General Surgery Services

Breast Health Services

Robotic Hernia Repair


Robotic assisted hernia repairs are now becoming the standard of care. The surgeon, not the robot, will perform the surgery; the robot refers to the equipment that is used. This equipment has much more mobility and fine movement, so the surgeon can operate as if they are using their own hands.  In my opinion, I provide a better hernia repair because the mesh is anchored with stitches all around the edge of the mesh, creating a secure repair. I also have less of a lifting restriction after surgery, so that patients can get back to regular life sooner.

Robotic Gallbladder Surgery


The advantage that I see in using a robotic approach to gallbladder surgery, is that I can inject the patient with the die that will light up the gallbladder and important drainage systems a bright green. This helps me to avoid any injury to these extremely important parts of the body so that I can provide the safest operation possible for my patients.


Appendicitis is something that will come on relatively quickly and progress to severe pain. Classically, the patient has pain in the right lower abdomen, but many people also come in with pain in the upper belly, or around the belly button.

The typical patient usually comes in through the ER; this surgery can be done through small incisions as a laparoscopic or robotic surgery. We don’t know the true cause of appendicitis, but some medical evidence suggests that it is related to a virus, so it occurs more commonly during the flu season. If recognized early, the patient can have a straightforward surgery and be home recovering in one or two days.

Lumps and Bumps

Many patients come in for lumps and bumps underneath the skin. They are not painful necessarily, but bothersome, either because patients want to know what they are, or because they don’t like the way they look. The most common thing that I see in my practice are either lipomas or sebaceous cysts.If they are small enough, they can be removed in the office under local anesthesia, but sometimes they are big enough to require a trip to the operating room.

A lump or bump that shows an increase in size or that looks like it’s tethered to the skin should be removed, just so that you know it is not something serious. Call 210-504-5053 to schedule an appointment.

Cancer Genetic Counseling

Genetic Counseling: We are discovering now that many common and rare cancers are related to genetic changes in our DNA. This includes breast, colon, pancreatic and prostate cancer. Some patients will have many family members that have different kinds of cancers, or maybe many family members with the same cancer. There are several cancers that we know now can be grouped together and can sometimes be found to be associated with a particular gene; a famous recent example is Angelina Jolie. She carries a BRCA gene and had surgery to reduce her future risk of not only breast cancer, but also ovarian and pancreatic cancer.

For those patients that seem to have certain cancers that run in their family, or if they have a family member with a rare cancer, such as pancreatic cancer, then I discussed with those patients the option of genetic testing. Genetic testing is a saliva test that can be done in the office; almost all insurance companies pay for this if the patient has a family history of cancer that is strong enough to warrant the test. Please call the office to schedule an appointment for genetic counseling if you think you might be one of these patients.

Hemorrhoid Care

In one sense, everyone has hemorrhoids (or piles), the pillow-like clusters of veins that lie just beneath the mucous membranes lining the lowest part of the rectum and the anus. The condition most of us call hemorrhoids (or piles) develops when those veins become swollen and distended, like varicose veins in the legs. Because the blood vessels involved must continually battle gravity to get blood back up to the heart, some people believe hemorrhoids are part of the price we pay for being upright creatures.

There are two kinds of hemorrhoids: internal hemorrhoids, which occur in the lower rectum, and external hemorrhoids, which develop under the skin around the anus. External hemorrhoids are the most uncomfortable, because the overlying skin becomes irritated and erodes. If a blood clot forms inside an external hemorrhoid, the pain can be sudden and severe. You might feel or see a lump around the anus. The clot usually dissolves, leaving excess skin (a skin tag), which may itch or become irritated.

Internal hemorrhoids are typically painless, even when they produce bleeding. You might, for example, see bright red blood on the toilet paper or dripping into the toilet bowl. Internal hemorrhoids may also prolapse, or extend beyond the anus, causing several potential problems. When a hemorrhoid protrudes, it can collect small amounts of mucus and tiny stool particles that may cause an irritation called pruritus ani. Wiping constantly to try to relieve the itching can worsen the problem.

General Surgery Services

Dr. Palafox provides a wide range of general surgery services, ranging from “lump and bump” procedures that can be done in the office to complex abdominal hernia repairs using the latest technology in robotic-assisted laparoscopic approaches.

Dr. Palafox is a compassionate surgeon and will listen to you as you describe your symptoms and concerns, discuss treatment options, and explain what to expect with surgery and during recovery.

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Breast Cancer Surgery

The primary treatment for breast cancer remains surgery. We will discuss with you all of the surgical options for your cure, including plastic surgery options for reconstruction. We also provide a comprehensive consultation to include information regarding chemotherapy, radiation, and genetic counseling services.

Breast Ultrasound & Biopsy

If a mass or other abnormality can be found by ultrasound, then we can perform a core needle biopsy, often on the same day as your initial visit. This can be done comfortably under local anesthesia, and often provides a faster diagnosis. Overall, about 80% of breast biopsies are not cancer, but only a tissue sample can provide the most definitive information. Please call the office to schedule an appointment.

Implant Removal

Over time, breast implants can change shape, move, or develop contracture, or scarring, which can become painful. Some patients will develop symptoms that are consistent with breast implant-related illness.

Many insurances will cover the removal of breast implants if it is for a medically appropriate reason. Please call the office to schedule a consultation if you have any concerns about your implants.

Breast Pain

Most of us will have breast pain at some point in our lives.  Breast cancer is associated with about 10% of the time, so most breast pain has nothing to do with cancer.  It can really limit your lifestyle, however.  Call the office and make an appointment to discuss non-surgical options to manage pain.

Cancer Genetic Counseling

Since the BRCA gene was first discovered in 1994, there have been over 20 genes that have been found to be associated with a substantially higher risk of breast cancer, not to mention other cancers. The American Society of Breast  Surgery now recommends that any woman diagnosed with breast cancer be tested for one of these genes, regardless of the age at which she was diagnosed. To schedule an office or video genetic counseling appointment, please call 210-504-5053.

Breast Health Services

Dr. Palafox evaluates and manages diseases of the breast, ranging from breast pain to breast implant-related illness to breast cancer.

She has made a personal commitment to herself and to her patients to provide the highest quality care, and she will walk with you throughout treatment and recovery.  She takes cancer care and survivorship personally and will remain with you throughout your healing process.

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