Surgery

Surgery

In the MediDerm clinic, we perform several types of surgical procedures. For our patients, this is just one step in our caring for their health. We assure you that our team will stand by you each step of the way – from initial examination to the surgical procedure and full recovery.

DERMATOSURGERY

Surgical procedures are an indispensable part of diagnostic therapeutic methods in dermatology. The frequently used procedure is excision; taking skin samples for pathohistological diagnosis. After it, the tissue is healed without scarring and no sewing is required. There is also the deep biopsy in local anesthesia, which affects all skin layers. Sewing is necessary afterward, sometimes with subcutaneous stitches. A procedure that removes benign and malignant skin tumors in dermatology is known as the “excisio in toto” (complete surgical removal). This procedure is performed in local anesthesia and as a final stage of the procedure itself involves placing various types of stitches in the cut area.

PROCEDURE: The growth to be analyzed is placed in 4% formalin for pathohistological examination. Once a final diagnosis of the skin growth is obtained, our patients are promptly informed. After two days, the patient comes in for a bandage change, and after 7-14 days, depending on the area from which the lesion was removed, stitches are removed. The final histopathologic diagnosis is obtained within 3-4 weeks, of which we inform our patients via the contact they have left us. Indications for surgical removal are moles, lipomas, various cysts, malignant skin tumors, and melanomas.

SKIN REJUVENATION

Soft Surgery (Plexr +)

A unique device in the market that has many uses in aesthetic medicine – non-surgical blepharoplasty, periorbital regeneration, perioral rejuvenation, neck and cheeks rejuvenation, hyper and hypopigmentation removal, nipple removal, keratosis and fibromyalgia, and acne and stretch mark scars. Profilho is a dermal filler that combines high and low molecular weight hyaluronic acid and thus combats the loss of volume, tone, and elasticity of the skin, and stimulates the synthesis of 4 types of collagen and elastin. The application takes place in 5 areas of the face and thus acts as a full face treatment.

The application last for only 10-15 minutes. During the application, 2 ml of hyaluronic acid is applied. After this, the face immediately looks fresher and the full effect is visible within a month. Profilho can also be used for the neck, upper arms, and fists.

HAND SURGERY AND SCAR CORRECTION

HAND SURGERY

Hand tumors

The most common hand tumors are CYSTIC TUMORS or GANGLIONS. They occur more frequently in women in the area of the wrist, usually about 2-3 cm large. They are ball-shaped, filled with gelatinous mass. They usually have no symptoms, but they can cause pain and reduce joint movement. Non-surgical treatment includes tumor compression and cyst puncture, with the likelihood of reoccurrence being over 80%, as this does not remove the communication between the wrists and the tumors. By surgical treatment in our clinic, we achieve a much higher percentage of full healing because with the surgery we remove the ganglion in its entirety. The procedure is performed in local anesthesia in a bloodless field.Sindrom karpalnog kanala.

Carpal canal syndrome

It occurs as a result of pressure on the nerve that passes through the wrist towards the hand. The most common causes of pressure are inflammation of the muscular tendons that pass through the channel, ligament thickening, rheumatoid arthritis, pressure after trauma…

Symptoms:

  • stiffness, unclear pain, and tingling in the wrist
  • changes in the muscles of the hands, hypotrophy, weakness, and loss of sensation

The procedure consists of a cut in the area of the carpal canal, releasing the nerve from the pressure. It’s performed in local anesthesia.

Dupuytren’s contracture

It begins as a nodule, most commonly in the palm area of the 4th and 5th finger. Fracture of the finger falls into a more advanced stage of the disease when surgical treatment is indicated. The most commonly performed of the surgical procedures is the PARTIAL FASCYTECTOMY by removing the thickened and changed fascias.

SCAR SURGERY

Scars are divided according to appearance, size, color, localization, and manner of creation (after burns, radiation, trauma).

