Core Concepts of Dermatologic Surgery

Dermatologic surgery has become an integral and essential component of dermatological practice. The American Society for Dermatological Surgery refers to dermatologic surgery as a “specialty dealing with the diagnosis and treatment of medically necessary and cosmetic conditions of the skin, hair, nails, veins, mucous membranes and adjacent tissues by various surgical, reconstructive, cosmetic and nonsurgical methods” [1]. They propose that the purpose of dermatologic surgery is to repair and/or improve the function and cosmetic appearance of skin tissue. There are various dermatologic surgery procedures ranging from conventional dermatologic surgery techniques like cryotherapy, nail surgeries, and vitiligo surgeries; to more advanced cosmetic procedures like facial rejuvenation, lip augmentation, and fillers; to use of lasers, light sources, and energy-based devices. In addition to all the advances taking place in this field, one needs to be aware of the core concepts of dermatologic surgery which hold true for all these advancements. While the basics of dermatologic surgery like patient selection, Operation Theatre (OT) setup, and asepsis are covered in dermatologic surgery textbooks, the themes underlying the development and rationale of these procedures are not discussed. These fundamental concepts are learned through experience and do not translate well in textbooks. They can also guide goals and direct the development of further innovations.