A cyst is a closed sac under the skin that contains liquid or semi-solid material, often made of keratin, the protein that makes up skin and hair. Yes, plastic surgeons frequently perform the surgical removal of various types of cysts, including epidermoid, pilar, and sebaceous cysts, as well as lipomas, which are benign fatty tumors. Their involvement is primarily due to their specialized training in achieving the best possible cosmetic outcome for the patient. This focus on aesthetic precision distinguishes their approach from that of other medical specialists who also perform cyst excision.
When Plastic Surgeons Are the Preferred Choice for Cyst Removal
The decision to seek a plastic surgeon for cyst removal is generally driven by the lesion’s location and the patient’s desire to minimize visible scarring. Cysts situated in highly visible areas, such as the face, neck, scalp, or hands, are often referred to a plastic surgeon. These areas require a meticulous approach to incision placement and closure to blend the resulting scar into the surrounding skin’s natural contours.
Plastic surgeons are particularly sought after for the removal of larger or more complex subcutaneous lesions that may require advanced tissue manipulation. A larger cyst or lipoma requires a longer incision, increasing the challenge of achieving an inconspicuous scar. If lesions have been previously inflamed or infected, the surrounding tissue may be scarred and difficult to work with, making the plastic surgeon’s expertise in reconstruction valuable.
The aesthetic consideration extends beyond simple scar reduction to include techniques that manage the surrounding skin’s tension and contour. The goal is not only to remove the lesion completely but also to ensure the final result does not create an unnatural depression or bulge in the skin. This expertise makes them the preferred choice when the primary concern is the long-term appearance of the treated area.
The Procedure: Minimizing Scarring During Excision
A plastic surgeon’s technique for cyst removal is tailored to mitigate visible scarring, beginning with careful pre-operative planning. The procedure starts with the injection of a local anesthetic, such as lidocaine, around the cyst. The surgeon then meticulously plans the elliptical incision to follow the body’s natural skin tension lines, sometimes referred to as relaxed skin tension lines or Biodynamic Excisional Skin Tension (BEST) lines.
Aligning the incision with these tension lines ensures the final scar lies parallel to the skin’s natural creases, reducing tension across the wound and promoting a less noticeable scar. Following the incision, the surgeon carefully dissects the entire cyst sac or capsule from the surrounding subcutaneous tissue. Removing the cyst wall intact prevents recurrence, which is a risk if fragments of the lining are left behind.
The layered closure provides support to the wound and minimizes tension on the skin’s surface. Deep, often dissolvable, sutures are placed in the underlying tissue layers to take the bulk of the tension off the final skin closure. The superficial skin layer is then closed with very fine sutures or specialized tapes, ensuring the edges are perfectly aligned for optimal healing.
Post-operative care focuses on scar management, with the plastic surgeon providing specific instructions on wound care and scar treatments. Recommendations frequently include the use of silicone sheets, scar massage, or specialized medical tape to further improve the scar’s appearance as it matures. This comprehensive approach is designed to yield the smallest and least noticeable scar possible.
Who Else Removes Cysts? Comparing Medical Specialists
While plastic surgeons specialize in aesthetic outcomes, several other medical professionals also perform cyst removal procedures.
Dermatologists
Dermatologists frequently manage smaller, superficial cysts and lesions, often utilizing less invasive techniques like a punch biopsy or minimal excision. Their expertise is centered on skin conditions, making them typically the first point of contact for minor skin growths.
General Surgeons
General surgeons remove cysts, particularly larger, deeper, or more complicated lesions located on the torso or limbs. Their focus is primarily on the complete, safe, and functional removal of the mass, especially if the lesion is medically concerning or requires a deeper dissection. They may also be involved if the cyst has become infected or has ruptured.
Primary Care Physicians
Primary care physicians may also remove small, uncomplicated cysts in an office setting, depending on their training and comfort level.
For any cyst that is large, recurrent, in a highly visible location, or where an optimal cosmetic result is desired, a plastic surgeon or an experienced dermatologist is generally the most appropriate referral. The choice of specialist depends on the lesion’s size, location, and the patient’s priority regarding scarring versus medical necessity.