Facial skin surgery & aesthetic reconstruction in Auckland

The cost depends on the size and location of the lesion, the complexity of the closure (primary closure, local flap, or skin graft), whether intravenous sedation is required, and whether pathology is included. Pathology fees are usually charged separately by the laboratory. At your consultation a full written estimate will be provided covering surgeon, theatre and pathology, along with any sedation cost where indicated.

You can make a self-referral for a skin surgery consultation, and a GP or dermatologist referral is not required to make an appointment. Many patients do come to us via referral from their GP or dermatologist, particularly for confirmed or suspected non-melanoma skin cancers (basal cell carcinoma or squamous cell carcinoma) where a biopsy has already been performed elsewhere. Please bring any prior pathology reports, clinical photographs or biopsy results to your appointment, or have your referring clinician forward them ahead of time. At consultation we will examine the lesion, discuss closure and aesthetic planning, and give you a treatment plan with all of your options.

GPs and dermatologists routinely manage many smaller lesion removals on the trunk and limbs. Specialist oral and maxillofacial surgeon involvement is usually recommended when the lesion is on the face, head or neck in a cosmetically sensitive area, when complex reconstruction is required after excision, when a prior excision was incomplete and revision is needed, or when the lesion is closely related to important structures such as the eyes, lips, nose or facial nerve. Because most of our skin surgery is on the face, incisions are planned along the natural skin tension lines where possible, and the aesthetic outcome of the scar is weighed alongside clearance of the lesion.

Most facial skin surgery is performed under local anaesthesia in one of our purpose designed surgical procedure rooms, with a protective dressing applied over the sutures (stitches) afterwards. Intravenous sedation (twilight anaesthesia) is offered for larger lesions, longer reconstructive cases, or for patients who are particularly anxious, and adds a deeply relaxed and drowsy state on top of the local anaesthetic. General anaesthesia (complete anaesthesia) at an affiliated Auckland hospital, with a specialist anaesthetist, is usually reserved for the most complex post-Mohs reconstructions or extensive non-melanoma skin cancer surgery. At consultation we will recommend the modality that suits your case.

Most patients return to desk-based work within 1 to 3 days after skin surgery. The protective dressing is kept dry and intact initially, and sutures (stitches) usually come out at 5 to 7 days for facial work, or 10 to 14 days for the scalp and body. Vigorous exercise can usually resume around 2 weeks once the wound has settled. The scar continues to mature over the following 6 to 12 months, gradually softening and paling from an initial pink raised appearance to a fine pale line. Sun protection (SPF50 and a hat) during this maturation window is the single most important factor in the final scar outcome, alongside gentle massage from around week 3.

Yes. Skin lesions that have been removed are sent for analysis under a microscope by a pathologist, and you will be given the results at your follow up appointment. This applies to moles (naevi), cysts, suspicious or changing lesions, and any non-melanoma skin cancer excision, so that both the histopathological diagnosis and the clearance of the surgical margins can be confirmed. Where the pathology identifies an incompletely excised lesion or a more aggressive subtype, further treatment options will be discussed at the follow up and a revised plan agreed. We will also write to your GP or dermatologist with the pathology result where they have referred you.

All skin surgery leaves some scar, although careful planning can make a significant difference to the final appearance. Incisions are placed along the natural skin tension lines wherever possible, layered closure is used to minimise wound tension during healing, and sun protection during the 12-month maturation phase is critical to avoid post- inflammatory pigmentation. Most facial scars settle to a fine pale line by 12 months, although individual healing varies with skin type, lesion location and the size of the original defect. Scar revision (excision and re-closure, Z-plasty, or serial excision in selected cases) can be considered if the mature result is unsatisfactory, usually no earlier than 12 months after the original surgery.