Skin Surgery Treatment

Skin Surgery in Singapore

Dr. Liew Hui Min

accredited consultant dermatologist

When faced with concerning skin lesions, cysts, or growths, you may feel anxious about both the condition and treatment options. Skin surgery encompasses surgical procedures to remove, repair, or reconstruct skin tissue affected by medical conditions, injuries, or cosmetic concerns. These procedures range from simple excisions of benign moles to complex reconstructions following skin cancer removal.

Suitability Treatment Process Recovery Benefits Risks FAQ Conclusion

What is Skin Surgery?

Skin surgery refers to surgical procedures performed on skin and underlying tissues to diagnose, treat, or remove skin conditions. These procedures involve careful excision, repair, or reconstruction of skin tissue using surgical techniques. Skin surgery addresses conditions from benign growths like cysts and lipomas to malignant lesions requiring complete removal with clear margins.

The procedures typically involve local anaesthesia and can be performed in an outpatient setting, though complex cases may require operating theatre facilities. Modern skin surgery techniques focus on complete removal of problematic tissue while minimising scarring and preserving the natural appearance of surrounding skin. Common conditions treated include skin cancers (basal cell carcinoma, squamous cell carcinoma, melanoma), benign tumours, cysts, lipomas, suspicious moles, chronic wounds, and scar revisions.

Who is a Suitable Candidate?

Ideal Candidates

Patients with suspicious or changing moles requiring biopsy or removal
Individuals with diagnosed skin cancers needing surgical excision
Those with painful or infected cysts requiring drainage and removal
Patients with lipomas causing discomfort or cosmetic concerns
Individuals with benign skin growths affecting daily activities
Those seeking removal of skin tags or other benign lesions

Relative Contraindications

Active skin infections at the surgical site requiring treatment first, though treatment with antibiotics can be given concurrently during the surgery and soon after surgery
Bleeding disorders or medications that significantly impair clotting
Severe immunosuppression affecting wound healing capacity
Unrealistic expectations about cosmetic outcomes
Certain medical conditions that impair healing (uncontrolled diabetes)
Allergy to local anaesthetics without available alternatives

A thorough assessment by Dr Liew Hui Min will determine your suitability for skin surgery, considering your medical history, current medications, and specific skin condition.

Treatment Techniques & Approaches

Simple Excision

Simple excision involves removing the entire lesion with a small margin of healthy tissue. This technique is used for small benign lesions, suspicious moles, and early-stage skin cancers. The surgeon creates an elliptical incision around the lesion, removes it completely, and closes the wound with sutures. This approach provides tissue for pathological examination while achieving good cosmetic results.
Moh’s Micrographic Surgery

Moh’s surgery is a precise technique for removing certain skin cancers, particularly on the face and other cosmetically sensitive areas. The surgeon removes thin tissue layers sequentially, examining each microscopically until no cancer cells remain. This approach achieves good cure rates while preserving healthy tissue, making it suitable for facial skin cancers. Our dermatologist will recommend a qualified surgeon if this treatment is necessary after the initial skin biopsy.
Technology & Equipment Used

Modern skin surgery uses technologies to enhance precision and outcomes. Electrocautery devices control bleeding and can destroy small lesions. Dermoscopy aids pre-surgical planning by providing magnified views of skin lesions. Modern suturing materials and techniques minimise scarring. Some procedures employ laser technology for precise tissue removal or radiofrequency devices for bloodless excision.
Wide Local Excision

Wide local excision is employed for confirmed skin cancers or lesions with uncertain margins. This technique removes the lesion with a larger margin of surrounding healthy tissue to ensure complete removal of potentially cancerous cells. The margin size depends on the cancer type and stage. Closure may require undermining surrounding tissue or occasionally skin grafts for larger defects.

The Treatment Process

Pre-Treatment Preparation

Before skin surgery, you’ll undergo a comprehensive consultation where the surgeon examines the lesion and discusses the surgical plan. Pre-operative photographs may be taken for documentation. Blood tests might be required for extensive procedures. You’ll receive instructions about medications to avoid, particularly blood thinners and certain supplements. On surgery day, clean the area as directed and wear comfortable, loose clothing.

During the Procedure

The surgical area is cleaned and draped in a sterile manner. Local anaesthetic is injected around the lesion, ensuring complete numbness. For simple excisions, the surgeon marks planned incision lines and removes the lesion with appropriate margins. The specimen is preserved for pathological examination. Bleeding is controlled using electrocautery or pressure. Wound edges are aligned and sutured in layers to minimise tension and optimise healing. The procedure typically takes 20-60 minutes depending on size and complexity.

Immediate Post-Treatment

After surgery, a pressure dressing is applied to minimise bleeding and swelling. You’ll receive wound care instructions and pain medication prescriptions if needed. Most patients return home immediately after the procedure. The surgical site may feel tight or uncomfortable as anaesthetic wears off. You’ll be advised about activity restrictions and signs of complications. A follow-up appointment is scheduled for suture removal and pathology results discussion.

Recovery & Aftercare

First 24-48 Hours

Keep the surgical dressing dry and intact for 24-48 hours. Some bleeding or oozing is normal initially. Apply ice packs near (not on) the surgical site to reduce swelling. Take prescribed pain medication as directed, though many patients find over-the-counter options sufficient. Avoid strenuous activities that could stress the surgical site. Sleep with the affected area elevated if possible.

First Week

After 48 hours, begin gentle wound cleaning as instructed. Apply prescribed antibiotic ointment and fresh dressings daily. Avoid soaking the wound (quick showers are permitted). Limit physical activities that could stretch or traumatise the surgical site. Watch for infection signs including increased redness, warmth, pus, or fever. Sutures are removed after 5-14 days depending on location.

