Procedures

Abscess and Cyst Drainage

An abscess is a painful collection of pus caused by bacterial infection, while cysts are fluid-filled sacs beneath the skin. Both can cause discomfort, swelling, and pain. Our facility provides incision and drainage procedures to relieve symptoms, remove infected material, and promote healing. This is a safe, effective treatment performed under local anesthesia.

Initial Assessment: Your provider will examine the area to determine if drainage is appropriate. In some cases, ultrasound imaging may be used to assess the size and location of the abscess or cyst.
Anesthesia and Preparation: The area is cleaned with antiseptic solution, and local anesthetic is injected around the abscess or cyst to numb the area. Oral pain medication or mild sedation may be provided if needed for larger or deeper collections.
Drainage Procedure: A small incision is made in the skin, and the pus or fluid is gently drained. Sterile instruments may be used to break up any pockets of infection to ensure complete drainage. The cavity is then thoroughly cleaned with sterile saline solution.
Packing and Dressing: Depending on the size, a small piece of gauze packing may be placed inside the cavity to keep it open and allow continued drainage. A sterile dressing is applied over the area to protect the wound.
Antibiotics: Oral antibiotics may be prescribed to treat the infection and prevent its spread, and it's important to complete the full course even if symptoms improve.
Follow-Up: You will need to return in 2-3 days for packing removal and wound check. Additional visits may be necessary until the wound heals

Ear Lavage and Cerumen Removal

Earwax (cerumen) naturally protects and cleans the ear canal, but sometimes it accumulates and causes blockage, leading to decreased hearing, ear pain, or a feeling of fullness. Our providers safely remove impacted earwax using gentle irrigation techniques or manual removal with specialized instruments, providing immediate relief.

Pre-Treatment Assessment: Your provider will examine your ears using an otoscope to visualize the ear canal and eardrum, confirm cerumen impaction, and ensure there are no contraindications to irrigation such as ear tubes or perforated eardrum.
Softening Drops: If the wax is very hard, cerumenolytic drops (such as carbamide peroxide or mineral oil) may be placed in the ear for 15-30 minutes before irrigation to soften the wax and make removal easier.
Irrigation Technique: Warm water or a saline solution at body temperature is gently introduced into the ear canal using a specialized syringe or irrigation device. The water flows around and behind the wax, flushing it out. You'll hold a basin beneath your ear to catch the water and wax.
Manual Removal Option: For stubborn or hard wax, your provider may use specialized instruments such as a curette (small scoop), alligator forceps, or suction device to carefully remove the cerumen under direct visualization.
Post-Procedure: After removal, your provider will examine the ear again to ensure complete clearance and verify that the eardrum is intact and healthy. A few drops of drying solution (isopropyl alcohol) may be placed in the ear to remove residual moisture.
Immediate Relief: Most patients experience immediate improvement in hearing and relief from the sensation of ear fullness once the wax is removed.
Prevention Tips: Avoid using cotton swabs in the ear canal, as they can push wax deeper. Over-the-counter ear drops can be used periodically if you're prone to wax buildup.

Ganglion Cyst Aspiration

Ganglion cysts are non-cancerous, fluid-filled lumps that commonly develop along tendons or joints in the wrist, hand, or fingers. While benign, they can cause pain, limit movement, or create cosmetic concerns. Aspiration is a minimally invasive procedure that drains the cyst, providing relief without the need for surgery.

Diagnosis and Evaluation: Your provider will examine the lump to confirm it's a ganglion cyst. The cyst typically feels like a smooth, round or oval bump that may change in size. Ultrasound imaging may be used to visualize the cyst and guide the aspiration procedure.
Anesthesia: The skin over the cyst is cleaned with antiseptic, and local anesthetic is injected to numb the area. This ensures you feel no pain during the aspiration.
Aspiration Procedure: Using ultrasound guidance when needed, a needle is inserted into the cyst, and the thick, gel-like fluid is withdrawn into a syringe. The goal is to remove as much fluid as possible to collapse the cyst.
Steroid Injection: After draining the cyst, your provider may inject a small amount of corticosteroid medication into the cyst cavity to reduce inflammation and decrease the likelihood of recurrence.
Post-Procedure Care: A bandage is applied to the puncture site. You may be advised to wear a splint or brace to immobilize the joint and prevent the cyst from refilling quickly.
Success Rate and Recurrence: Aspiration successfully removes the cyst fluid, but because the cyst wall and its connection to the joint or tendon remain, ganglion cysts can recur. Multiple aspirations may be needed, or surgical removal may be recommended for persistent cysts.
Activity Modification: Avoid activities that stress the affected joint for 1-2 weeks after aspiration. Gradually resume normal activities as tolerated.

Ingrown Toenail Removal

Ingrown toenails occur when the edge of the toenail grows into the surrounding skin, causing pain, redness, and swelling. Our facility offers professional removal procedures to provide immediate relief and prevent infection. This minimally invasive treatment can be performed in-office under local anesthesia.

