Dermatologic Surgery in Puebla

What is dermatologic surgery?

Dermatologic surgery is the surgical removal of skin lesions —moles (nevi), cysts, lipomas, warts and cutaneous tumours, both benign and malignant— performed by a surgeon in an operating or procedure room. Its dual aim is to remove the lesion completely and, where appropriate, to reconstruct the resulting defect so the scar is both functional and discreet.

One principle sets it apart from laser or cautery treatments: surgery preserves the tissue so it can be analysed. Every lesion removed is sent for histopathology —the microscopic study of the tissue by a pathologist— which confirms what it truly was and, in the case of cancer, whether it was removed with adequate margins. Burning or vaporising a lesion with a laser destroys that information: it can look fine on the surface and leave disease underneath.

For that reason, when there is a suspicion of skin cancer —basal cell carcinoma, squamous cell carcinoma or melanoma— the correct approach is surgical excision with tissue analysis, never a laser treatment alone. Lasers have their place in already-diagnosed benign lesions and in polishing scars, not in a lesion whose nature is still unknown.

Skin is an organ, and operating on it well demands the same judgement as any surgery: correct margins, layered closure, respect for the skin’s tension lines and, if the defect is large, reconstruction techniques. A mole removed without judgement leaves a scar worse than the lesion; removed with technique, it is barely noticeable.

Techniques used by Dr. Arístides Arellano

Not every lesion is removed the same way. The technique is defined at the consultation according to the type of lesion, its size, its location and, above all, whether it is benign or suspicious for malignancy:

• Simple excision with primary closure: the lesion is removed as a spindle and the skin is closed in layers, following the natural tension lines so the scar stays fine and aligned. It is the technique of choice for most moles, nevi and small benign lesions.
• Excision with safety margins plus histopathology: when the lesion is suspicious or already known to be a skin cancer, it is removed with a margin of healthy tissue around it and everything is sent for study. The pathologist confirms the diagnosis and verifies that the borders are clear; the cure depends on that.
• Biopsy (shave, punch or incisional): when a diagnosis is needed before deciding on the definitive surgery, a representative sample of the lesion is taken for analysis.
• Removal of cysts and lipomas: sebaceous or epidermoid cysts are taken out whole, with their capsule, to prevent recurrence; lipomas (benign fatty tumours) are freed from the tissue and extracted intact.
• Reconstruction with flaps or skin grafts: when an excision —especially of a cancer on the face— leaves a defect that cannot be closed directly, it is reconstructed by moving neighbouring skin (a flap) or bringing skin from another area (a graft). This is where plastic-surgery training makes the difference to the final result.
• Electrosurgery and curettage: reserved for already-diagnosed superficial benign lesions —warts, keratoses, small fibromas— where studying the whole tissue is not required.

How is it performed?

Most dermatologic surgery is performed under local anaesthesia, on an outpatient basis, in a session lasting 20 to 60 minutes depending on the size of the lesion and whether reconstruction is needed. Large, multiple or flap-requiring lesions may be done under sedation.

After infiltrating the anaesthetic, Dr. Arístides marks the limits of the excision respecting the skin’s tension lines, removes the lesion with the appropriate margin and —except for superficial benign lesions treated with electrosurgery— places it in a container to send it for histopathology. He then closes the defect in layers, with internal sutures that take off tension plus surface sutures, or with a flap or graft when the size demands it.

The histopathology result usually takes a few days. When it confirms that the lesion was a cancer and that the borders came back clear, the lesion is considered treated; if a border was involved, a margin widening is scheduled. This traceability —knowing exactly what was removed and whether it was removed completely— is the reason surgery exists over methods that destroy the tissue.

The whole procedure is planned at the consultation: which lesion is operated, with which technique, with which type of closure and what to expect from the scar. When a lesion coincides with another facial procedure, resolving it in the same session may be considered; what to combine and what not is decided at the consultation.

All surgery carries risk and requires a prior medical assessment. Results may vary according to each patient, their anatomy and their individual healing process.

