Pilonidal Cyst Removal Surgery NYC

Do you have a recurring problem with ingrown hairs at your tailbone or between your buttcheeks? Learn about pilonidal cysts today to see if you need medical attention for your long-term butt pimples. Bespoke Surgical is an elite anal surgery practice in NYC that features pilonidal cyst specialists, so we’re equipped to help you. Schedule an appointment today.

What Is A Pilonidal Cyst?

Pilonidal cysts are pockets of tissue that are usually filled with hair, fluid, or air. They are typically started by loose hairs that have punctured the skin. The body reacts to form a cyst in order to try and force out the hair. Friction, tight clothes, or sitting for long periods of time can all cause a pilonidal cyst.

What Causes a Pilonidal Cyst?

According to Dr. Goldstein, pilonidal cysts on top of the butt crack occur because of the hair and deep creases in that area. Localized friction from normal daily activities, such as sitting and walking, causes repeated rubbing. This, in turn, causes a hair follicle to become ingrown instead of growing out normally. The follicle tracks its way into the depths of the skin crease, which causes a localized infection, an abscess, or both.

Talk about a literal pain in the ass! And one doesn’t necessarily have to have a hairy ass for this to occur, though an abundance of hair is a major predisposing factor. Another cause can be that one has coarse hair that just so happens to be in the perfect spot which leads to this bothersome condition.

What Is Pilonidal Disease?

Pilonidal disease is a chronic skin condition where people face repeated issues of pineal cysts in posterior pelvic areas. It is indicated by one or more sinus tracts, which are cavities with a narrow opening on the skin surface. In most cases, the cavity is filled with nests of hair. A non-inflamed lump is known as a pilonidal cyst, but if the sinus becomes infected a pilonidal abscess may form.

What Are Pilonidal Cyst Symptoms?

Generally, patients will feel a painful cyst on their buttocks crack. Most people gradually feel tenderness and pressure over the tailbone and don’t really know what to make of it. However, you should seek medical attention if you experience any of the following:

If the area is inflamed or feels tender.
Pain that worsens when sitting.
An abscess with draining pus or blood, which may have a foul odor.
Nausea, fever or fatigue.

Pilonidal Cyst Risk Factors

Coarse body hair, especially in the buttocks area
Being overweight/obese
Excessive sweating, especially in the buttocks area
Pressure in the buttocks area from long periods of sitting or tight clothing
Family history of pilonidal cysts

Find Out If Surgery Is Right for You

Not every pilonidal cyst calls for the same approach. We’ll assess the size, depth, and recurrence pattern to recommend the least invasive effective option.

Start With a Surgical Evaluation

How to Treat a Pilonidal Cyst

If caught early, pilonidal cyst treatment starts with simple techniques. Warm baths or warm compresses can decrease the localized infection. If it’s a recurring problem or isn’t healing, you’ll want to consider taking further action.

Preventative measures like laser hair removal in the patch of one’s butt-crease and padding on hard seating may be just what is needed to decrease recurrence.

If you want to take further steps, consider investing in a pubic hair care kit specially designed to reduce ingrown hair in your buttcrack.

When Do I Need Pilonidal Cyst Removal Surgery?

If your pilonidal cyst doesn’t heal, you’ll want to see a doctor. Pilonidal disease that is painful or infected needs medical attention as well.

In short: if you have a hair follicle (a dimple or pimple on the crease) and a tract/abscess that is constantly draining secretions, then something needs to be done surgically.

What to Expect During Pilonidal Cyst Removal

An average pilonidal cystectomy takes around 45 minutes. Pilonidal cyst drainage is imperative for the initial treatment of an abscess. The key is to make sure you see a surgical specialist who focuses on the appropriate placement of the incision. Strategic placement not only will lead to the immediate resolution, but also will allow for the minimization of the amount of tissue needed for the subsequent surgical excision. One will feel so much relief with this drainage and then, of course, the addition of antibiotics. We like to note that for this procedure, local anesthesia in the region has limited efficacy due to the localized inflamed tissues.

Post-procedure, the drainage cavity is irrigated and then packed. Patients are advised to take baths the evening after the procedure and then daily to assist in improvement. With the antibiotics and the local cleaning routine, all should improve within a few days.

The usual protocol is to schedule a follow-up appointment about two weeks post-incision and drainage, and then plan for the future subsequent excision. This usually is warranted as the above drainage just takes care of the abscess, but fails to remove the actual pilonidal hair follicle, which is the cause of the issue at hand.

Pilonidal Cyst Removal Recovery

Now, because it’s natural for this cyst to be chronically infected, there is a chance of a post-operative infection after pilonidal cyst removal. Most surgeons not only give antibiotics in the operating room and irrigate the wound with antibiotic solution, but also give pills post-operatively to decrease the chance of reinfection. That said, with the usual offset to midline incision, you may get central wound opening that clearly is a preferred outcome versus leaving the entire wound open. Dr. Goldstein usually discusses with his clients that he would rather have a small opening that will heal quickly with in-office tactics, than have their entire excised cyst cavity left open. For the most part, these heal quite well and rather easily, with the post operative pain being no different than the pain experienced when it was present.

