Hello, this is Dr. Kohrita from
Kohrita Hiro Orthopedic and Plastic Surgery Clinic,
located in Shin-Osaka, Yodogawa Ward, Osaka City.
In this case, we present a patient who underwent surgical removal
of a facial atheroma (epidermoid cyst) using the punch technique.
One year after surgery, the scar was barely visible.
👨⚕️ About the Patient
The patient was a man in his 50s.
He visited our clinic after being referred by the president of his company,
who had previously undergone facial atheroma surgery at our clinic and
recommended it highly.
⚖️ About the Surgery
The surgery was performed using
a 5mm punch excision method (punch technique).
The entire cyst wall (capsule) was completely removed,
reducing the risk of recurrence to a minimum.
Postoperative wound management was done using
the Natsui-Style Moist Wound Healing Method.
The postoperative protocol includes:
・No disinfection was performed.
・No antibiotics were prescribed.
・Showering and bathing were allowed from the day after surgery.
⏰ One Year Later: Follow-Up Visit
One year after the initial surgery, the patient returned for removal
of another atheroma on a different site.
At that time, we had the opportunity to photograph
the site of the original surgery.
The patient commented:
“I can barely see the scar. I’m glad I came the first time,
so I decided to come again.”
We were very pleased to hear such positive feedback.
🔄 Summary
Even facial atheromas can be treated with minimal scarring
when proper surgical methods and wound care are applied.
The combination of the punch technique and
Natsui-Style Moist Wound Healing is a hallmark of our clinic.
Before surgery: a noticeable bulge caused by an epidermoid cyst is visible in the center of the face (50s male).
During surgery: the cyst capsule is being carefully removed to prevent recurrence (facial cyst, male in his 50s).
Immediate-postop: After punch excision of the atheroma: the wound is small, clean, and shows almost no bleeding.
The cyst capsule has been cleanly excised during the surgery.
Post-op day 1:After punch excision of facial atheroma; nearly blood-free and stable appearance.
Post-op day 7: the wound is healing well with no swelling or discomfort (facial cyst, male in his 50s).
Day 15 after surgery: the patient reports “I’ve almost forgotten I had surgery.” No symptoms remain (facial cyst, 50s male).
Day 21 after surgery: the wound is fully healed, with no redness, pain, or noticeable scarring (50s male).
One year after surgery: the scar is barely visible, and the result is remarkably natural (50s male).
❓ Frequently Asked Questions (FAQ) About Atheromas
Q1. What is an atheroma (epidermoid cyst)?
An atheroma is a benign, sac-like tumor under the skin
that contains sebum and keratin.
It rarely disappears on its own and may become inflamed,
leading to swelling, pain, or pus.
Q2. Can atheromas heal on their own?
No. They may shrink temporarily,
but the capsule remains and often causes recurrence.
Surgical removal is required to prevent recurrence.
Q3. Can surgery be done during inflammation?
Yes. While some clinics may advise waiting,
we can perform the punch excision even during inflammation.
In fact, early surgery often helps reduce pain and swelling faster.
Q4. Are antibiotics effective for inflamed atheromas?
No. Inflammation occurs inside the capsule,
which lacks blood flow, so antibiotics are ineffective.
Complete surgical removal of the capsule is necessary.
Q5. What surgical method is used?
We use the “punch technique” to remove
the entire capsule through a small incision,
minimizing scarring and pain.
Q6. What is the postoperative care like?
We use the Natsui-Style Moist Wound Healing Method,
which involves:
・No disinfection
・No gauze changes needed
・Shower and bath from the next day
・No antibiotics usually required
Q7. Is recurrence possible after surgery?
If the capsule is fully removed,
recurrence is extremely rare.
We prioritize complete capsule removal during surgery.
Q8. How painful is it after surgery?
Most patients report minimal pain, even in inflamed cases.
Many say, “It hurt much less than I expected.”
Q9. Is it better to operate while the atheroma is still small?
Yes. Smaller cysts are easier to remove,
with less scarring and faster recovery.
Delaying surgery may increase pain and complications.
Q10. Is the surgery covered by health insurance?
Yes. Atheroma surgery is covered under national health insurance.
The out-of-pocket cost may vary depending on
the size and location of the cyst.
Our Philosophy: Natsui-Style Moist Wound Healing
The “Natsui-Style Moist Wound Healing“ method was
established by Dr. Makoto Natsui,
a highly respected Japanese plastic surgeon.
This approach avoids disinfection and gauze,
maintaining a moist wound environment to minimize pain
and promote natural,rapid healing.
Our clinic practices wound management based on
Dr. Natsui’s effective treatment philosophy.
▶ Official Website: “New Wound Treatment” by Dr. Makoto Natsui (Japanese)
▶Learn more about Natsui-Style Moist Wound Healing
🖊️ Author Information
Author: Dr. Hirotaka Kohrita
(Director, Kohrita Hiro Orthopedic & Plastic Surgery Clinic)
Specialties: Orthopedic surgery, plastic surgery, burn care, epidermoid cyst surgery
Experience: Over 6,000 total surgeries (approx. 500 per year),
with more than 1,000 clinical cases published on our official blog.
All cases are personally diagnosed, operated on, and followed up by the director himself.
🔗 [View All Atheroma Blog Posts]
This post was originally written in Japanese and translated
into English using a translation tool.
We appreciate your understanding if some phrases are not perfectly natural.
