Dr. Power commonly performs minor plastic surgery procedures under local anesthetic. These procedures include:
Cosmetic mole removal
Moles are benign skin growths, which may be pigmented or skin-toned. If a mole is bothersome cosmetically or subject to irritation due to location (for example, when combing, shaving, or frequently irritated from overlying clothing), elective mole removal may be performed. Surgical options for mole removal include shave vs. elliptical excision. Stitches are not required for shave excisions. The mole is shaved level with the surrounding skin surface. The risk of recurrence is higher following this technique since a portion of the mole may be left behind in the underlying skin. During elliptical excision, the mole removal is full-thickness which lowers the risk of recurrence. Stitches are required following elliptical excision to reapproximate the skin edges. A small linear scar results following this technique, which is placed parallel to natural skin creases to optimize healing.
If any mole changes in appearance or new symptoms develop (such as bleeding, itchiness, or ulceration), please see your primary care physician to have the lesion assessed clinically. When examining precancerous and cancerous skin lesions, remember the “ABCDs”. This is an easy tool for patients to consider when performing self-examinations. “A” refers to asymmetry. Any mole that appears asymmetric or grows asymmetrically should be evaluated. “B” stands for borders. Benign (non-cancerous moles) generally demonstrate well-defined borders. It should be easy to tell where the mole starts at the junction with surrounding skin. If the borders change in appearance or become less defined, please have the mole assessed. “C” refers to color. Benign moles generally appear uniform in pigmentation. If the color changes or appears heterogeneous, this is another feature that should prompt medical evaluation. Lastly, “D” stands for diameter. Any mole greater than 6mm should also be given extra attention. That being said, skin cancers may be smaller than 6mm and many benign lesions larger than 6mm. Any lesion that increases in size should also be evaluated. Dr. Power also accepts referrals for skin cancers and irregular skin lesions. If medical concerns arise regarding your skin lesion, you may have a referral faxed to our office (416-962-1011) by your primary care physician and a consultation will be booked.
Cysts are common benign bumps beneath the skin. They may develop from a block pore or oil gland. Skin cells and debris develop underneath the skin surface. This causes inflammation to develop and it becomes encapsulated or walled off by the body. Cysts may increase in size over time and result in intermittent drainage that has a characteristic odor. They may become infected, however inflammation more commonly occurs when the cyst is active and producing more debris within the capsule. During periods of inflammation, the cyst may become locally tender, increase in size, and develop overlying redness. This redness generally does not extend beyond the cyst boundaries. During periods of inflammation, patients may benefit from incision and drainage (which decompresses the cyst and reduces the inflammation) or steroid injection. Risks and benefits of both approaches will be discussed in consultation.
For cysts that are asymptomatic, elective excision is an option for cosmesis. During this procedure, the blocked pore (referred to as the punctum) is removed through a small ellipse overlying the cyst. Carefully resecting the punctum as well as cyst capsule may lower the risk of recurrence.
A lipoma is a benign lump underneath the skin surface, which may have a similar appearance to a cyst. A punctum is not present overlying a lipoma and is a distinguishing feature. A lipoma consists of benign fat cells and may increase in size over time. If a lipoma changes in appearance or new symptoms develop (such as pain or tingling), it is important to present to your primary care physician for clinical assessment. If interested in proceeding with elective lipoma removal, this may be performed under local anesthetic.
There are different options for scar revision which may depend on several factors:
Length of time the scar has been present
How the scar developed
Scar appearance – for example, its depth, location, orientation, quality
Factors relating to the patient’s skin thickness and pigmentation
Although it is not possible to remove a scar completely, its appearance may be improved through various techniques. Some scars may benefit from re-excision followed by meticulous wound closure. Surgically created scars are often more precise than ones caused by trauma. Elevated scars may benefit from dermabrasion, which is a surgical technique to resurface the scar by removing the outer layers of tissue. Depressed scars may sometimes be released surgically or injected with hyaluronic acid fillers.
If a scar has been present for less than a year, it is generally recommended to wait until final scar maturation before considering any revision techniques. In the interim, scar massage performed several times daily may help to flatten and soften the scar as well as desensitize the region. There are other non-surgical treatments for immature scars. If elevated, immature scars may benefit from either silicone gel (for the head and neck region) or silicone sheeting (for the body). The silicone may improve scar appearance through hydration and potentially by increasing scar temperature as it matures. Other types of elevated or thickened scars may benefit from steroid injection.