Surgical pearls in dermatology: Tips for scalp, nail, and cutaneous procedures

Dermatologic surgeons often perform procedures independently without the assistance of a surgical team, which poses specific technical and operational challenges. Although many of these maneuvers are commonly used in clinical practice, they remain underreported in the scientific literature. This article describes five straightforward and cost-effective techniques that can minimize complications and improve surgical outcomes for both trainees and experienced dermatologic surgeons performing procedures independently. These strategies are based on a review of the existing literature and the authors’ personal experiences and include methods for safe exposure of scalp lesions with microporous tape and glove finger fragments; construction of compressive dressings; utilizing botulinum toxin vial caps for compressing earlobe incisions to prevent keloids; adapting a 3-mL syringe for postoperative support of the nasal ala; and draining subungual hematomas using a heated needle. The objective is to share techniques and maneuvers that enhance execution and minimize complications of dermatologic procedures performed without assistance.