normal breakfast. PLEASE TAKE ALL MORNING MEDICINES AS USUAL.

You will be provided written wound care instructions following the surgery, which can also be found here.