Skin Grafts


Skin grafting is a surgical procedure that involves removing skin from one area of the body and moving it, or transplanting it, to a different area of the body. This surgery may be done if a part of your body has lost its protective covering of skin due to burns, injury, or illness.

Split-thickness grafts

A split-thickness graft involves removing the top layer of the skin — the epidermis — as well as a portion of the deeper layer of the skin, called the dermis. These layers are taken from the donor site, which is the area where the healthy skin is located. Split-thickness skin grafts are usually harvested from the front or outer thigh, abdomen, buttocks, or back.

Split-thickness grafts are used to cover large areas. These grafts tend to be fragile and typically have a shiny or smooth appearance. They may also appear paler than the adjoining skin. Split-thickness grafts don’t grow as readily as ungrafted skin, so children who get them may need additional grafts as they grow older.

Skin Graft

Full-thickness grafts

A full-thickness graft involves removing all of the epidermis and dermis from the donor site. These are usually taken from the abdomen, groin, forearm, or area above the clavicle (collarbone). They tend to be smaller pieces of skin, as the donor site from where it’s harvested is usually pulled together and closed in a straight-line incision with stitches or staples.

Full-thickness grafts are generally used for small wounds on highly visible parts of the body, such as the face. Unlike split-thickness grafts, full-thickness grafts blend in well with the skin around them and tend to have a better cosmetic outcome.


The graft should start developing blood vessels and connecting to the skin around it within 36 hours. If these blood vessels don’t begin to form shortly after the surgery, it could be a sign that your body is rejecting the graft.

This may happen for several reasons including infection, fluid or blood collecting under the graft, or too much movement of the graft on the wound. This may also happen if you smoke or have poor blood flow to the area being grafted. You may need another surgery and a new graft if the first graft doesn’t take.

The donor site will heal within one to two weeks, but the graft site will take a bit longer to heal. For at least three to four weeks after the surgery, you’ll need to avoid doing any activities that could stretch or injure the graft site. A follow-up appointment will be needed to determine when you can resume your normal activities.

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Mole Removal

Mole Removal

A mole is typically a small spot, mark, or raised area on your skin. This could be a freckle, skin tag, or any small pigmented patch. Under a local injection anesthetic, a mole is generally treated with a shave and cautery technique. This means that a small knife blade is used to remove the mole at the skin level, and then a cautery device is used to stop any bleeding. They often heal imperceptibly, with little evidence of scarring (not always, but surely 99% of the time).


If there is discomfort, it can be relieved with prescribed pain medication. A scab usually will develop, and then heal within a week or two. Also any redness that occurs will disappear within two to four weeks. Most scars that do appear slowly fade over time.

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A lipoma is a growth of fat cells in a thin, fibrous capsule usually found just below the skin. Lipomas are the most common noncancerous soft-tissue growth.

Lipomas are found most often on the torso, neck, upper thighs, upper arms, and armpits, but they can occur almost anywhere in the body. One or more lipomas may be present at the same time.

Lipoma removal surgery often only requires local anesthesia and can be performed as an out-patient procedure, but this depends on the size and number of the lipomas and the method of removal.

The skin is incised over the lipoma, and the fatty tissue is meticulously dissected away. The dissection technique may, in selected cases, be combined with a “press and squeeze” method. The surgeon places the incision directly over the lump and orients it in such a way that it gets hidden by natural wrinkles and creases of the skin. It’s analogous to delivering a baby through a small access area. After the lipoma has been completely removed from under the skin, the incision will be meticulously sutured closed with dissolving sutures.

Diagram of a Lipoma

People who have a family relative with one or more lipomas have a higher risk of developing this condition. Lipomas are also more likely to occur in people aged between 40 and 60 years old. Other risk factors for developing a lipoma may include:

  • Obesity
  • High cholesterol
  • Diabetes
  • Liver disease
  • Glucose intolerance

Liposuction is a minimally invasive method that involves removal of the fatty tissue lump by making a tiny incision at the site. The surgeon may even decide to place the incision in a remote hidden site. Liposuction is more commonly used for removal lipomas on the face and other visible areas.

When should you consider removing a lipoma?

Lipomas are usually harmless, so most people do not need to have surgery to remove them. People may want to remove a lipoma that:

  • is cancerous
  • is large, impinges on movement, or growing quickly
  • causes bothersome symptoms, such as pain and discomfort
  • interferes with normal body functions
  • causes distress for cosmetic reasons
  • the doctor is unable to confirm is a lipoma rather than another type of tumor

Removal procedure

Dr. Michael K. Kim can often remove a lipoma surgically. One method is to make a small cut in the skin and then squeeze out the lipoma. The person is usually under local anesthesia during the procedure and should be able to return home on the same day.