Who is a good candidate?

A good candidate is anyone with a skin lesion that must be studied or removed —for suspicion of malignancy, for symptoms or for cosmetic reasons— and in general health that allows a minor operation. The consultation defines the urgency and the technique:

• Moles that change: that grow, change colour, bleed, itch or have irregular or asymmetric borders. A changing mole should be seen promptly; it is not treated with laser, it is studied.
• Lesions suspicious for skin cancer or cancer already confirmed by biopsy (basal cell, squamous cell or melanoma) requiring excision with margins and histopathology.
• Cysts, lipomas and other benign lesions that are bothersome, become inflamed, grow or are uncomfortable because of their location.
• Moles or lesions in visible areas that the patient wishes to remove for cosmetic reasons, seeking the best possible scar.
• Lesions that rub against clothing or when shaving and become repeatedly irritated.
• It is not the right path when the lesion first needs a dermatologic diagnosis of another kind, nor does it replace regular skin checks; this is guided at the consultation.

Recommended post-surgical treatments

To care for the scar and help it stay as inconspicuous as possible, once the sutures are removed Dr. Arístides may recommend, case by case, strict sun protection of the area, topical scar treatment and, over the already-matured scar, laser polishing. See the full guide: Post-surgical recovery and care.

Before and after

Most patients want to see before-and-after photographs before deciding. Out of respect for each person’s privacy, Dr. Arístides Arellano shows real cases —always with documented consent— during your in-person consultation, where you can review results from patients with a starting point similar to yours. Results may vary from patient to patient.

Approximate price

The cost of dermatologic surgery has no single figure, and publishing one would be misleading: it depends on the size and number of lesions, their location, whether reconstruction with a flap or graft is required, and the histopathology study, which the pathology laboratory quotes separately. It is therefore defined at your consultation, with a written quote and no surprises. Approximate price — the definitive cost is set at your private consultation with Dr. Arístides Arellano. See the price list.

About Dr. Arístides Arellano

Dr. Arístides Arellano is a plastic surgeon holding a specialty licence: he practises under a Mexican medical licence (D.G.P. 1125959) and a specialty licence in Plastic & Reconstructive Surgery (0002008), both issued by the Directorate General of Professions (DGP), which reissued his certificate of professional standing in 2025. His career began before Mexico’s present-day specialty-board system existed: he belongs to the founding generation of plastic surgery in Puebla, the second generation of a surgical tradition started in 1971 by Dr. Francisco Arellano Ocampo. Trust is verified, not promised: both licences are public and anyone can look them up in the DGP’s National Registry of Professionals.

Related patient guide

Before deciding who should operate on you, it is worth getting informed: How to choose a plastic surgeon in Puebla — part of the series of informational guides reviewed by Dr. Arístides Arellano.

Trust is verified, not promised. All 210 scanned documents —degree, licences, diplomas, publications and certificates, from 1977 to 2025— are open in Dr. Arístides Arellano’s credential archive, alongside an explanation of the difference between a specialty licence and a board certification.

Recovery · step by step

• Days 1–2Dressing over the wound, kept dry. Mild discomfort, controlled with analgesics. Avoid wetting or straining the area.
• Days 3–7Wound care as indicated. The wound closes on the surface. Relative rest of the operated area; low-impact daily activity may resume.
• Days 7–14Removal of surface sutures depending on location (earlier on the face, later on trunk and limbs). The histopathology result usually arrives in these days.
• Weeks 2–6The scar is closed but still immature, reddish or firm. Strict sun protection and, if indicated, topical scar treatment. Gradual return to exercise.
• Months 3–12The scar matures, lightens and flattens progressively. This is the time to consider laser polishing if needed. The definitive result is seen in this period.

Frequently asked questions

Every figure published on this site is approximate and is not a quote. Any procedure or treatment first requires a private assessment consultation with Dr. Arístides Arellano —$800 MXN, charged separately— and it is at that consultation that the definitive cost of your case is determined.

Educational content; it does not replace a medical consultation. Results may vary from person to person.