Dermatologic surgery is a discipline that has evolved dramatically from the mid-20th century to the present day. Dermabrasion, chemical peels, hair transplantation, Mohs chemosurgery, and excisional surgery were performed principally by a select group of NYU dermatologists in the 1950s, while cutaneous laser surgery was first performed at the University of Cincinnati in the 1960s. Over the years, the number of dermatologists performing these procedures increased significantly. Our knowledge of basic science has also advanced, as has our clinical expertise in wound healing and postoperative care. Dermatologic surgeons have become experts in Mohs micrographic surgery and defect reconstruction, while our cosmetic armamentarium has grown to include botulinum toxins, a variety of soft tissue fillers, sclerotherapy, ambulatory phlebectomy, nonablative and ablative lasers, fractional resurfacing, lasers for the treatment of tattoos, pigmented and vascular lesions, and liposuction. Standards of training, patient safety, informed consent, anesthesia and analgesia, preoperative evaluation, and office accreditation are now recognized to be of vital importance, and have become disciplines of their own. Now, decades after a small group of dermatologists founded the American Society for Dermatologic Surgery in 1970, surgical training has become a fundamental and required part of all dermatology residencies, while postgraduate fellowship training in procedural dermatology is an ACGME accredited subspecialty.
Developing knowledge and expertise in any field requires starting with the basics, and building upon them. To that end, we have organized this text into the following sections: surgical principles, surgical skills, skin tumors, aesthetic and laser procedures, and aesthetic problems. We have endeavored to develop a consistent format for each chapter, with high-quality photographic images and graphics to enhance the presentation of each topic. The reader may choose to progress sequentially through the book, or to focus individually on the topics of interest to them.
Our goal in developing this textbook was to compile the current, state of the art information concerning all aspects of procedural dermatology. The authors of this text are without exception leaders in their fields with a passion for teaching, and we feel fortunate to have enlisted them to assist us in this endeavor. Our hope is that this book will become a resource for all practitioners of dermatologic surgery, from the novice to the seasoned surgeon looking to refine his or her skills in a particular area. We hope you enjoy reading this book as much as we have enjoyed putting it together.
Marc R. Avram, MD
Mathew M. Avram, MD, JD
Désirée Ratner, MD