Phone: 04 3800 125    Fax: 04 380 0127
62 - 66 Vivian Street, Te Aro, Wellington
nz dermatology & skin cancer center
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Skin Surgery

Dr Coutts and Dr Barker have extensive skin surgery experience and specialist training. More than anything else, the most important facet in safe and effective skin surgery is a thorough and complete understanding of what is being treated.

As consultant dermatologists they have been trained in diagnosis which allows them to select the best treatment. As dermatologists they have been trained in the simple but highly effective techniques such cryosurgery or curettage & cautery. They are also trained and equipped for complex skin flaps and skin graft repairs after skin cancer removal. This provides the patient with a singularly broad range of treatment options designed to meet the needs of the tumour being removed. We can therefore get effective tumour /lesion removal with the best possible cosmetic outcome (least scarring).
Surgery is performed under local anaesthetic which rapidly numbs the skin. The lesion may then be biopsied, curetted or excised.

Skin biopsy. This is sampling the skin (for rashes) or sampling a portion of a lesion to get pathological information to assist in diagnosis. Usually biopsies may be done in just a few minutes and after the skin area has been numbed. Sometimes a stitch is placed which is usually removed in a week. Results can take a week or longer to come back depending on what special test the dermatologists have asked for.

Curettage & Cautery. This is a rapid, cost effective way of simply removing small and low risk skin cancers. The skin is numbed and the lesion is scrapped away from the skin, leaving a graze-like area. No stitches are needed and the defect usually leaves a small whitish scar. This procedure is not suitable for all cancers but Dr Barker and Dr Coutts will use this for low risk lesions.Curettage & Cautery

Excision of lesion. This is the standard method of removal for many lesions, including the brown (pigmented) lesions. The lesion edges are carefully marked out and a margin of healthy tissue around the growth is cut out with the growth so we can be confident it has all been removed. The edges can then be pulled together and stitched.

Flap Repairs. When a lesion has been removed but there is not enough skin to simply pull the area together we will often recruit skin from an adjacent area using special cuts to flip or move skin around. There are many ways of doing this to effectively hide scars in natural creases of the skin.Flap Repair

Skin Graft Repairs. If a lesion has been removed and there is not enough adjacent skin to fill the defect we will take skin from a separate site and stitch it in place as a skin graft. These usually heal very well and can give good long term results.
After all surgical removal of lesions we can also revise scars, laser treat scars or dermastamp scars to improve the appearance, usually after letting the scar settle for a few months.Skin Graft

Mohs Micrographic Surgery. For very difficult tumours (or tumours which have been incompletely removed by other practitioners) and for cases when there is a special need to keep the scarring to a minimum then Mohs Micrographic Surgery is available. Dr Barker has performed a fellowship in Mohs Surgery in the United Kingdom. This technique provides the highest cure rates and has the bonus of keeping the amount of skin removed to a minimum. The NZDSCC is the only centre in the Wellington region that provides this technique. The Centre is an affiliated provider for Southern Cross for Mohs surgery. Futher information on Mohs surgery can be found at DermNet