Special attention should be paid to scarring after burns due to the possibility of developing skin cancer, which requires urgent surgical intervention!

Surgical procedures for their removal last for a short time (30 minutes) and afterward you can return to your daily activities within 1-2 days. There are different shapes of scars, which also defines the method of their removal:

  • ATROPY (intact white or pigmented scar of a solid, hard consistency)
  • HIPERTROPHIC (the surface of the scar is raised and occupies a larger area than the damaged skin)
  • CELLOID (there is a tendency to a growth of the scar, there is an individual tendency to tensor traumatic or non-traumatic tissue binding)

METHODS OF SCAR REMOVAL

  • surgical removal
  • cryotherapy (liquid nitrogen freezing)
  • laser
  • electrostriction
  • dermabrasion
  • medical peeling
  • intralesional drug application
  • silicone therapy
  • radiotherapy
  • phototherapy.

Curretage – a procedure in which by using a sharp metal spoon (curette) the indicated benign formation is completely scraped off the skin or visible mucosa. This method is most commonly used for the removal of vulgar and planar varies, seborrhoeic keratosis, pyogenic granulomas, condylomas, and various benign keratocyte formations.

Electrocautery – a diathermic procedure in which two electrodes are used. One of these electrodes has the shape of a loop (or needle) – it is used to access the pathological form that is being removed without bleeding or sewing.

Cryotherapy is carried out with liquid nitrogen at a temperature of -178 ° C. With a wadding wad or a special applicator, liquid nitrogen is applied directly to the skin that needs to be treated with light pressure. The application lasts up to 50 seconds, depending on the thickness of the change, its nature, and the part of the skin that is being treated with cryotherapy. For most changes in the skin, it is necessary to repeat cryotherapy in intervals of 10-14 days to reach full healing.

Indications for cryotherapy:

  • viral and plain warts
  • actinic and seborrhoeic keratoses (wrinkled skin on the skin)
  • condyles (genital warts)
  • smaller hemangiomas (benign tumors)
  • lymphangiomas
  • keloids (scars created by the uncontrolled formation of connective tissue)
  • surface basaliomas (the most common form of skin cancer).

AESTETICHS OPERATIONS

In the MediDerm clinic, a special place is given to the aesthetic medicine. Our team of experts, using the latest methods and the best materials, returns a smile on the face of our patients. All services in the polyclinic, as well as aesthetic, are guaranteed to be conducted with the highest degree of discretion.

LIP AESTETICHS

Various interventions are available within lips aesthetics, from classic surgical procedures to the application of one’s own fatty tissue preparations (LIPOFILER) or hyaluronic acid, as natural implants or implants from artificial materials.

BLEPHAROPLASTY

The aesthetic correction of the eyebrows and the eyelids removes the excess skin and the associated fat tissue, which removes the wrinkles around the eyes. The result is a smoother and cleaner look, and the eyes seem larger. Removal of excess skin in the lower eyelids area is also performed. The eyelids surgery is a simple surgical procedure of rejuvenation.

It is performed in local anesthesia and the vasoconstrictor is added so that the bleeding is minimal, as well as the postoperative underlay. The stitches are removed 5-7 days after the surgical procedure, and within ten days after the surgery, the hematomas and the postoperative swelling are withdrawn. The scar on the lid is invisible and the fat of the lower eyelid is removed without external scarring.

Result: a permanent solution for lowered eyelids and bags under your eyes!

OTOPLASTICS (EAR CORRECTION)

The deformation of the ear, or its irregular position compared to the head, is an inborn malformation. This corrective operation can be performed after the fifth year of life. The surgery is performed in an ambulatory manner in local anesthesia and for a few days after the operation, it is necessary to wear the head circumference. The stitches are resorbable within ten days. The scar is almost invisible.

LIPOFILLING

Transfer of fatty tissue or lipofilling is used to fill the irregularities in the body where dents have occurred or where previously limited tissue recovery has occurred after damage. The lipofilling results last several years and this is his greatest advantage compared to various filers.