Procedure Overview: The affected toe is numbed with a local anesthetic injection. Your provider will then carefully remove the ingrown portion of the nail using sterile instruments. In some cases, a chemical may be applied to prevent regrowth of the problematic nail edge.
Pain Management: Local anesthesia ensures you feel no pain during the procedure. You may feel some pressure, but the area will be completely numb. After the procedure, over-the-counter pain relievers are typically sufficient for any mild discomfort.
Procedure Duration: The entire process takes approximately 30-45 minutes, including numbing time and the removal itself. Most patients can walk immediately after the procedure.
Recovery and Aftercare: Keep the area clean and dry for the first 24-48 hours. We'll provide detailed aftercare instructions including soaking instructions and dressing changes. Most patients return to normal activities within a few days.
Follow-Up Care: A follow-up visit is typically scheduled 1-2 weeks after the procedure to ensure proper healing and remove any packing material if used.

IUD Removal

An intrauterine device (IUD) is a highly effective long-term contraceptive that must be removed at expiration or if you experience side effects or wish to become pregnant. IUD removal is a quick, simple procedure performed in our office that typically takes only a few minutes and is usually less uncomfortable than insertion.

Scheduling Your Removal: IUDs should be removed when they expire (3-10 years depending on the type), if you want to conceive, or if you're experiencing problems such as pain, heavy bleeding, or the IUD has moved out of place.
Pre-Procedure Preparation: No special preparation is needed. You may take over-the-counter pain medication 30-60 minutes before your appointment if desired. If you're sexually active and don't want to become pregnant, avoid intercourse for 7 days before removal or use backup contraception, as you can conceive immediately after IUD removal.
The Removal Process: You'll lie on an exam table in the same position as during a gynecological exam. Your provider inserts a speculum to visualize the cervix and locate the IUD strings hanging through the cervical opening.
Simple Removal: Using ring forceps or a specialized grasping tool, your provider gently pulls on the IUD strings. The flexible arms of the T-shaped IUD fold up as it slides out through the cervical opening. Most women describe feeling a brief cramp or pinch.
Difficult Removals: If the strings aren't visible or the IUD doesn't come out easily, ultrasound guidance or a special hook may be used to locate and grasp the IUD. In rare cases where the IUD is embedded in the uterine wall, a hysteroscopy may be needed.
Immediate Replacement: If you wish to continue using an IUD for contraception, a new IUD can be inserted immediately after the old one is removed during the same visit.
Post-Removal: You may experience mild cramping and light spotting for a day or two. Your fertility returns immediately after IUD removal, so use alternative contraception if you don't want to become pregnant.

Intra-Articular Knee Injections

Joint injections deliver medication directly into the knee joint to reduce inflammation, relieve pain, and improve mobility. This treatment is effective for conditions such as osteoarthritis, rheumatoid arthritis, and other inflammatory joint conditions. Injections can provide significant relief when conservative treatments like medications and physical therapy haven't been effective.

Types of Injections: We offer corticosteroid injections to reduce inflammation, hyaluronic acid injections to improve joint lubrication, and aspirations to remove excess fluid from the joint. Your provider will recommend the most appropriate treatment based on your condition.
Pre-Procedure Preparation: The skin over your knee is thoroughly cleaned with antiseptic solution. Your provider may use ultrasound guidance to ensure precise needle placement within the joint space.
The Injection Process: Local anesthetic may be applied to numb the skin, though many patients tolerate the injection without it. A needle is carefully inserted into the knee joint, and if needed, excess fluid is removed before medication is injected. You may feel pressure but should experience minimal pain.
Immediate Post-Procedure: After the injection, a small bandage is applied to the injection site. You may experience temporary warmth or fullness in the joint, which is normal.
Activity Guidelines: Rest and elevate your knee for the remainder of the day. Avoid strenuous activities for 24-48 hours. Ice can be applied to reduce any mild swelling or discomfort.
Expected Results: Corticosteroid injections typically provide relief within 2-3 days, while hyaluronic acid injections may take 2-3 weeks to reach full effect. Benefits can last several weeks to months depending on the type of injection and your condition.

Laceration Repair

Lacerations are cuts or tears in the skin that require proper cleaning and closure to promote healing and minimize scarring. Our facility provides expert wound care, utilizing the most appropriate repair technique based on the size, location, and depth of your injury. Prompt professional treatment reduces infection risk and ensures the best cosmetic outcome.

Wound Assessment: Your provider will examine the laceration to determine its depth, check for foreign materials, assess for nerve or tendon damage, and decide on the best closure method.
Cleaning and Preparation: The wound is thoroughly irrigated with sterile saline solution to remove debris and bacteria. The surrounding skin is cleaned with antiseptic, and local anesthetic is injected around the wound edges to numb the area.
Closure Methods: Depending on the wound, we may use sutures (stitches) for deeper cuts, skin adhesive (Dermabond) for small superficial wounds, staples for scalp lacerations, or adhesive strips (Steri-Strips) for minor cuts with clean edges.
Multi-Layer Closure: For deeper lacerations, we use dissolvable sutures beneath the skin to provide strength, followed by surface sutures for precise edge alignment. This technique minimizes scarring and provides the best cosmetic results.
Tetanus Protection: If your tetanus vaccine isn't current or the wound is contaminated, a tetanus booster will be recommended or administered.
Wound Care Instructions: Keep the area clean and dry for the first 24-48 hours. After that, gentle washing with soap and water is recommended. Apply antibiotic ointment as directed and keep the wound covered with a clean bandage.
Suture Removal: Non-dissolvable sutures are typically removed within 5-14 days, depending on the location. Face sutures are removed sooner (5-7 days) for best cosmetic results, while sutures on joints or areas of tension stay longer.

