Minor Surgery Information

Once a skin cancer has been surgically removed, it is important to repair the hole immediately and skilfully to avoid unnecessary disfigurement. All surgery leaves scars, and these scars can take up to 12 months to fully mature. Factors that will influence the scarring include smoking & genetic make-up. Considerable training and skill are also required to plan and perform surgery in such a way that the inevitable scar is as inconspicuous as possible. The simplest repairs can involve a straight-line scar, but even these can be disfiguring if it is puckered, placed in the wrong direction or has train-track marks. More complex repairs involving a skin flap (moving local tissues to fill the hole ) or skin grafts (borrowing skin from another part of your body and placing it into the hole) are best left to Specialist Surgeons with qualifications in Reconstructive techniques. Please visit the website for the New Zealand Association of Plastic Surgeons at www.plasticsurgery.org.nz for further information.

The common Local Anesthetics are Lignocaine & Marcain. A mixture of the two is usually used to provide rapid onset with long duration. Added adrenaline helps to reduce bleeding.

There are two aspects to this: the fine needle gives a brief sharp prick, but the anaesthetic itself does sting for a few seconds. The injection will remove sensations of pain, but, it is normal to sometimes feel some sensations of ‘pushing, pulling & tugging’ during the procedure, as the nerves for those sensations take longer to block. We can offer inhalational Nitrous Oxide (laughing gas) for additional comfort.

Only the top of the lesion or mole is removed, and the remaining raw area is left to heal. These wounds are dressed with antibiotic ointment for 5-7 days until it dries & flakes off.
Using this technique, the scar can be very good, but the lesion may re-grow in time, so it is not used for skin cancers.

The entire lesion is removed with a safety margin of normal skin. The wound is stitched closed.

On occasion, these are stitched closed with hidden dissolving sutures. Otherwise, a non-dissolving suture is used which requires removal.

A skin graft is a thin shaving of skin from a donor site (such as thigh), which is transferred to cover the wound.
To heal, grafts depend on in-growth of blood supply. Infection, bleeding and movement reduce the chance of graft ‘take’.
These dressings must be kept dry & are first changed at 5-7 days.

Tissue adjacent to the defect is moved to close the wound.
Planning of these repairs can be complex, requiring in-depth knowledge of the underlying anatomy to take into account blood vessels and nerves.
The defect created by moving this flap is closed directly with sutures.

Please do not wear make-up on the day of your facial surgery.
During the procedure an electric machine is used to cauterize any small bleeding points in your wound. In order for this to work, an “earthing’ plate is placed on your bare skin. This can be initially quite cold!
You may have some pain after your operation. In the majority of cases this is minor & is dealt with very well by taking Paracetamol only.
The body part operated on will need to be elevated. This will encourage swelling to subside quicker & reduce the chance of bleeding. It will also reduce the pain you may experience post-operatively.
For some operations, an antibiotic to reduce the chance of infection will be prescribed. This does not reduce the chance to 0%. Infections may make the resulting scar less aesthetic than planned.
You will be given written instructions on how to look after your wound after the operation. In general, they need to be kept dry.
No dressing is water-proof.
If you are taking blood thinners regularly, you may re-start them 2 days after your operation, but please discuss this at your initial consultation.
Your surgery is likely to leave a scar. Scars may take up to 9 months to mature / fade. This time can be reduced by taping the scar with Micropore tape or massage of the scars. A small group of patients will have a genetic pre-disposition for forming thickened, red & itchy scars called Keloids.
The results of any tissue sent to the laboratory should be available in approx. 7-10 days and the practice nurse will phone you with the results. There is a 1 in 20 chance that something further may need to be done based on those results. (e.g. further investigation, treatment or surgery)
Smoking has a detrimental effect on healing tissue: It will make infection more likely, will make the scars less cosmetically-appealing than planned & will increase the chance of skin dying on flaps & grafts. Ideally, you should stop 8 weeks pre-operatively.
If your surgery is on your head & neck or lower legs, you should arrange a driver to pick you up.
No guarantee can be given as to the histological result issued from the laboratory. Lesions thought to be cancers, could ultimately be reported as benign. A biopsy for lesions that appear indeterminate may be offered.