The lipofilling procedure is performed in two steps: the first step is liposuction to collect fatty tissue. It is taken from the parts of the body where it’s found the most – mostly from the stomach or thigh. The tissue thus obtained is immediately processed to prepare for the application and then applied to the desired areas. It is common to repeat the method several times (1 – 3) to get the desired results.

VARICOSE VEINS SURGERY

Surgical treatment of varicose veins is the only method that offers a cure, as it involves removing the site of enlarged veins, as well as removing expanded and swaddling surface veins. In our clinic, the removal of extended veins is done according to the methods and procedures of the leading European clinics for phlebology, with particular attention given to the minimal risk of the procedure itself, as well as rapid recovery and healing.

Contemporary classical vein surgery is performed outpatient in local anesthesia and does not last more than an hour and a half, and after 15-20 minutes after surgery, you go home without having the need for someone’s help. After the surgery, it is not recommended to lie down! The operation consists of 3 phases:

  1. Crossectomy is performed through a cut in the groove where the main surface vein is located in the deep vein. The surgeon separates the deep vein saphen from the vein and removes five veins that swell into the main vein in that lobe. The importance of the crossectomy is that if it is not done, the enlarged veins will return again despite the removal of the surface veins – we get a recurrence.
  2. Striping: a part of the main surface vein is taken out, from the groove to the lower knee, by new probes that protect the surrounding tissue and cause minimal bleeding.
  3. Miniflebectomy: where all the remaining enlarged veins on the leg are covered with special hooves through miniature openings on the skin that do not need to be sew and do not leave visible scars on the leg. In this way, we achieve remarkable results in terms of aesthetics.

Benefits of this operational procedure

The procedure is performed outpatient, in local anesthesia. Immediately after the surgery the patient is referred to short-term home care and is completely independent and mobile. Removal of the main surface vein is carried out with a special probe and the vein comes out (as when we twist a sock), which significantly saves the surrounding tissue and the post-surgery hematomas are 80% smaller than in conventional striping.

Operational cuts of the skin are only 2-3 mm long, no sewing is needed and the scars are completely lost after several months, resulting in excellent aesthetic results. The possibility of re-occurrence of varicose veins after the procedure is only 1.7%.

Endovenous technique

This technique closes the main surface vein on the inside, which so clogged remains in the leg. Your body will eventually break it down, and in this way, any injury to the surrounding tissue is avoided. There are three methods of endovenous vein treatments, all done under ultrasonic supervision (Colore Doppler):

ENDOVENOUS LASER TREATMENT – EVLT

The heat of the laser beams causes photo termolysis, ie damage to all vein wall layers. In this way, it irreversibly damages the vein on the spot where blood is clotted. Blood flow is no longer possible and the vein is excluded from the circulation. A laser treatment is minimally invasive, causing minimal damage to the surrounding tissue. Laser is most commonly used for treating major surface veins, the end result being vein dehydration, which eliminates unwanted venous blood flow through the damaged vein.

RADIO-FREQUENCY CLOSURE – RFA

Radio-frequency closure of the vein is a minimally invasive surgical technique performed outpatient. Microwaves that heat up the inner wall of the vein are used to damage the bad vein.

Benefits of the RFA procedure: no blood loss, short duration (30 min), no cut in the groin, return to daily activities within 1-2 days, excellent aesthetic effect without scarring or swelling.

FOAM SCLEROTHERAPY OF THE VEIN – UGFS

It is based on artificially caused inflammation of the expanded vein wall by injecting it with a sclerosing agent in foam form. The wall of the veins sticks together, the vein shrivels and eventually dies, causing the dysfunctional vein to be excluded from the circulation and preventing further spread and possible complications. The well-performed surgery is almost painless and lasts for 20-30 minutes, after which elastic bandages are placed on the leg and worn for several days. The method is 90-95% successful and complications are very rare.