Dermato-surgery simply means surgery of the skin and related conditions. Because of in depth knowledge of skin anatomy and physiology, skilled dermatologists are adept at performing skin surgeries and delivering superior results.
Skin/Mucosal Biopsy – It is minor surgical procedure done on OPD basis where small tissue of the skin is cut with the help of disposable sterile biopsy punch under local anesthesia in order to confirm the diagnosis of skin disorders. Tissue obtained is sent to expert dermatopathologist where it is stained with special dyes and examined under microscope to arrive at the final diagnosis.
Radiosurgery/Electrocautery – These special devices utilize radio waves or electric energy to destroy target tissue without damaging surrounding skin. It is used to treat conditions like Skin tags, Moles, Warts, Syringomas, Scrotal cysts, etc.
Ear lobe repair (Auroplasty) – It is a reconstructive surgical procedure performed to repair elongated or torn ear lobes. This can be achieved either using sutures under local anesthesia or special tissue glue.
Cyst Removal – Epithelial or Sebaceous cysts are closed sac like structures formed inside the skin due to collection of keratin or sebum. Under local anesthesia, cysts are opened with small incision and removed along with its wall to prevent recurrence.
Lipoma excision – This is a benign tumour of fat cells. It is excised with a novel technique named NHET (Narrow Hole Extrusion Technique) wherein large tumour can be removed through a small opening resulting in minimum scarring.
Corn Surgery – Corns are removed completely with excision surgery under local anesthesia or scraped with sterile surgical blade layer by layer at regular intervals causing minimal pain or bleeding (Paring).Acne Scar Surgery –
Molluscum Extraction – Molluscum Contagiosum is a contagious viral infection of skin causing pearly white colored elevated lesions. These lesions need to be removed to avoid spread of infection to other parts of body as well close contacts of the patient. This is done under topical anesthesia with the help of a curette or radiocautery.
Vitiligo is mainly treated by medical line of management, however for certain lesions which fail to respond to medications alone, surgery becomes the preferred choice of treatment.
The cases which are suitable for surgery are:
The basic principal surgical method is to transfer the pigment cells- melanocytes from normal skin to the stable vitiligo patch. This is done either by tissue grafts or cellular grafts.
Autologous non-cultured Melanocyte- Keratinocyte cell suspension grafting - This novel surgical technique is the latest breakthrough in the field of vitiligo surgery. Superficial layer of the skin, about one sixth to one-tenth the size of the recipient area is obtained from the donor area. With a specialized method, the pigment cells and the epidermal cells are then extracted from this donor tissue to obtain a suspension. The recipient skin is prepared and this suspension is then applied over the area. A surgical dressing is placed over the site.
The major advantages are
The vitiligo patch usually appears reddish or even white after the dressing is removed. Re-pigmentation over the area starts showing only after 2-3 months. This can be aided by phototherapy to see faster results.
These above mentioned techniques are time tested and scientifically proven to achieve excellent results. However there is no 100% guarantee that will assure the complete re-pigmentation of the vitiligo patches as this depends on your body’s response to the transplanted pigment cells, it varies from patient to patient and thus cannot be predicted by the doctor. Many times a delayed response is seen so don’t get discouraged if you don’t see results in 2-3 months time. If small areas fail to re-pigment after surgery they tend to respond favorably to the medical management or phototherapy.