Excision of Skin & Soft Tissue Lesions

Overview

Mr Nguyen removes a wide variety of lumps and growths, including epidermoid cysts (blocked glands that have formed a sac under the skin), lipomas (soft fatty lumps), sebaceous cysts, pilonidal sinuses (a cyst near the tailbone or between the buttocks), perianal lumps (growths near the back passage), atypical moles, and soft tissue tumours.

For small or shallow lesions, the procedure is usually done under local anaesthetic — you are awake and the area is completely numbed, so you feel pressure but no pain. Larger or deeper lesions may need a short general anaesthetic. Everything removed is sent to pathology (a laboratory) for analysis, so you know with certainty what it was.

Who needs this procedure?

• An epidermoid or sebaceous cyst (a pocket of fluid or keratin under the skin) that keeps getting infected, is growing, or is bothering you
• A lipoma (a soft, moveable fatty lump) that is causing discomfort or you simply want removed
• A lump that needs a biopsy — it is removed completely so it can be fully examined under a microscope
• A pilonidal cyst or sinus — a pocket or tunnel near the tailbone or in the crease between the buttocks that keeps getting inflamed or infected
• A perianal lump — such as a persistent skin tag, anal wart, or other growth near the back passage
• Any soft tissue lump that needs both diagnosis and treatment in one go

Benefits

• Removes the problem and gives you a definitive answer at the same time — pathology is performed on everything that is excised
• Most small lesions need only local anaesthetic — you stay awake, go home the same day, and need minimal time off
• When the cyst wall is removed intact, the recurrence rate is very low
• Mr Nguyen plans incisions carefully with cosmesis in mind — scars are kept as small and neat as possible
• If pathology unexpectedly finds something that needs further attention, you will be guided through the next steps with a clear plan

Risks & considerations

• Wound infection — occurs in about 3–5% of cases overall, and can be higher for lesions near the back passage or groin where keeping a wound dry is harder. Most infections are treated with a short course of antibiotics and heal well.
• Haematoma (a collection of blood under the wound) — affects around 1–3% of patients and usually resolves on its own, though occasionally needs drainage
• Recurrence — if a cyst wall ruptures during removal, some cells may remain and the cyst can grow back over time. Mr Nguyen takes care to remove the sac intact to minimise this.
• Wound breakdown — more common in wounds near the back passage or groin; heals more slowly but does heal
• Scarring — every skin incision leaves a scar; with careful closure this is generally minimal and fades well over 12–18 months
• Unexpected findings on pathology — in a small number of cases, what looked benign turns out to need further treatment. If this happens, Mr Nguyen will explain clearly what it means and what the next steps are.

Before the procedure

• Mr Nguyen will examine the lump and may request an ultrasound scan beforehand to understand its size, depth, and character before operating
• For most skin lesions, no bowel preparation is needed — there are no special diet restrictions
• Mr Nguyen will walk you through the risks and what to realistically expect before you sign consent — this includes talking about wound healing and the small possibility of the lesion coming back

On the day

• Local anaesthetic is injected to numb the area (or general anaesthetic if planned) — from this point you should feel pressure and movement but no pain
• Mr Nguyen marks the incision line to plan the best approach for access and the neatest scar possible
• The lesion is removed with a small rim of normal tissue around it; for cysts, care is taken to remove the sac whole so it cannot grow back
• The wound is closed in layers with fine stitches, finishing with a neat internal skin closure that does not need to be removed
• The removed tissue is labelled and sent to the pathology laboratory
• A dressing is applied, and you will be given clear written instructions on how to care for the wound at home

Recovery & aftercare

• Day 0–1: Some mild aching around the wound is normal; regular paracetamol is usually all you need
• Days 1–3: You can return to light normal activities. Keep the wound dry for the first 48 hours — no soaking in the bath or swimming pool yet.
• Full healing: Expect 2–4 weeks for the wound to heal completely, depending on its size and location. Wounds near the back passage or groin take a little longer.
• If pathology shows something that needs further treatment, Mr Nguyen will contact you promptly and explain exactly what is needed and why — you will not be left waiting and wondering
• A post-operative review with Mr Nguyen is routinely arranged 2–6 weeks following your procedure, with timing depending on the type of operation — this review is provided at no charge

Related patient guides

Articles written for patients and their families — to help you understand what you are experiencing and what to expect.