The careful observation of one’s body could reveal the presence of subcutaneous swellings related to solids or liquid referable to cysts or lipomas, respectively.
The clinical and instrumental examination allows in most cases to determine the benign nature, nevertheless the differential diagnosis with some malignant diseases may not be completely smooth in pre-operative site. It happens in fact that during surgery, the experienced surgeon can observe suspicious aspects to malignancy. Only surgical excision, therefore, offers the possibility to reach a definitive diagnosis by histopathological examination of the resected specimen.
Usually surgery is performed as an outpatient procedure and is very simple from a technical point of view, however, is not free of complications, which should they occur, would be adequately well-managed in a Level III center.
The center in which in fact, we can count on a functional network of professionals with specific expertise in the field of dermatology, anesthesia, oncology, radiology guarantees maximum serenity and security in undergoing surgery.
Preparation for surgery
At least one week before the operation should be suspended the intake of medicines containing acetyl-salicylic acid (Aspirin) and the smoke: some studies have shown that the incidence of complications in the wound healing process is 10 times higher in those who smokes.
They must report the current medical treatments, possible allergies to medications, the presence of a known or suspected pregnancy.
The day before the surgery is preferable to perform a thorough cleansing of the incision site.
Do not wear metal objects on the day or nail polish on the hands and feet nails. Show up the day of the face without makeup.
It usually performs local anesthesia practiced by the surgeon. When needed you are made mild sedation so that you get the nice effect of not even remember the surgery.
The intervention of the tumor excision is performed with a scalpel and then using a suture usually intradermal and sterile plasters so you do not even need to remove the stitches.
In cases of larger tumors it may be necessary to mobilize the tissues from a nearby region of the body.
The removal is carried out so that the only by the possibility of definitive diagnosis by sending the pathologist specialist for histopathological examination.
Pain: more than a pain you will experience a nuisance that, when needed, is well controlled with standard analgesics; it is advisable to always place the ice in the treated area for periods of 15 minutes purpose analgesic, anti-inflammatory and anti-edema.
The onset of severe pain, sudden and persistent could mean the development of a hematoma or infection, so the surgeon should be informed promptly.
If it had been applied to external stitches, they will be removed after a few days.
Sometimes they may appear bruising (bruises) in the treated area. They last 7-10 days and can be disguised with makeup.
It is recommended not to wet the dressing and do not expose it to sunlight or heat sources. For a couple of weeks we should not play sports and demanding physical exercises; it is rather advisable to go for walks outdoors. Avoid exposure to the sun and / or tanning beds for at least six months or, if necessary, protect yourself with total protection creams to prevent diseases of the scarring.
You may occur COMPLICATIONS GENERAL, present in all types of surgery such as:
• A modest bleeding wound is normal. If important entities may require surgical reintervention.
• The infection usually manifests with pain, skin rash and swelling, accompanied by fever or not, and is treated with antibiotics, local dressings and only rarely requires surgery. It may result in the loss of tissue resulting in formation of unsightly scars.
• The formation of haematomas (collections of blood in depth), although very rare, is an occurrence that may occur during the postoperative course and is manifested by the rapid onset of swelling or severe pain and can be facilitated by increases in blood pressure caused by intense physical exertion. Sometimes hematomas need to be suctioned or evacuated via the re-opening of a section of the surgical wound.
• The wound dehiscence or her spontaneous reopening is a fairly common complication particularly in diabetic patients and smokers. In most cases it tends to heal with local dressings and only rarely is needed a new suture.
Among COMPLICATIONS SPECIFICATIONS include:
• Nerve damage (rare). Related clinical manifestations are generally temporary.
• Chronic pain (very rare).
• Allergies. There are reports of allergic reactions to patches, sutures and topical creams. Generally they are of little clinical significance. More serious systemic reactions, generally due to local anesthetics or drugs taken in the peri-operative period. Serious reactions may require additional medical treatment.
• “Dog Ears”. Consist of small folds of skin at one end or both of the wound. Fall within the technical need to contain the length of the wound. They may disappear in the months following, or more rarely require a little tweaking of a few millimeters lengthening the final scar.
• incomplete excision. It is possible that an occurrence is highlighted histopathological examination, according to which they will decide whether or not to expand margins.
• Local recurrence. Even after removal well executed it is possible that a malignant tumor may recur.
• skin necrosis. rare, but possible especially in the more complex reconstructive procedures. It is due to a vascular suffering of the covering flap or skin graft to engraftment failure, occurs more frequently in patients with diabetes and smoking. You sometimes need a reparative surgery.
• Seroma. Absorption of the wound by the serum from the adipose tissue which was partly damaged during the removal of massive subcutaneous lipomas. You may need the placement of a drain in the wound or its aspiration syringe.
Dr. Grassetti will be made to bring down the scars in the natural folds of the body as much as possible trying to cover up. Sometimes because of post-operative complications or excessive skin reactivity of some patients the scars may become reddened, raised, widened, thus being of poor quality. In such cases they can be treated with outpatient medical treatment or if necessary with a revision surgery of distance scar one year after.