Biopsy & Surgery RefinedMD


What is a Biopsy?

A biopsy is the primary diagnostic tool of any good dermatologist worth his/her credentials. It is a simple, painless removal of either part or all of a skin lesion or a little plug of skin in an area of unexplained inflammation.

How does a Biopsy work?

The tissue is then taken to a lab where it is processed and cut into small, thin slices of tissue. The tissue is placed on a microscope slide in order to examine it for diagnosis. This process also helps Dr. Swengel to make a decision as to future therapy or need for surgery.

What can I expect on the day of Biopsy?

Once the area determined to be the best spot for making the diagnosis is selected, it is cleaned with an alcohol wipe. An injection of a local anesthetic is made only in the spot to be biopsied.

Even this injection is virtually painless. The experts at Refined Dermatology take the time to “buffer” our anesthetic to a neutral PH making the initial burn a thing of the past.

Super small needles are barely felt prior to a very slow injection of the anesthetic to numb up the area.

If we only need a bump or top layer of skin, a superficial shave is taken.

If we need a deep sample to determine what is going on in the deeper tissue, we take a core sample of skin. This needs to be closed with a couple of stitches to speed up healing and give you the best long-term appearance.

What are Surgeries?

Surgeries can range from cosmetic excisions to medically necessary removal of skin cancers and other lesions requiring excision.

Refined Dermatology surgeries require prepping the skin with sterilizing skin preps and local anesthetics. We drape the area with sterile towels then remove the lesion with the correct margins.
This is followed by what is called a layered closure.

This entails several layers of suture.  The deep sutures are the ones that do all the work. They take the tension off the wound in order to heal with the least amount of scarring. The top stitches are really there for a short period of time to “approximate” the top layer of skin for the best cosmetic results.

Orientation of a wound closure is something that is very important for best long-term results and appearance.  When able, we can hide a closure in a skin fold or in a shadowed spot so that the “casual eye” does not see it. Whenever there is a full thickness cut in the skin there will be a scar, period.  The trick is to hide the scar as much as possible and provide the suturing and support in order to make the postoperative suture line as fine as possible.

Dr. Swengel is a board certified dermatologist and surgeon who specializes in skin cancer, biopsies, and surgery. Call Refined Dermatology for your skin cancer biopsy and surgery needs.


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