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MINOR SURGERY

Technically, Minor Surgery is any invasive procedure, performed without general anaesthesia in which only skin, mucus membranes and connective/fat tissue are resected. From a more practical point of view, minor surgery covers all those surgical procedures, performed under local anaesthesia, in an office-based setting, to remove and excise skin lesions and small lumps.
The most common lesions treated in minor surgery are:

  • Skin tags;
  • Warts and Verrucas;
  • Benign moles and nevi, mainly for cosmetic reasons;
  • Hairy moles;
  • Crusting skin lesions;
  • Vascular blemishes, like red spots or cherry angiomas;
  • Xanthelasmas;
  • Millia;
  • Suturing of minor injuries;
  • Removal of foreign objects;
  • Incision and Drainage of infected lumps;
    Sebaceous cysts;
  • Lipomas;
  • Ingrown toenails.

Lipoma scalpLipoma scalp

Hypertrophic skinHypertrophic skin

sebaceous cyst scalpSebaceous cyst scalp

The demand for these treatments have skyrocketed as, in the UK, they are no longer commissioned by the NHS in some regions or the backlog is incredibly long, even years of waiting.

Some of these minor surgeries or minor operations can be performed by general practitioners (GP) and even cosmetic practitioners. However, for certain procedures, and to achieve best cosmetic and long lasting results, an experienced surgeon should be the preferred option

HOW ARE THESE MINOR OPERATIONS PERFORMED?

All of them are performed under some form of anaesthesia, either topical or injected, and most are done in the doctor’s office. If the anaesthetic agent is to be injected, a small needle will be used, to minimise the discomfort, and once the effect is achieved, the entire surgery will be done with no pain at all.

DIFFERENT TECHNIQUES CAN BE USED TO ACHIEVE THE EXCISION OF THE SKIN LESIONS:

Cryosurgery

CryosurgeryCryosurgery

The lesion is frozen using special devices that will deliver liquid nitrogen to the area to be treated. This will produce a burn injury and the treated lesion will be turned into a scab, which will eventually fall off, leaving a new skin behind. Cryosurgery is quick, easy to perform, and does not need any anaesthesia. It is mainly used to treat warts and verrucas.

Electrocautery

ElectrocauteryUsing electrocautery for surgery

In this case, a device that delivers an electrical current, cuts and coagulates the lesion, so it can be shaved with no bleeding. Local anaesthesia is generally required, and after excision, a small black scab will appear. This scab may take several days to fall off, and the newly formed skin will be exposed. When proper care is taken, the cosmetic results are excellent, as there is no need for sutures.

Electrocautery, also known as hyfrecator, can also be used as an aid to perform more advanced minor surgeries, such as lipoma removal, helping to achieve a perfect haemostasis.

This method is mainly used to treat skin tags and pedunculated benign moles, but it is also useful to treat warts.

Plasma Surgery

Here, a radiofrequency current is used to treat the lesion. This so-called “plasma” produces a change in the protein structure which in turn will desiccate the lesion, which will eventually fall off. There are several devices in the market, working at different frequencies, and it is mainly used for the treatment of small lesions at delicate areas (such as eyelids), millia and xantelasmas.

Traditional Surgery

This is the traditional, standard surgery, where a blade is used to excise the lesion and sutures will be used to approximate the edges of the skin. This is the method of choice to treat cysts, lipomas, moles and when a pathology sample is required. It is performed under local anaesthesia, and, when the surgeon is knowledgeable and experienced, the cosmetic results could also be very good.

In most cases, skin sutures need to be removed 7 to 10 days after the minor operation. This is a pain free procedure and is usually performed by health care assistants.

With one of my lipoma patientsWith one of my lipoma patients

FREQUENTLY ASKED QUESTIONS

Can I get rid of my lumps and bumps with minor surgery?

Absolutely! Minor surgery is indicated to safely remove those unwanted lumps and bumps, such as skin tags, moles and warts, or to suture skin cuts and remove foreign bodies in the skin and subcutaneous tissue. But it can also be used to remove bigger lesions such as sebaceous cysts – most commonly seen in the scalp and the back – and even lipomas, without the need of hospitalisations and without interrupting your daily activities.

Where are these minor surgeries performed?

These procedures are normally performed in the doctors office, in a clean environment and using all sterile instruments and drapes to minimise the possibility of a wound infection. And the premises, if the procedure is performed in England , must be CQC registered. OR The premises must be registered and approved by the corresponding regulatory body. In England, for instance, this regulatory body is the CQC (Commission of Quality Control).

Is minor surgery painful? Will I feel anything?

No. These treatments are NOT painful, as they are performed under local anaesthesia. You will only thing a small prick and a bit of stinginess when the local anaesthesia is injected. THis will last only a few seconds until the numbing effect is achieved, And after that, you will no feel anything, “Nada”

Do I need to fast or get a blood test before these minor surgeries?

No. These procedures are performed in an office setting, under local anaesthesia, so there is no need to fast before the surgery, as is the case for in-hospital surgical cases. Regarding blood tests, unless your doctor indicates you otherwise (for instance, if you are diabetic and your blood sugar is not well controlled), there is no need to perform any pre-procedure blood checks.

Do I need to have my stitches removed or do they just fall off?

When sutures need to be applied to close the skin incision, in most cases, they need to be removed in 7 to 10 days after the procedure. Sutures placed deeper (in case that they are needed) are absorbed by your body and therefore, don’t need to be removed. Don’t worry, suture removal it’s a pain free procedure and it will not take longer than 5 or 10 minutes.

I am taking blood thinners. Can I still have my mole removed?

Yes. According to the current guidelines to perform minor surgery and dental procedures on patients taking these medications, you don’t have to stop taking them, and your procedure can still go ahead. Make sure your doctor knows about you taking this medication and he/she will instruct you how to be prepared for your minor surgery.

ABOUT DR. ALMEIDA

As a Consultant surgeon, Dr. Almeida has been treating skin lesions and lipomas for 2 decades, and he has personally performed thousands of these procedures at different clinics in Europe. He also teaches and trains medical professionals on minor surgery techniques. Therefore, if you need a skilled and expert professional to deal with your “bumps and lumps””, whether cosmetic or more medical. Dr. Almeida is your “go-to” expert.

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