In-Office Procedures


At Premiere Surgical Specialists, we know you lead a busy lifestyle, and your time is valuable. Our expert surgeons and skilled nursing staff are able to offer a variety of services in the office, at a time and place more convenient and comfortable to you. Just make an appointment! Our services in the office include:

Breast Biopsy


Patients with breast masses, lumps , abnormal imaging and symptoms should consider prompt surgical evaluation. The surgeons at Premiere Surgical Specialists have expertise and over 75 years of combined experience in diagnosing, treating and curing both benign and malignant breast disorders. Our surgeons have privileges at all the hospitals in the Reno-Sparks area. We follow the National Comprehensive Cancer Network guidelines and closely collaborate with the community oncologists, plastic surgeons and geneticists.


Patients with pain, skin changes, nipple discharge, breast lumps, deformities or other breast signs or symptoms may frequently be diagnosed by evaluations or biopsies in our office. Mammograms may assist in this process for patients greater than 40 years of age but are not necessarily required. The best imaging tool for breast mass diagnosis is ultrasound which is available at low cost right in our office. Needle biopsy using ultrasound guidance is usually the preferred method of breast mass diagnosis and can frequently be done under local anesthesia in our office the first visit. Open biopsies and excisions may also be done in the office under local anesthesia. We believe that surgeon directed biopsy optimizes ultimate outcome by taking into consideration which approach to biopsy is best considering the overall care plan. We keep appointment slots open in our schedules to promptly evaluate new patients with Breast problems to expedite care and reduce worry. For more information on Breast Procedures, please Click Here.

Suspicious Or Symptomatic Skin Lesions


Skin growths or moles that are symptomatic or suspicious can be evaluated, biopsied and removed in our office under local anesthesia. These may be benign (non-cancerous) or malignant (cancer). If the lesion is growing, irritated, non-healing, itchy, bleeding or black or multicolored, let our surgeons evaluate it promptly. Some lesions can be fatal if discovered late such as melanoma or Merkel cell tumors. Common warts, sebaceous cysts or lipomas may cause symptoms relieved by surgical excision. If they are removed for non cosmetic reasons the surgical removal will usually be covered by insurance. If the lesions are underneath the skin, evaluation with ultrasound may be diagnostic. Ultrasound is available and less expensive in our office.

Treatment Of Varicose Veins


Varicose veins are a common surgical disease evaluated and treated in our office. Patients present with progressive enlargement of symptomatic superficial veins in their legs or mats of unsightly dermal varicosities or “spider” veins. Treatment of these veins is important as they can lead to difficult problems with skin breakdown and draining ulcers in the lower legs and ankles. Patients may have symptoms ranging from leg fatigue to pain and swelling usually aggravated by standing. These veins may spontaneously clot or bleed. Most patients have a family history of leg vein problems but they can be caused by prior episodes of clotting. Support stockings may be helpful in relieving symptoms but do little to prevent disease progression. Properly prescribed stockings may be difficult to put on and wear particularly in our warm climate.


Treatment of varicose veins has become increasingly office based. Painful surgical excision and  stripping procedures  have been generally replaced with minimally invasive  procedures. We offer injection sclerotherapy. This procedure is completely ambulatory and relatively painless. Treatment of spider veins with injection sclerotherapy is a cosmetic procedure that will make you feel better about wearing shorts or dresses. This can be scheduled in our office but is not a covered benefit by insurance plans.