It consists of the removal (partial or total) of skin lesions (benign or malignant), respecting the characteristics of the pathology in question and seeking the best possible aesthetic-functional result.

Among the different types of benign tumors, the following stand out: nevi, syringomas, keloids, lipomas, cysts, leiomyomas, neuromas, hemangiomas, among others.

Among malignant lesions, the most common tumors are: basal cell carcinoma (BCC), squamous cell or squamous cell carcinoma (SCC) and melanoma.

Unlike clinical treatments (medicines, laser, etc.), which may be indicated for some selected cases of injuries, all surgical treatments involve cut(s) in the skin and/or mucous membrane(s) and, consequently, scar(s) .

There is no surgery without scar(s). What exists is well-planned surgery, with final scar(s) well positioned and camouflaged, when possible, in natural reliefs of the skin, achieving barely noticeable results.

Not all skin injuries require surgical removal. After due assessment by a qualified doctor, who will examine the injury and relevant personal data, possible procedures will be discussed with the patient, ranging from simple periodic monitoring, through non-surgical treatments, to surgery itself.

In cases of surgical treatment, there are still several planning possibilities that should be discussed with the patient.

The surgery schedule varies depending on the type of lesion (whether benign, malignant, fast-growing or not, imposing functional limitations or not, etc.), and can only occur after proper evaluation of the patient by a qualified doctor.

During the consultation, the plastic surgeon should learn details about the lesion in question (time of appearance; whether there was previous trauma to the region; associated symptoms – itching, bleeding, discharge of secretion, etc.; growth rate; family relationship, etc.), as well as the patient's general health (history of healing in general; history of illnesses; medications, vitamins or any other substances used - alcohol, cigarettes, illicit drugs; possible allergies; family history, etc.) .

Be sincere and don't omit information, even if it seems silly. The smallest details can make a difference in the final result.

Every duly qualified plastic surgeon has completed AT LEAST:
• 06 (six) years of medical school;
• 02 (two) years of specialization in General Surgery;
• 03 (three) years of specialization in Plastic Surgery (in a Service accredited by SBCP).

At the end of this long period of training, a final assessment is still necessary, comprising curricular analysis + written test + oral test, so that the surgeon can finally receive the Title of Specialist from the Brazilian Society of Plastic Surgery.

All SBCP members can be found in the list available on the website. Find out about your surgeon!

The procedure must be carried out in an environment authorized by the Health Surveillance, comfortable for the patient and medical team, and may vary in structure depending on the degree of complexity of the planned surgery.

• Pre-operative recommendations (fasting time, medications or any other substances that should be discontinued and how far in advance, care of the surgery site);
• Scheduled type of anesthesia and length of stay;
• Need for help when being released home;
• Rest time;
• Care of the surgical wound;
• Medications that will be needed;
• Possible complications/intercurrences.

Any and all surgical procedures involve risks. These will be minimized by correct pre-operative assessment, surgical planning and adequate post-operative care. Among the possible complications/intercurrences, we can mention:

• Bleeding/bruising (accumulation of blood internally);
• Infection;
• Poor healing (hypertrophy, keloids, retractions, color changes);
• Changes in sensitivity;
• Necrosis and partial or total loss of flaps or grafts performed;
• Recurrence of the injury;
• Reaction to the products used (suture threads, tapes, injectable solutions);
• Complications inherent to the anesthetic procedure;
• Need for a new surgical procedure.

Healing is a complex process full of peculiarities depending on the nature of each person. Despite all the competent care given to the surgeon, sometimes the final results obtained are less than expected. Talk to your surgeon and clarify any doubts, avoiding frustration and looking for possible alternatives to unsatisfactory results.

Anesthesia:
It may be local, regional, with or without sedation and even general, depending on the proposed procedure and the patient's surgical risk. The surgeon, anesthesiologist and patient must talk and define the most comfortable and safe option for everyone.

Surgery:
The planning of the surgical procedure varies depending on the characteristics of the injury (location, type, size). Initially, the surgeon may choose to perform a biopsy (partial or total removal of the lesion) to study the fragment in the laboratory by a specialized professional (Pathologist) and plan the definitive procedure in the future.

The complete treatment may be carried out in one or more surgical stages, depending on the characteristics of the injury in question. Often the definitive reconstruction of the area initially operated on to remove a large lesion or one suspected of being malignant will need to be postponed until another time.

In the case of small lesions, surgery may consist of simply removing the lesion and closing the skin as discreetly as possible. In larger lesions, it may be necessary to use flaps (recruitment of healthy tissue adjacent to the lesion) or grafts (segments of skin of varying thickness, obtained from healthy regions distant from the lesion) to properly close the wound generated after resection.

In the case of malignant lesions (already diagnosed by previous biopsy), it is necessary to expand the resection margins beyond the visible limits of the lesion, guided by its characteristics (location, type, size) and possibly by pre-operative assessment ( throughout the surgery) of the fragments resected by a Pathologist, in order to achieve complete removal with “free margins” (absence of local residual disease). Mohs micrographic surgery may be indicated.

Furthermore, in cases of malignant lesions, it may also be necessary to carry out supplements to local surgical treatment, such as: biopsy/lymph node resection, radiotherapy, chemotherapy, photodynamic therapy, etc.

Post-anesthetic recovery:
After surgery, the patient will continue to be under the influence of some of the medications given during surgery, with recovery time varying depending on the type of anesthesia. Analgesics are administered, which, if necessary, will continue to be used by the patient at home, for greater comfort and pain control.

The length of stay varies depending on the surgery performed. At the time of release, the patient must receive all appropriate prescriptions and guidance regarding home care and an expected return date for reevaluation.

Post-operative recovery:
After surgery to remove any type of skin lesion, the operated area will be sensitive, painful and red. A small volume of liquid may be eliminated through the wound or crusts may form (“scabs”).

Follow your surgeon's instructions: avoid physical activities that force the operated area, carry out dressing changes as recommended, use correctly prescribed medications, protect the scar from the sun for the specified period of time, etc.

A good quality final scar is the result of adequate surgical technique + organic factors specific to each patient + due post-operative management.

Talk to your surgeon. Depending on the type of surgery and anesthesia planned, it may be important for someone to accompany you for at least the first few hours after the procedure.

In the long term…
Every surgery causes scar(s). As far as possible, respecting the characteristics and treatment needs of the pathology in question (skin lesion), scars are planned in such a way as to be in positions that reduce tension on their edges, facilitating healing, and/or camouflaged in existing reliefs. in the skin.

Healing is a complex process full of peculiarities depending on the nature of each person. Changes that are more (initial phase) or less (later) apparent continue to occur even months after the procedure. A good quality final scar is the result of adequate surgical technique + organic factors specific to each patient + due post-operative management.

Depending on the type, size and location of the injury, greater or lesser deformities may result from the surgical procedure. In the case of malignant lesions (skin cancer), despite efforts aimed at the best possible aesthetic-functional result, the most important thing is to achieve a cure for the disease.

• Surgeon's fees;
• Surgical team (anesthetist, assistant surgeon(s), instrumentation);
• Admission to Hospital/Clinic;
• Pathologist/histopathological examination;
• Extra materials and/or medicines;
• Private nursing;
• Complementary post-operative treatment.

Remember that your health is at stake. The result of the procedure, good or bad, will stay with you for the rest of your life. Look for a suitably qualified surgeon and demand that your surgery be carried out in safe accommodation. In the end, what's cheap can be expensive.