Surgical Tips for Improving Cosmetic Outcomes in Dermatologic Surgery

Conclusions

• The presentation concludes that simple preoperative communication tricks, like marking plans on the back of a glove and showing orienting lines, can improve patient understanding and surgical precision.
• It suggests that microdosing clindamycin in local anesthetic may reduce infection risk enough to spare many dermatologic surgery patients from oral antibiotics.
• A major takeaway is that minimizing pain during numbing and procedures improves the patient’s overall perception of the surgeon’s skill and experience.
• The talk concludes that assistants can be used more efficiently for knot tying under tension, but that surgeons can also manage tension independently with a slipknot technique.
• It emphasizes that longer-lasting absorbable sutures such as PDS or Maxon are preferable for high-tension trunk and extremity wounds because scar strength returns slowly.
• The presentation argues that buried vertical mattress or heart-shaped setback sutures provide better eversion and scar outcomes than standard deep sutures in many closures.
• It concludes that properly placed deep sutures should leave the epidermal edges nearly tension-free, which improves healing and cosmetic results.
• Running subcuticular closure is presented as an attractive option for trunk and extremities when strong deep sutures are placed first.
• The talk suggests that flipping the forceps into an overhand position helps grasp needles more effectively in thick skin or with small needles.
• It concludes that running horizontal mattress sutures are especially useful in high-tension or cosmetically sensitive areas because they offload tension and improve long-term scar appearance.