Long Term Recovery

Complete healing occurs over weeks to months. The surgical scar initially appears red or pink, gradually fading to match surrounding skin. Sun protection is crucial – use SPF 50+ sunscreen on healed wounds. Scar massage with moisturiser can begin after suture removal. Final cosmetic results may take 6-12 months as scars mature and remodel.

Benefits of Skin Surgery

Skin surgery offers definitive treatment for skin conditions that cannot be managed with topical or non-invasive methods. Complete excision provides tissue for accurate diagnosis through pathological examination, crucial for detecting skin cancers early. Removal of painful or infected cysts provides immediate relief and prevents recurrence. Excising suspicious moles offers peace of mind and potentially life-saving early cancer detection.

The procedures improve quality of life by removing lesions that catch on clothing, cause discomfort, or create self-consciousness. Modern techniques result in minimal scarring, with surgical scars often less noticeable than original lesions. For skin cancers, surgical excision provides good cure rates compared to other treatment modalities. Sending removed tissue for testing ensures accurate diagnosis and appropriate further treatment if needed.

Risks & Potential Complications

Common Side Effects

Temporary bruising and swelling around the surgical site resolve within 1-2 weeks. Mild to moderate discomfort is expected but controlled with pain medication. Tightness or pulling sensations are normal as tissues heal. All surgical procedures result in some scarring, though modern techniques minimise appearance. Temporary numbness around the surgical site may occur from disruption of small nerve endings, improving over months.

Rare Complications

Infection occurs in less than 5% of cases and responds well to antibiotics when identified early. Excessive bleeding is uncommon but may require additional intervention. Poor wound healing or wound separation can occur, particularly in patients with diabetes or smokers. Hypertrophic or keloid scarring may develop in predisposed individuals. Rarely, nerve damage causes persistent numbness or altered sensation.

Our experienced surgeons employ sterile technique, careful tissue handling, and appropriate wound closure to minimise risks. Pre-operative assessment identifies patients at higher risk, allowing preventive measures.

Frequently Asked Questions

How long does skin surgery take?

Most procedures take 15-60 minutes, depending on lesion size and complexity. Simple excisions of small moles or cysts take 20-30 minutes, while larger lesions or complex closures may take an hour. Multiple lesions can be removed in one session, extending total procedure time.

Will I have a scar after skin surgery?

All surgical procedures involving skin incisions result in scars. Our surgeons use techniques to minimise scarring, including precise incision placement along natural skin lines, careful suturing, and appropriate scar care. Most surgical scars fade significantly over 6-12 months.

When can I return to normal activities?

Recovery varies by procedure location and extent. Most patients return to desk work within 1-2 days. Avoid strenuous exercise and heavy lifting for 2-4 weeks depending on surgical site. Facial surgeries may require less activity restriction than procedures on joints or areas under tension. Your surgeon provides specific guidelines based on your procedure.

Is skin surgery painful?

The procedure is painless due to local anaesthesia. You may feel the initial needle prick and pressure during surgery, but no pain. Post-operatively, patients experience mild to moderate discomfort for 2-3 days, controlled with prescribed pain medication. Many find over-the-counter pain relievers sufficient after the first day.

How soon will I know if the removed lesion is cancerous?

Pathology results take 5-10 working days. The doctor will discuss the results with you when you return for a review. If benign, you’ll receive confirmation and continue routine follow-up. If cancerous cells are detected, we’ll schedule an urgent consultation to discuss findings and additional treatment.

Can multiple skin lesions be removed in one session?

Yes, multiple lesions can be removed during one surgical session. This minimises recovery time and is convenient for patients. The number safely removed depends on size, location, and total surgical time. Your surgeon assesses and advises the optimal approach during consultation.

What happens if skin cancer is found?

If cancer is suspected during surgery, the surgeon ensures adequate margins. Once pathology confirms diagnosis and examines margins, additional treatment may be recommended. This might involve further surgery, oncologist referral, or other treatments depending on cancer type and stage.

How can I minimise scarring?

Follow post-operative care instructions for optimal healing. Keep wounds clean and moist with prescribed ointments, avoid sun exposure on healing wounds, and use silicone sheets or gels once healed. Gentle scar massage starting 2-3 weeks post-surgery improves appearance. Avoid smoking and maintain good nutrition for better healing.

Conclusion

Skin surgery provides a safe, effective solution for removing skin lesions, from benign growths to skin cancers. With proper surgical technique and post-operative care, patients achieve good medical and cosmetic outcomes. Successful skin surgery requires choosing an experienced surgeon who can accurately diagnose your condition, select the appropriate surgical approach, and execute the procedure precisely. Whether dealing with a suspicious mole, painful cyst, or confirmed skin cancer, timely surgical intervention provides peace of mind and definitive treatment.

Dr Liew Hui Min

Dually Accredited Dermatologist In Singapore and the UK

Dr. Liew Hui Min is an accredited consultant dermatologist from the Ministry of Health and the General Medical Council UK.

Her clinical interest includes:

Paediatric Dermatology,
Women’s Dermatology,
General Adult Dermatology.

Having trained in major London Hospitals, Dr Liew returned to Singapore in 2014 as a Consultant at KK Women’s and Children’s Hospital (KKH) where she specialised in paediatric, women, obstetric and vulva dermatology. Currently, Dr Liew practices at The Skin Drs. clinic located at Gleneagles Hospital.

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