Minor Surgical Procedures

Minor surgical procedures cover short interventions that can be performed in the office under local anaesthesia, without hospital admission. Lipoma (fatty lump) and epidermal cyst excision, mole/wart removal, soft-tissue abscess drainage, ingrown toenail correction and foreign-body removal are the most common.

Which Procedures Qualify as "Minor Surgery"?

• Lipoma excision — complete removal of soft, mobile subcutaneous benign fatty lumps.
• Epidermal (sebaceous) cyst excision — not drainage; the capsule is removed in full to prevent recurrence.
• Mole (naevus) and skin-tag excision — with histopathology when indicated.
• Acrochordons (skin tags) — small pedunculated growths on the neck, axilla and groin.
• Soft-tissue abscess drainage — incision and drainage of pus collections.
• Ingrown toenail surgery — segmental removal or phenol matrixectomy for a permanent solution.
• Foreign-body removal — glass, wood or metal splinters embedded under the skin.
• Pilonidal sinus dressings and elective excision planning.
• Nail-bed injuries.
• Suturing of small wounds.

Pre-Procedure Assessment

A detailed history is taken: medications (especially anticoagulants — aspirin, clopidogrel, warfarin, NOACs), allergies (especially local anaesthetics), diabetes control, prior infections and pregnancy status. For suspicious or deeper lumps, ultrasound clarifies the lesion's relationship to vessels and nerves. Anticoagulant management is planned with the prescribing physician.

Local Anaesthesia: A Pain-Free Experience

All procedures use lidocaine (with or without epinephrine) infiltration. Topical anaesthetic cream is applied 20–30 minutes before to dull the needle prick. In children and on facial areas, "buffered lidocaine" minimises burning. For sensitive zones near vessels or nerves, regional nerve blocks are used.

The Procedure

A sterile field is prepared; the skin is cleaned with chlorhexidine or povidone iodine. After anaesthesia, an incision appropriate to the lesion is made. Every excised tissue — especially moles, cysts and suspicious lumps — is sent to histopathology. The defect is closed with primary closure, local flap or, rarely, a skin graft, planned along Langer's lines for the best aesthetic outcome. Sutures are removed in 5–14 days depending on location.

Aftercare

• Dressing stays dry for 24–48 hours; afterwards, gentle daily cleaning and an antibacterial ointment.
• Mild swelling and tenderness are normal; paracetamol usually suffices. NSAIDs require physician approval.
• Cold packs (15 min on / 15 min off) during the first 48 hours reduce swelling.
• Avoid heavy sport, swimming and skin-stretching movements for the first 2 weeks.
• SPF 50+ sun protection for at least 3 months prevents scar darkening.
• Silicone gel for 4–12 weeks; PRP or mesotherapy as needed.

Risks and Complication Management

Risks are low: infection (<2%), haematoma, allergic reaction, scarring (keloid risk especially on the décolletage and shoulders), rarely nerve injury. In high-risk areas (face, near joints, keloid-prone skin) special technique and pre-warning are planned. Informed consent is obtained for every procedure.

Who Is Not a Candidate?

• Active systemic or local skin infection (needs treatment first)
• Uncontrolled diabetes or bleeding disorder
• Known allergy to local anaesthetics (alternative plan)
• Very large, deep, or vessel/nerve-related lumps — general or plastic surgery referral is preferred