【Case Report】A Sebaceous Cyst in the Left Sideburn Treated with the “Punch Excision Method” and Healed Beautifully with the Natsui-Style Moist Wound Healing Technique｜Kohrita Hiro Orthopedic & Plastic Surgery Clinic
This is Dr. Kohrita, Director of Kohrita Hiro Orthopedic & Plastic Surgery Clinic, located in Shin-Osaka, Yodogawa Ward, Osaka City.
Today, I would like to share a case of epidermoid cyst (also known as an atheroma or sebaceous cyst).
This is a relatively common benign skin condition in which a sac-like lump forms beneath the skin.
While often thought of as harmless, leaving a sebaceous cyst untreated can lead to inflammation, redness, swelling, pain, and pus discharge. In some cases, the cyst can recur multiple times.
That’s why proper diagnosis and treatment are essential.
■ Patient Information
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Age: 62
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Gender: Male
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Affected Area: Left sideburn (in front of the ear)
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Initial Consultation: The patient was initially seen at another clinic, where he was prescribed antibiotics and told to wait and observe. However, his symptoms showed no improvement. After searching online, he found our clinic and decided to consult us.
■ Surgical Method: “Punch Excision” for Minimally Invasive Removal
At our clinic, we actively use the punch excision technique for the treatment of sebaceous cysts.
This method targets the small opening (often seen as a black dot) at the center of the cyst. Using a specialized instrument called a trephine (or biopsy punch), we make a small circular incision to remove both the contents and the cyst wall (sac) in one go—a low-invasive surgical option.
<Benefits of Punch Excision>
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Very small and discreet scar
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Short procedure time – can be performed on an outpatient basis
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Local anesthesia only is required
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Complete removal of the cyst sac leads to a low recurrence rate
In this case, the cyst was safely removed using this method, and postoperative pain was minimal.
■ Postoperative Care: Moist Wound Healing with the “Natsui-Style” Approach
For wound care after surgery, we utilized the “Natsui-style moist wound healing technique,” developed by Dr. Makoto Natsui.
This modern approach keeps the wound moist rather than dry, promoting natural healing and minimizing scarring.
<Key Features of the Natsui-Style Moist Healing Method>
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No need for disinfection or daily gauze changes
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Less pain
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Lower risk of infection
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Cleaner, more aesthetically pleasing scar outcome
In this case, the patient was not given any antibiotics or disinfectants, and yet healing progressed smoothly.
Daily showering and bathing were permitted, and no signs of infection were observed throughout the recovery.
■ 5-Year Follow-Up: Excellent Cosmetic Results and Patient Satisfaction
The patient returned to our clinic five years later for a different concern.
Upon examination of the previously treated area (left sideburn), we found the site had healed beautifully, with no noticeable scarring.
The patient expressed satisfaction, saying, “I’m so glad it healed cleanly.”
He also graciously agreed to let us take photos for documentation (thank you for your consent to publish).
Epidermoid cyst before surgical removal (approximately 2 cm in diameter on the cheek).
Surgical removal of a 2 cm epidermoid cyst capsule on the cheek using the punch excision method.
Immediately after removal of the 2 cm epidermoid cyst capsule from the cheek using the punch excision method.
Postoperative Day 1: Mild swelling and redness after removal of a cheek epidermoid cyst.
Postoperative Day 5: No swelling, pain, or infection after punch excision of a 2 cm epidermoid cyst on the cheek.
Day 12 post-op: The cheek wound after cyst removal is healing flat, with no infection or pain.
Day 19 post-op: The cheek wound is nearly healed, with no signs of infection or discomfort.
5 years post-op: The cyst removal site on the cheek is barely detectable, with the skin fully restored.
■ If You Suspect a Sebaceous Cyst – Don’t Wait
Sebaceous cysts rarely go away on their own.
Delaying treatment increases the risk of inflammation and infection, and once inflamed, treatment becomes more difficult and scarring is more likely.
■ High-Quality Sebaceous Cyst Treatment in Shin-Osaka
At Kohrita Hiro Orthopedic & Plastic Surgery Clinic (near Shin-Osaka Station), we offer minimally invasive punch excision surgery combined with pain-free postoperative care using the Natsui-style moist wound healing method.
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“Could this be a sebaceous cyst?”
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“Another doctor told me to wait and observe, but I’m still concerned…”
If that sounds like you, please don’t hesitate to contact our clinic for a consultation.
We’re here to help you achieve a clean and complete recovery.
I am using a translation tool for this English version,
so some parts may be unclear.
Thank you for your understanding.
Kohrita Hiro Orthopedic & Plastic Surgery Clinic
Dr. Kohrita
Osaka, Shin-Osaka area
