Surgical Dermatology: What to Expect Before, During, and After a Skin Procedure

By Dr. Salyards, Refine Dermatology | Knoxville, Tennessee

The thought of having a skin procedure can feel intimidating, especially if you have never had

one before. Whether your dermatologist recommends a biopsy to evaluate a suspicious spot or

a procedure to remove a skin lesion, it is natural to have questions about what to expect.

The good news is that many dermatologic procedures are simpler than patients anticipate. Most

are performed right in the dermatology office using local anesthesia, allowing you to remain

awake and comfortable throughout the process.

At Refine Dermatology in Knoxville, Tennessee, we believe that feeling informed is an important

part of feeling confident in your care. Dr. Jill Salyards, board-certified dermatologist and founder

of Refine Dermatology, provides personalized, physician-led care to help patients understand

their options and feel comfortable every step of the way.

What Is Surgical Dermatology?

Surgical dermatology involves procedures performed to diagnose, remove, or treat a variety of

skin conditions. These procedures range from quick, minimally invasive treatments to more

involved surgeries for conditions such as skin cancer.

Your dermatologist may recommend a procedure to examine a concerning spot, remove a

bothersome skin growth, or treat a confirmed skin cancer. The appropriate approach depends

on several factors, including the type of lesion, its size, its location, and whether additional

testing is needed.

Many dermatologic procedures can be completed in the office using local anesthesia. This

means the treatment area is numbed while you remain awake, and most patients can return

home shortly after their appointment.

Understanding why a procedure is recommended and what it involves can make the experience

feel much more manageable.

Common Types of Dermatologic Procedures

Not every skin procedure is the same. At Refine Dermatology, recommendations are tailored to

each patient's individual needs and the condition that is being evaluated or treated.

Skin Biopsies

A skin biopsy involves removing a small sample of skin so it can be examined under a

microscope. Your dermatologist may recommend a biopsy if a spot has changed in appearance,

a lesion looks suspicious, or a skin condition needs further evaluation to establish a diagnosis.

The specific biopsy technique depends on the area being examined and the characteristics of

the lesion. In most cases, the skin is numbed first, and the sample is collected using a small

instrument.

The tissue is then sent to a laboratory for evaluation. Once the results are available, your

dermatologist can explain the findings and discuss whether any additional treatment is

necessary.

A biopsy does not automatically mean something is cancerous. It is simply an important

diagnostic tool that helps your dermatologist determine what is happening with your skin.

Surgical Excision

An excision involves surgically removing a skin lesion. This may be recommended for certain

cysts, lipomas, or skin cancers, depending on the diagnosis and other clinical factors.

After numbing the area with local anesthesia, the dermatologist carefully removes the lesion.

For certain conditions, a small margin of surrounding skin may also need to be removed.

Stitches are often used to close the area and support proper healing.

The length and complexity of an excision depend on the size, location, and type of lesion being

treated. Your dermatologist will explain the recommended approach and what you can expect

during recovery before proceeding.

Electrodessication and Curettage

Electrodessication and curettage, sometimes called ED&C, is a procedure used to treat certain

superficial skin cancers and other appropriate skin lesions.

During the procedure, the dermatologist gently scrapes away the targeted tissue using a

specialized instrument called a curette. An electric device is then used to cauterize the

treatment area, helping destroy remaining abnormal cells and control bleeding.

This procedure generally does not require stitches and can often be completed relatively quickly.

However, it is not appropriate for every skin cancer or every location on the body. Your

dermatologist will determine whether it is a suitable treatment option based on the specific

diagnosis.

Mohs Micrographic Surgery

For certain skin cancers, your dermatologist may recommend Mohs micrographic surgery. This

specialized technique is designed to remove skin cancer while preserving as much healthy

surrounding tissue as possible.

During Mohs surgery, the surgeon removes the visible cancer along with a thin layer of surrounding tissue. Each layer is carefully examined under a microscope while the patient waits. If cancer cells remain at the edges of the removed tissue, additional layers are taken only where needed.

This process continues until the examined margins are clear. Mohs surgery is commonly used for certain skin cancers, particularly those in cosmetically sensitive areas or locations where preserving healthy tissue is especially important.

When Mohs surgery is recommended, your dermatologist can help explain the next steps and coordinate care with the appropriate specialist.

What Happens During a Dermatologic Procedure?

Knowing what to expect on the day of your appointment can help ease some of the uncertainty surrounding a skin procedure.

First, your dermatologist will review the treatment plan and answer any remaining questions. The area will then be cleaned and numbed using a local anesthetic.

The injection is often the part patients notice most. You may feel a brief pinch or stinging sensation as the medication is administered, but once the area is numb, you should generally feel pressure or movement rather than pain. If you experience discomfort during the procedure, let your dermatologist know.

The procedure itself may take as little as 15 to 30 minutes, although more involved treatments can take longer. The exact timing depends on the type of procedure, the size and location of the area being treated, and other individual factors.

Afterward, your dermatologist will explain how to care for the treatment site at home, including how to keep it clean, when to change the dressing, and what signs to watch for during healing.

Our goal is to make sure you understand each step and feel comfortable asking questions along the way.

Recovery and Wound Care After Skin Surgery

Recovery varies depending on the procedure performed, the location of the treatment, and your individual healing process. Many patients can return to their usual activities relatively quickly, although you may need to modify certain activities temporarily to protect the area.

Following your dermatologist's wound care instructions is one of the most important things you

can do to support healing. Depending on your procedure, these instructions may include

keeping the site covered, applying a recommended ointment, changing the dressing regularly,

and avoiding activities that could stretch or irritate the wound.

If stitches are placed, you may need a follow-up appointment for their removal. Your dermatologist will let you know when to return based on the location of the wound and the type of closure used.

Some mild tenderness, bruising, or swelling may occur after a procedure. However, increasing pain, spreading redness, warmth, pus, or fever can indicate a complication and should prompt you to contact your healthcare provider.

If you have questions about your healing progress, do not hesitate to reach out to your dermatology team. Following up when needed helps ensure that any concerns are addressed appropriately.

Will a Skin Procedure Leave a Scar?

Any procedure that cuts or removes tissue from the skin can leave a scar. However, the appearance of a scar depends on several factors, including the type and location of the procedure, your natural healing tendencies, and how well the area is cared for afterward.

At Refine Dermatology, we are intentional about surgical technique, wound closure, and aftercare to support the best possible healing outcome. While no one can guarantee that a scar will be invisible, careful planning and appropriate wound care can help minimize its appearance over time.

Sun protection is important as the area heals. Protecting the site from ultraviolet exposure can help reduce the risk of discoloration and support a more even appearance as the scar matures.

If you have concerns about scarring, bring them up before your procedure. Your dermatologist can explain what is realistic for your particular treatment and recommend appropriate aftercare.

Feel Confident About Your Skin Health

Hearing that you need a skin procedure can bring up questions, but you do not have to navigate the experience alone. Many dermatologic procedures are routine office treatments, and understanding the process can make them feel far less overwhelming.

Whether you need a biopsy, an excision, or treatment for a skin cancer, the right approach begins with an individualized evaluation and a clear understanding of your options.

At Refine Dermatology, we are committed to providing thoughtful, physician-led care in an environment where patients feel heard, informed, and comfortable. We will walk you through the recommended procedure, explain what to expect, and provide guidance to help you feel confident throughout your treatment and recovery.

If you have a spot you are concerned about or have been told you may need a skin procedure, we invite you to schedule an appointment with Refine Dermatology in Knoxville, Tennessee. We are here to help you understand your options and take the next step toward healthier skin.