That said, Dr. Kim may need to make a more significant incision to remove larger lipomas entirely. It is also possible to remove some lipomas using liposuction. To do this, the doctor will need to cut into the lump and insert a thin, hollow tube through the incision. They will then use the tube to suck the mass of fat cells out of the body.

After surgery, Dr. Kim will usually send the lipoma material to a laboratory for analysis. These types of operations will often only leave a small scar once the wound has healed.


Patients may return home immediately following their lipoma removal but should expect to return for a post-operative visit to ensure your treatment site is healing properly. No matter the technique used to excise the lipoma, Dr. Kim will typically sent out a sample to a laboratory for testing, ensuring the fatty tissue is not cancerous. Although benign lipomas are not cancerous, strict precautions are always made to ensure the safety and health of each patient.

Check out my blog video post detailing a successful large lipoma removal surgery.

What are the pros and cons of lipoma removal surgery?


  • Surgically removing a lipoma prevents it from becoming larger.
  • The removed tissue is large enough to biopsy and confirm that there’s nothing more serious going on. Sometimes doctors mistake liposarcoma (a malignant tumor) for deep seated lipoma, so removing it proactively could save your life.
  • Once the growth is gone, you’ll likely feel more comfortable and be more satisfied with your appearance.


  • There’s a small risk of infection or irritation at the removal site.
  • The procedure will result in a small scar, so consider the location if that’s a concern.
  • There is a chance of lipoma recurrence in the same site or surrounding tissue.

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Cyst Removal

Cyst Removal

cystremovalCysts in the skin are also known as sebaceous cysts or epidermoid cysts. Cysts that are very large and result in symptoms due to their size may be surgically removed. Sometimes the fluid contained within a cyst can be drained, or aspirated, by inserting a needle or catheter into the cyst cavity, resulting in collapse of the cyst. Imaging such as ultrasound or CT scanning may be used for guidance in draining (aspirating) cyst contents.

Cyst or lesion removal is performed on an outpatient basis. Anesthesia is used to prevent any pain or discomfort during treatment.

Dr. Kim is very conscientious of the placement and nature of incisions; with the right technique, the scarring can be minimal. For example, by placing the incision in the natural creases of the skin and using special closure techniques, the resulting scar is hardly visible.

After the area has been numbed, Dr. Kim will make the incisions around the lesion or cyst. He then excises the tissue and if it seems suspicious, a specimen may be sent to a pathologist for further examination. The incision is closed with suture material and dressed with a bandage.


Cyst or lesion removal typically does not require extensive downtime or recovery. Most patients are able to return to work or school the next day. 

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Skin Cancer

Skin Cancer


Melanoma is the most dangerous form of skin cancer and Florida has the highest rates of melanoma in the United States. It has the potential to grow and spread, invade the bloodstream and spread to other parts of the body, such as the lungs, brain or even bone. Early detection, diagnosis and surgery are the most important factors in achieving a positive result when treating a melanoma. For more information on melanoma, please visit the officialSkin Cancer Foundation's website.

Basal Cell Carcinoma

Basal cell carcinoma (BCC) is a type of skin cancer. Caused by excessive exposure to ultraviolet (UV) radiation from the sun, it appears most commonly on areas of the body with the greatest sun exposure. BCCs are normally painless and slow to develop. They can look like ulcers or open sores or scars, with a pale waxy appearance being quite common. BCCs spread to other areas extremely rarely but if left to grow they can be extremely disfiguring when finally removed.

BCCs are easily treated in their early stages. The larger the tumor has grown, however, the more extensive the treatment needed. While BCCs seldom spread to vital organs, they can cause major disfigurement and occasionally result in nerve or muscle injury. Certain rare, aggressive forms can be lethal if not treated promptly.

When small skin cancers are removed, the scars are usually cosmetically acceptable. If the tumors are very large, a skin graft or flap may be used to repair the wound in order to achieve the best cosmetic result and facilitate healing.

Squamous Cell Carcinoma

Squamous cell carcinoma (SCC) is another more aggressive skin cancer. Squamous cell carcinoma is an uncontrolled growth of abnormal cells arising in the squamous cells, which compose most of the skin’s upper layers (the epidermis).

While SCCs most often occur on sun-exposed areas, they can also occur in any part of the body where squamous cells are present such as the inside of the mouth or even genitalia. They often look like crusty red sores or warts and they may bleed. They can spread to lymph nodes and become extremely difficult to treat, so early intervention is crucial to a cure.

SCCs often look like scaly red patches, open sores, elevated growths with a central depression, or warts; they may crust or bleed. They can become disfiguring and sometimes deadly if allowed to grow.

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