Skin Biopsies

A skin biopsy is a diagnostic procedure where a small sample of skin tissue is removed and examined under a microscope. This helps diagnose various skin conditions, including skin cancer, inflammatory disorders, and infections. Our experienced providers perform several types of biopsies to ensure accurate diagnosis and optimal cosmetic outcomes.

Types of Biopsies: We perform punch biopsies (removing a small cylindrical sample), shave biopsies (removing surface layers), and excisional biopsies (removing the entire lesion). Your provider will recommend the most appropriate method based on the location and nature of the area being examined.
Preparation: The area is cleaned with an antiseptic solution, and local anesthetic is injected to numb the site. You'll feel a brief pinch from the anesthetic injection, but the biopsy itself should be painless.
The Procedure: Using sterile techniques, your provider will remove the tissue sample. Punch biopsies may require 1-2 stitches, shave biopsies typically don't need sutures, and excisional biopsies are closed with stitches. The entire procedure takes 15-20 minutes.
Laboratory Analysis: The tissue sample is sent to a pathology laboratory where it's examined under a microscope. Results are typically available within 7-10 days, and we'll contact you to discuss the findings.
Wound Care: Keep the biopsy site clean and covered with a bandage. Avoid strenuous activity for a few days. If you received stitches, they'll be removed in 5-14 days depending on the location.

Skin Tag Removal

Skin tags are small, benign skin growths that hang from the surface of the skin on a thin stalk. They commonly appear on the neck, underarms, eyelids, and skin folds. While harmless, many people choose to have them removed for cosmetic reasons or because they catch on clothing or jewelry. Removal is quick, safe, and can be performed during a brief office visit.

Multiple Removal Methods: We offer several removal techniques: snip excision (cutting with surgical scissors), electrocautery (burning with an electric probe), or ligation (tying off the blood supply). Your provider will recommend the best method based on the size, location, and number of skin tags.
Preparation: The area is cleaned with alcohol or antiseptic solution. For larger skin tags or sensitive locations, local anesthetic is injected to numb the area. Very small skin tags may be removed without anesthetic.
Snip Excision: This is the most common method for removing skin tags. After numbing the area, your provider uses sterile surgical scissors to quickly cut the skin tag at its base. A solution may be applied to stop any minor bleeding.
Snip Excision: This is the most common method for removing skin tags. After numbing the area, your provider uses sterile surgical scissors to quickly cut the skin tag at its base. A solution may be applied to stop any minor bleeding.
Tetanus Protection: If your tetanus vaccine isn't current or the wound is contaminated, a tetanus booster will be recommended or administered.
Wound Care Instructions: Keep the area clean and dry for the first 24-48 hours. After that, gentle washing with soap and water is recommended. Apply antibiotic ointment as directed and keep the wound covered with a clean bandage.
Suture Removal: Non-dissolvable sutures are typically removed within 5-14 days, depending on the location. Face sutures are removed sooner (5-7 days) for best cosmetic results, while sutures on joints or areas of tension stay longer.

Vasectomy

A vasectomy is a permanent form of male birth control that involves cutting or blocking the vas deferens tubes that carry sperm. This safe, effective procedure is performed in our office under local anesthesia and takes only 20-30 minutes. It's one of the most reliable forms of contraception, with a success rate over 99% once confirmed effective.

Pre-Procedure Consultation: We'll discuss the permanent nature of the procedure, alternative birth control options, and answer all your questions. You should be certain about your decision, as reversal is difficult and not always successful.
Preparation: The scrotal area is shaved and cleaned with antiseptic solution. You'll lie on an exam table, and sterile drapes are positioned to maintain a sterile field.
Anesthesia: Local anesthetic is injected into the scrotum to numb the area. You'll feel a brief pinch, after which the area becomes completely numb.
The Procedure: We offer both traditional and no-scalpel vasectomy techniques. Through one or two small openings, each vas deferens is located, cut, and sealed. The vas deferens is then returned to the scrotum, and the opening is closed or left to heal naturally depending on the technique used.
Immediate Recovery: You'll rest for a short time after the procedure before going home. Arrange for someone to drive you home. Apply ice packs and wear supportive underwear to minimize swelling.
Post-Procedure Care: Rest for 2-3 days and avoid heavy lifting and sexual activity for about a week. Mild discomfort and swelling are normal and can be managed with over-the-counter pain relievers.
Follow-Up Testing: A vasectomy is not immediately effective. Continue using backup contraception until a semen analysis confirms no sperm are present, typically after 12-16 weeks or 20-30 ejaculations.

Comprehensive Medical Procedures for Your Health