A cyst is a closed sac of tissue that forms beneath the skin or inside the body, typically containing fluid, air, or semi-solid material like keratin or pus. While many of these growths are benign and pose no immediate health danger, removal is frequently sought for several practical reasons. These reasons often relate to discomfort, such as when a cyst causes pain, becomes repeatedly infected, or interferes with movement due to its size or location. Aesthetic concerns are also a common motivator for seeking professional removal.
Pre-Removal Assessment and Planning
Before any removal procedure is scheduled, a thorough assessment determines the nature and structure of the growth. This begins with a physical examination, where a healthcare provider assesses the cyst’s size, consistency, mobility, and proximity to sensitive structures. The initial evaluation is essential for deciding whether the growth is a simple cyst, a lipoma, or another type of lump.
Diagnostic imaging, such as ultrasound, visualizes the internal contents and confirms composition, distinguishing between fluid-filled and solid material. For deeper or more complex masses, a Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI) may be used to map the cyst’s relationship to surrounding organs and blood vessels. These scans help the provider choose the safest and most effective method of removal.
If the cyst’s nature is uncertain, fine-needle aspiration (FNA) may be performed using a thin needle to extract a sample of cells or fluid. The sample is sent for pathological analysis to rule out malignant cells. This diagnostic step is crucial for planning, as a suspicion of malignancy will drastically alter the subsequent treatment plan, often requiring a specialized surgical approach.
Non-Surgical Removal Techniques
For superficial or fluid-filled cysts, a non-surgical approach is often the initial treatment choice. The most common technique is aspiration, using a sterile needle and syringe to drain the contents. After the site is cleaned and local anesthesia is injected, a needle is inserted into the sac, often guided by ultrasound for deeper cysts.
The practitioner withdraws the accumulated material, which varies depending on the cyst type (e.g., thick fluid, keratinous paste, or serous liquid). Aspiration offers quick relief from pressure and swelling. However, because the procedure leaves the cyst wall intact, the cyst has a high chance of recurring.
Another option combines aspiration with an injection of a corticosteroid solution into the empty sac. The steroid injection reduces inflammation and irritates the cyst wall lining. This encourages the sac to collapse and scar down, reducing the likelihood of refilling and recurrence. These procedures are typically reserved for inflamed or smaller cysts where the complete removal of the sac is not immediately necessary.
Surgical Excision Procedures
Surgical excision is performed when a cyst is deep, has a thick wall, or has recurred after aspiration. This is the definitive treatment because removing the entire cyst sac (capsule) guarantees the cyst will not grow back. The procedure usually begins with local anesthesia, though general anesthesia may be used for large or deeply situated cysts.
The surgeon makes a precise, often elliptical, incision directly over the cyst, following natural skin lines to minimize scarring. Using careful dissection, the surgeon separates the cyst capsule from the surrounding healthy tissue. Maintaining the capsule’s integrity is important; rupturing the sac can cause contents to spill, increasing the risk of inflammation or recurrence if wall fragments are left behind.
Once the entire cyst and its wall are freed from the surrounding tissue, it is removed. The wound is closed in layers, often using dissolvable sutures deep within the tissue to reduce tension, followed by sutures or adhesive strips on the skin. For internal cysts (e.g., on ovaries or kidneys), laparoscopic surgery may be utilized, using small incisions and specialized instruments for less patient trauma.
Post-Procedure Care and Recovery
Proper aftercare is necessary following any removal procedure to promote healing and prevent complications. Immediately after, the site is bandaged; mild pain, swelling, or bruising is expected and managed with over-the-counter medication. Patients receive instructions on keeping the wound clean and dry, usually involving gentle washing after the initial 24 to 48 hours.
The wound should be monitored for signs of infection, such as excessive redness, warmth, increased pain, or yellow/green drainage. Patients are advised to avoid strenuous activities or heavy lifting for one to two weeks, which prevents the wound from reopening and ensures a better aesthetic outcome.
Recovery time varies; aspiration sites may heal in a few days, while surgical excisions requiring sutures can take up to two weeks to close. Non-dissolvable sutures are removed by a healthcare professional seven to fourteen days after surgery, when the final healing process is reviewed during a follow-up.