A 50-year-old woman presented with a round subcutaneous nodule on her right cheek,
diagnosed as an epidermoid cyst.
Although she had been told at another clinic that
“facial cyst surgery will leave a scar,”
the lesion was safely removed at our clinic
using the minimally invasive punch excision technique
combined with advanced moist wound care (Natsui-style).
💠 Told “Facial cyst surgery will leave a scar…”
Patient: Female, 50s
Location: Right cheek
The patient first visited a local plastic surgery clinic
for a facial epidermoid cyst (atheroma).
However, the doctor advised against surgery, saying:
“It’s better not to operate since the resulting facial scar may be too noticeable.”
Feeling anxious as the cyst gradually enlarged and became more visible,
she searched online for a clinic that could treat facial cysts with minimal scarring
—and traveled from outside Osaka to visit our clinic for surgery.
💠 Punch Excision (Minimal Incision Method) for Minimal Scarring
Even facial cysts can be safely removed when the appropriate technique is used.
At our clinic, we perform the punch excision (minimal incision method)
to minimize visible scarring.
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Complete removal including the capsule → recurrence rate under 1%
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Procedure time: about 15 minutes under local anesthesia
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No sutures required
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Wound managed with Natsui-style moist healing
💧 Natsui-Style Moist Wound Healing
After surgery, no disinfection or gauze is used.
By maintaining a moist environment with hydrocolloid dressing,
the wound heals without pain, infection, or dryness, promoting natural skin regeneration.
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No disinfection
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No routine antibiotics (unless infection signs appear)
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Showering and bathing allowed from the next day
📸 Postoperative Course and Results
Immediately after surgery, mild redness was observed,
but the healing process was smooth.
Preoperative photo of an epidermoid cyst on the right cheek (female, 50s). The patient was advised against surgery elsewhere due to scarring but scheduled for punch excision at our clinic.
Intraoperative view: removal of the epidermoid cyst capsule and its contents from the right cheek (female, 50s) using the punch excision technique.
Immediate postoperative view after punch excision of an epidermoid cyst (right cheek, female 50s). The surgical site shows almost no bleeding and a clean surface.
Excised specimen of an epidermoid cyst (right cheek, female 50s) completely removed with its capsule using the punch excision technique.
Post-op day 4 after epidermoid cyst removal (right cheek, female 50s). No pain, swelling, or bleeding; epithelialization is progressing smoothly.
Post-op day 11 after epidermoid cyst removal (right cheek, female 50s). No pain, swelling, or bleeding; the wound is nearly healed.
When the patient revisited our clinic six years later for a different reason,
we re-examined the surgical site.
Six years after epidermoid cyst removal (right cheek, female 50s). The scar is almost invisible, and there is no discomfort.
The patient happily said:
“At first I was worried, but I’m truly glad I decided to have the surgery here.”
It was a deeply rewarding moment for me as a surgeon.
🔍 FAQ (Frequently Asked Questions)
Q1. Will facial cyst surgery always leave a scar?
While a completely scar-free result cannot be guaranteed (no surgery is truly scar-free),
the combination of punch excision and moist wound care allows
most scars to fade significantly over time, becoming barely visible.
Q2. Can surgery be done if the cyst is inflamed?
Yes. Even in inflamed cases, safe excision is possible in most situations.
We recommend early consultation before the cyst enlarges or ruptures.
Q3. How many follow-up visits are needed after surgery?
Please return the next day to remove the hemostatic dressing.
After that, one visit per week for about three weeks is ideal if the healing is smooth.
Q4. Is recurrence common after punch excision?
Our clinic performs about 500 cyst surgeries annually, totaling over 6,000 cases.
Among our confirmed cases, the recurrence rate is below 1%,
because the capsule is completely removed.
However, this technique requires surgical experience and precision,
as incomplete removal can lead to recurrence.
Q5. Does the surgery really take only about 15 minutes?
Yes. Depending on cyst size, it usually takes 10–15 minutes under local anesthesia.
Patients can go home immediately after the procedure.
✍️ Author Information
Written by:
Dr. Daiki Kohrita, M.D.
Director, Kohrita Hiro Orthopedic and Plastic Surgery Clinic (Osaka, Japan)
Board-Certified Orthopedic and Plastic Surgeon
Specialties: Orthopedic Surgery, Plastic Surgery,
Burn and Wound Management, Epidermoid Cyst Surgery
Experience: Over 6,000 cyst surgeries (about 500 per year) and 1,000+ published case reports.
All cases are personally examined, operated, and followed up by Dr. Kohrita himself.
