Skin Surgery Services at IVSI

Procedural Dermatology — What We Do and How It’s Performed

International Vein & Skin Institute offers a range of in-office procedures used to diagnose, remove, or manage skin lesions. Each procedure is selected based on lesion type, depth, location, diagnostic requirements, and healing considerations.

All procedures are personally performed by Dr. Tryzno using sterile technique, appropriate anesthesia, and established medical standards. Surgical CO₂ laser technology is used selectively as a cutting or ablative instrument when it provides advantages in precision, hemostasis, or cosmetic outcome.

DIAGNOSTIC BIOPSY PROCEDURES

Biopsy procedures are performed to establish or confirm the diagnosis of a skin lesion when clinical examination alone is not sufficient.

PUNCH BIOPSY

A punch biopsy removes a full-thickness cylindrical sample of skin.

How it is performed:

Local anesthesia is administered
A circular punch instrument removes a small full-thickness skin sample
The wound is closed with 1–2 sutures
Tissue is sent for pathology examination

This method preserves tissue architecture and is commonly used for inflammatory conditions, pigmented lesions, or lesions requiring depth assessment.

SHAVE BIOPSY

A shave biopsy removes the raised portion of a lesion at the skin surface.

How it is performed:

Local anesthesia
Lesion is removed using a shave instrument or fine tissue scissors, depending on size
Hemostasis achieved using CO₂ laser coagulation
Sutures are typically not required
Tissue is submitted for pathology examination

Shave biopsy is often used for raised, superficial lesions when full-thickness sampling is not required.

EXCISIONAL BIOPSY

An excisional biopsy removes the entire lesion with a narrow margin for diagnostic purposes.

How it is performed:

Local anesthesia
Incision performed using a surgical CO₂ laser in cutting mode
A small surrounding margin is included
Wound is closed with simple sutures
Tissue is sent for pathology examination

This technique is used when complete removal is preferred and preservation of diagnostic integrity is essential.

THERAPEUTIC SKIN PROCEDURES

SURGICAL EXCISION

Surgical excision is performed to remove a lesion in its entirety with margins appropriate to the diagnosis.

How it is performed:

Incision performed using a surgical CO₂ laser in cutting mode
Lesion removed with appropriate margins
Wound closed in 1–3 layers, depending on size and location
Suturing follows accepted medical standards
Tissue submitted for histopathologic examination

This approach is used when complete removal is required while preserving surrounding healthy tissue, with margin selection based on clinical findings and diagnostic needs.

INCISION & DRAINAGE (I&D) — CYSTS & ABSCESSES

Incision and drainage is performed for inflamed, infected, or ruptured cysts and abscesses.

How it is performed:

Local anesthesia
Controlled incision to release contents
Cavity is irrigated
Packing or a drain may be placed when indicated to allow continued drainage
Wound may be partially closed or left open
Healing may occur by secondary intention

This procedure relieves infection and pressure but does not remove the cyst wall unless followed by later excision after inflammation has resolved.

LASER-BASED PROCEDURES

CO₂ LASER ABLATION / EVAPORATION (ABLATIVE LASER)

Ablative surgical CO₂ laser removes tissue by controlled vaporization.

How it is used:

Precise removal of selected lesions
Excellent bleeding control
Particularly useful in facial and cosmetically sensitive areas
Healing occurs through re-epithelialization

The CO₂ laser in this setting functions as a surgical instrument, not a cosmetic rejuvenation-based treatment.

NON-ABLATIVE LASER PROCEDURES — VASCULAR LESIONS

Non-ablative vascular lasers target hemoglobin within abnormal vessels. Healing varies by lesion type and may include temporary redness, bruising, or mild crusting.

Used for:

Cherry angiomas
Small pyogenic granulomas
Selected superficial vascular lesions

IMPORTANT CONSIDERATIONS & POST-PROCEDURE CARE

What happens after your procedure plays an important role in healing.

Careful adherence to post-operative instructions during the first several weeks supports proper wound healing and reduces the risk of complications.

SCARRING AND HEALING EXPECTATIONS

A permanent scar is an expected outcome of every surgical skin procedure
Meticulous wound care and appropriate follow-up help reduce the risk of unfavorable scarring
Some individuals may develop prominent scars despite appropriate care
Avoid touching, squeezing, or irritating the healing area
Friction from clothing, straps, or accessories should be minimized
Certain skin types are more prone to hypertrophic or keloid scarring

SUTURED WOUNDS — RISK OF DEHISCENCE

Healing wounds are sensitive to tension and movement.

Excessive motion may cause sutures to pull through tissue, resulting in wound separation.

High-risk areas include:

Back
Calves
Jawline
Perioral region
Other high-mobility areas

Activities such as running, squatting, bicycling, heavy lifting, excessive chewing, gum chewing, or exaggerated facial expressions may need to be limited.

Back excisions are particularly prone to tension-related healing issues. Activity restrictions are individualized based on procedure location.

YOUR ROLE IN PROPER HEALING

Every procedure at IVSI is performed using careful technique, appropriate planning, and established medical standards. However, healing after surgery is just as important as the procedure itself.

While surgical technique determines how a wound begins to heal, the final outcome depends significantly on how the treated area is cared for during recovery.

Proper healing requires active participation:

The procedure is performed by the physician
The healing process continues with the patient

Following post-procedure instructions, limiting activity when advised, and protecting the surgical site are essential to reduce complications such as wound separation, infection, and excessive scarring.

Clear instructions are provided, and follow-up is available whenever questions arise.

Skin Surgery Evaluation

A skin surgery evaluation helps determine the safest and most appropriate approach.

📞 Call (847) 518-9999 to schedule a skin surgery evaluation.

Medical Disclaimer
The information on this page is provided for educational purposes only and does not replace professional medical evaluation, diagnosis, or treatment. Treatment recommendations are based on individual clinical findings, diagnostic testing when indicated, and patient-specific factors. Outcomes may vary, and no specific medical or cosmetic result can be guaranteed.

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