After a successful complete excision, the pilonidal cyst removal wound is evaluated a week or so post-surgery and the staples are removed partially or fully at that time, if appropriate. Initially, one will be gentle with pressure-causing maneuvers so as to not separate the closure. Due to this particular region of the body, it can indeed still occur. Once everything has healed, in order to prevent recurrence, most clients get laser hair removal in the patch of the ass crack. This, along with proper pressure reducing mechanisms, allow for decreased recurrences of this pain in the ass, also know as a pilonidal cyst.

Pilonidal Cyst Removal Surgery Recovery Time

How long it will take for you to heal after pilonidal cyst removal depends on the way your surgery was done. If the incision was closed, it will probably take about 4 weeks to completely heal. If your incision is left open, it may take from a few weeks to several months to heal and scar over. Most people can go back to work and most activities after 2-4 weeks.

Talk With a Specialist About Recovery

Wound care after pilonidal surgery matters as much as the procedure itself. We’ll walk you through healing, follow-up visits, and when you can return to normal activity.

Start With a Surgical Evaluation

Pilonidal Cyst Removal Services at Bespoke Surgical

Bespoke Surgical is uniquely equipped to handle your booty with care. A lot of people see dermatologists as the first line of evaluation and treatment, yet from Dr. Goldstein’s experience, most do not go deep enough on their excisions to remove a pilonidal cyst.

Also, most chronic cysts need both local anesthesia and sedation for complete excision because the pimple that one sees is just the tip of the iceberg the full pilonidal cyst is quite large. Dr. Goldstein usually informs his clients that the incisions themselves can be quite large, larger than one may think. Our office is prepared with the know-how and equipment to extract the entire cyst.

With appropriate surgical techniques, offset to the midline incision and tissue transfer or excision with a rotational flap, one should achieve appropriate removal and closure as a one-stage procedure. This is why it’s imperative one sees a surgeon who performs a lot of these each year with full knowledge of the most up-to-date pilonidal cyst removal techniques. If you’re located in or near New York City, Bespoke Surgical might just be the practice for you.

We offer pilonidal cyst removal surgery at our New York City location. To schedule your consultation, contact us today.

FAQs about our Pilonidal Cyst Removal

How long does pilonidal cyst surgery take?

An average pilonidal cystectomy takes around 45 minutes.

How is a pilonidal cyst treated?

Early treatment can include warm baths or compresses. However, if the cyst is chronic or infected, surgical intervention is often necessary to fully remove the hair follicle and prevent recurrence.

Can I remove a pilonidal cyst on my own?

While certain home remedies can help manage symptoms, they don’t remove the cyst itself. You should seek medical attention if your cyst doesn’t heal, or if you experience a painful or infected pilonidal disease with symptoms like a draining abscess, nausea, fever, or fatigue.

Ready for answers?

Book a private surgical consultation.

Our team will review your registration and contact you within 24 hours to schedule the right appointment.

Prefer to speak with us? Call (212) 206-1501 today!

“During finals week of my sophomore year at NYU, you know, the time when you sit amongst the quiet stacks of books in the library for hours on end in the most uncomfortable desk chair, I started to literally feel a pain in my ass. It took me a few days to ascertain if it was coming from my actual asshole or a region in close proximity. After my go-to pain reliever, Advil, did nothing to minimize any pain and I started to develop more symptoms – a fever and localized swelling. I realized that it was from an infection in the area around my tailbone. Fuck, what a burden!

I did some Googling (after all, who doesn’t?) and realized it was indeed a pilonidal cyst. Yet, I must admit, I did need some assistance on the actual pronunciation of my new found friend. I subsequently took all the advice of warm baths and cushioning my seats, and managed to get an appointment with Dr. Goldstein for an evaluation. He confirmed Google’s diagnosis and, before I knew, it was all drained. That itself hurt just as much as the pilonidal cyst itself, but my symptoms abated almost immediately and I was finally able to study and pass all my exams.

Once things settled down, unfortunately, it became a chronic issue associated with persisting drainage, so Dr. Goldstein decided to perform a surgical procedure for excision of the entire cyst, tract, and all that came with it. While this may seem daunting, the procedure was straightforward and healed normally. Per Dr. Goldstein’s suggestion, I got laser hair removal, which has so far prevented any recurrence and now I am back to those fucking hard chairs studying for my doctorate. Now I come prepared with a cushion, though.”

PHYSICIANS

Dr. Evan Goldstein, D.O.

Dr. Evan Goldstein is the Founder and CEO of Bespoke Surgical, NYC’s leading sexual health private practice. He received his osteopathic doctorate from the University of Medicine and Dentistry School in 2002 and completed his residency in General Surgery at Maimonides Medical Center. In 2020, he was named one of NYC’s top LGBTQ+ business leaders by Crain’s New York and he is involved with GLSEN, ACRIA, HRC, and Callen-Lorde’s Howard J. Brown Society. All of these experiences and affiliations have shaped his whole-life approach towards the practice of private surgical care and sexual wellness.