Skin cyst removal is a common surgical procedure in Singapore. Skin cysts are common, noncancerous growths that can develop beneath the skin. Even though they are commonly referred to as sebaceous cysts, they are more accurately termed epidermal or epidermoid cysts as they do not actually involve the sebaceous gland. Other less common types of skin cysts include pilar cysts, dermoid cysts, pilonidal cysts and milia.
Skin cysts can appear as rounded, raised areas, often with a pore-like opening at the top known as a punctum. They may be skin-coloured, whitish, yellowish or bluish.
Skin cysts can appear anywhere on the skin including the scrotum, genitalia, fingers, and within the mouth but are most common on the face, scalp, neck, back or torso. While they are usually harmless, they can become uncomfortable or unsightly if left untreated.
Skin cysts develop when the infundibulum (opening of the pore/follicle) becomes damaged or blocked. The surface epidermal cells move deeper into the skin and multiply rather than slough off. Epidermal cells form the walls of the cyst. Keratin from the trapped skin cells mixes with sebum to form the often foul-smelling cyst contents.
Trauma to the area, such as a scratch or surgical wound, can cause damage to the gland or duct or lead to the implantation of skin cells into the skin, leading to the development of a cyst.
While skin cysts are slow-growing and often painless, there are some reasons why you may want to consider cyst removal, such as:
Incision and drainage involves making a small opening over the cyst and releasing the contents within the cyst. This is typically performed in the setting of an infected or ruptured cyst to clear away the cyst material and allow the infection or inflammation to resolve with the aid of antibiotic treatment.
Incision and drainage is usually not a permanent solution for sebaceous cysts, as the cyst wall is not removed. Once the infection/inflammation has settled down, a definitive procedure may be attempted to remove the cyst more completely.
Surgical excision is the most common technique for skin cyst removal.
Standard elliptical or lenticular excision involves:
Surgical excision uses a relatively large incision to deliver the cyst en bloc. This gives good visibility, more complete skin cyst removal and low recurrence risk. However, it may cause infection, bleeding, or nerve damage, and often results in a large linear scar that is more prone to widening or hypertrophic / keloid changes.
The desire to reduce surgical scarring and morbidity led to the development of more advanced methods such as minimal excision extraction. This involves making a much smaller incision, draining the contents of the cyst and using specialized surgical tools to remove the cyst wall through the small opening.
While this results in less scarring and faster healing than standard excision, it is more technically challenging, takes longer to do, may not remove the cyst wall as completely and may thus result in increased recurrence. Furthermore, the minimum size of the incision is still limited as it has to be big enough for the surgical tools to squeeze through, manoeuvre and extract the cyst walls. The actual size of the incision also depends on the surgeon's technical skill and experience.
This is a misnomer as laser skin cyst removal can sometimes still result in tiny pinpoint scars. Other times, though, the scar from laser skin cyst removal can be almost imperceptible compared to traditional surgical techniques.
Laser skin cyst removal involves using a laser to create a minute opening through which fine surgical instruments are inserted to clean out the contents of the cyst. Specialized tools and techniques are then used - either to coagulate and remove the cyst walls or to encourage the cyst walls to close up permanently.
While laser drainage and sclerotherapy skin cyst removals can produce minimal or no scarring, recurrence rates are relatively higher since the cyst wall is not actually physically removed.
Dr Wan is passionate about providing the best possible outcomes for patients seeking skin cyst removal procedures. Through years of experience and expertise in the field of medical aesthetics, Dr Wan has accumulated valuable insights into various methods of cyst removal, always seeking to strike a delicate balance between preventing recurrence and minimizing scarring.
Complete destruction or removal of the cyst wall is paramount in preventing cyst recurrence. However, as a medical aesthetics practitioner, Dr Wan is also acutely aware of the potential consequences of radical surgery, especially when it comes to scarring. While we strive to eradicate the cyst entirely, we must be mindful of the aesthetic implications that may follow.
When faced with cases involving infection or inflammation, removing the cyst wall surgically becomes a formidable challenge. The friability of the infected cyst wall and the difficulty in delineating surgical planes from the surrounding normal tissue necessitate a cautious approach. In such instances, Dr Wan recommends preliminary measures like incision and drainage or laser cyst removal to manage the infection or inflammation before proceeding with definitive surgery at a later stage if necessary.
While excision remains the gold standard for skin cyst removal due to its low recurrence risk, the trade-off is that traditional excision often results in relatively disfiguring scars and potential complications. To overcome these challenges, Dr Wan has explored alternative approaches to improve patient satisfaction and aesthetic outcomes.
Minimal incision extraction is one such approach that holds great promise in reducing scarring and enhancing the cosmetic outcome. However, this technique is not without its challenges. It demands more time and technical precision. Even so, the incision size is still limited by the size of access required for the surgical tools.
The delicate balance between preventing recurrence and minimizing scarring drives Dr Wan to constantly innovate skin cyst removal techniques to achieve the best results for patients. One such advancement is laser cyst removal, which shows immense potential in reducing scarring and lowering recurrence rates. Embracing such cutting-edge technologies allows us to deliver superior care and achieve the desired outcomes for those seeking cyst removal procedures.
FOUNDER / MEDICAL DIRECTOR
Yes, in many cases, your general practitioner (GP) can remove a cyst. However, whether your GP can perform the procedure depends on various factors, including the size, location, and complexity of the cyst.
While some GPs can perform incision and drainage or cyst removal surgeries, there are distinct advantages to consulting a specialist. Specialists have focused expertise and experience in cyst removal, access to advanced techniques like laser cyst removal, and a higher skill level to reduce complications. They prioritize aesthetics, offering personalized care and follow-up to ensure optimal outcomes. Additionally, specialized facilities and equipment are available, making the procedure more comfortable and effective. Choosing a specialist can lead to better results, lower risks, and a tailored approach to meet the patient's aesthetic goals and overall satisfaction.
How much does a cyst removal cost? The price of cyst removal in Singapore can range from a few hundred to a few thousand dollars. As with any medical procedure, the cost of skin cyst removal can vary significantly based on the size, location, chosen method and procedure complexity. While cost is an important consideration for many patients, Dr Wan encourages them to weigh it against the potential benefits of more advanced techniques. Investing in a higher-quality procedure may lead to better aesthetic outcomes, increased patient satisfaction, and reduced chances of complications like keloid scarring, which may require additional time and effort to address in the future.
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