A cyst is a closed sac-like structure that forms beneath the skin or within body tissues, often filled with fluid, semi-solid material, or keratin, which is a protein found in skin cells. These growths are typically benign and may develop due to a blocked duct, infection, or trauma. Cysts are commonly removed when they cause discomfort, become a cosmetic concern, or show signs of infection and inflammation. Surgical excision is the most common method for ensuring the entire cyst wall is removed, which significantly reduces the chance of recurrence.
Addressing Pain and Numbing Agents
The surgical removal of a cyst is designed to be a comfortable experience, and patients should not anticipate feeling sharp pain during the actual procedure. Pain is prevented by the targeted application of a local anesthetic, such as lidocaine, which temporarily blocks nerve signals in the treatment area. This numbing agent is injected directly into the skin and surrounding tissue at the site of the cyst, rendering the area insensate within minutes.
The most noticeable sensation is typically the initial injection of the local anesthetic itself. Patients often describe feeling a brief, sharp pinch from the needle, followed by a momentary burning or stinging sensation as the medication is dispersed. This temporary discomfort lasts only a few seconds until the lidocaine takes full effect. Once the area is numb, the healthcare provider will test the site to confirm a complete loss of sharp sensation before beginning the surgical excision.
The Steps of Cyst Removal
The procedure begins with the medical team cleansing the skin around the growth with an antiseptic solution to minimize the risk of post-operative infection. After the local anesthetic has taken full effect, the surgeon will make an incision directly over or around the cyst. This cut is often elliptical in shape, designed to follow the natural lines of the skin to minimize the visibility of the resulting scar.
During this stage, the patient will feel pressure and movement as the surgeon works, but should not experience pain due to the numbing agent. The core of the procedure involves the careful dissection of the cyst from the surrounding subcutaneous tissue. The surgeon’s goal is to remove the entire cyst sac, or capsule, intact, as leaving small fragments behind can lead to the cyst recurring.
Once the entire sac is freed and removed, the surgeon will inspect the cavity to ensure all remnants are gone and bleeding is controlled. The final step is closing the wound. This may involve placing dissolvable sutures in the deeper layers of tissue to reduce tension on the skin surface. The outer skin layer is then closed with either non-dissolvable sutures, which will need to be removed later, or with adhesive strips.
Managing Recovery and Expectations
Following the procedure, the local anesthesia will gradually wear off, a process that typically takes between two and six hours. As the numbness subsides, it is common to experience a dull ache, throbbing, or mild soreness at the incision site. This discomfort is normal and indicates the body’s natural healing response has begun. This is usually well-controlled with over-the-counter pain relievers like acetaminophen or ibuprofen, taken as directed by your physician.
Proper wound care is essential in the immediate post-operative period to prevent infection and promote optimal healing. Patients are instructed to keep the initial dressing clean and dry for the first 24 to 48 hours to allow the incision to seal. After this initial period, the wound can be gently cleaned with mild soap and lukewarm water, then carefully patted dry before a fresh dressing is applied. Submerging the wound in water, such as in a bath or pool, should be avoided for at least seven to ten days to prevent introducing bacteria.
The healing timeline varies based on the cyst’s size and location. Sutures placed on the face or neck are often removed within five to seven days. Those on areas subject to more movement, such as the back or extremities, may remain for 10 to 14 days. After the sutures are removed, adhesive strips may be applied for several days to provide additional support to the healing incision.
Monitoring the wound for specific warning signs of a complication is important. While some mild redness and swelling are expected, patients should contact their doctor immediately if they notice any of the following:
- Increasing pain that does not improve with medication.
- Spreading redness extending far from the incision line, or excessive swelling.
- Pus or a foul-smelling discharge from the wound.
- A fever above 100.4 degrees Fahrenheit.
- The wound opening up after closure.
Resuming strenuous physical activity, especially anything that stretches the skin around the incision, should be avoided for up to two weeks to ensure the wound heals properly. Following the surgeon’s specific instructions regarding lifting and exercise is essential for minimizing tension on the healing site.