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CASE & TREATMENT REPORT

Epidermoid Cyst (Face) — Punch Excision with Capsule Removal

A facial epidermoid cyst in a 50s female was removed with punch excision and full capsule …

症例・処置実績 粉瘤 くりぬき法

症例写真を掲載しています 治療内容や経過を分かりやすくお伝えするため、患部・処置中の写真を含む場合があります。

Epidermoid Cyst on the Face (50s Female)

Complete Capsule Removal with Punch Excision —
Right Temple Area

Osaka / Shin-Osaka

Hello, I’m Dr. Hirotaka Kohrita, director of
Kohrita-Hiro Orthopedic & Plastic Surgery Clinic in Shin-Osaka.
▶ View all Atheroma/Epidermoid Cyst Case Reports

Facial epidermoid cysts are especially concerning
for many patients because of the risk of visible scarring.

This case report presents a
50s female with an epidermoid cyst on the right temple,
completely removed using our minimally invasive
Punch Excision Technique, including full extraction of the capsule.

Even 1 year and 10 months postoperatively,
the surgical scar was barely noticeable.


🎥 Reference Video: Punch Excision for Facial Epidermoid Cyst (Different Case)

We previously published a surgical video demonstrating the same technique and postoperative care.
Although the video features a different patient, it helps illustrate the procedure and expected cosmetic outcome.

👉 Watch the reference video here

Original blog post —
“Facial Epidermoid Cyst Removed with Punch Technique –
1-Year Scar-Free Result”


About the Patient

  • Female, 50s

  • Cyst located on the right temple

  • Sought treatment at our clinic due to concern
    about cosmetic outcomes and visible scarring


Preoperative Findings

A well-defined epidermoid cyst approximately 25 mm in diameter
was present on the right temple.

Inflammation was minimal, typical of facial cysts.

Preoperative image of an epidermoid cyst on the right temple in a woman in her 50s, scheduled for punch excision.
Preoperative photo showing an epidermoid cyst on the right temple of a woman in her 50s. This lesion was removed using the punch excision technique.

Surgery: Punch Excision with Complete Capsule Removal

Under local anesthesia, a small circular opening
was created using a punch instrument.

The cyst contents and entire capsule
were carefully removed to minimize recurrence.

The wound opening was very small, requiring only minimal suturing.

Intraoperative image showing drainage of the contents of an epidermoid cyst on the right temple of a woman in her 50s. Minimal bleeding is observed.
Intraoperative scene of punch excision for an epidermoid cyst on the right temple. The cyst contents are being drained with very little bleeding.
Intraoperative image showing complete capsule removal of an epidermoid cyst on the right temple of a woman in her 50s using the punch excision technique.
Intraoperative scene showing the complete removal of the cyst capsule using the punch excision technique. Removing the entire capsule significantly reduces the risk of recurrence.

Excised Specimen

Specimen photo of an excised epidermoid cyst from the right temple of a woman in her 50s. The left side shows the cyst contents, and the right side shows the capsule.
Specimen of the excised epidermoid cyst. The left side shows the contents, while the right side shows the capsule, whose complete removal is essential to prevent recurrence.

Postoperative Wound Appearance

Immediately after surgery, bleeding was minimal
and the incision was small and cosmetically favorable.

Immediate postoperative image following punch excision of an epidermoid cyst on the right temple of a woman in her 50s. Minimal bleeding and a small, clean wound.
Immediate postoperative appearance after punch excision of a right-temple epidermoid cyst. The wound is small with almost no bleeding.

Postoperative Day 9

By day 9, epithelialization had progressed well.
Pain and bleeding were almost nonexistent,
aided by the Natsui-Style Moist Wound Healing Method,
which involves no disinfection.

Postoperative day 9 photo of a right-temple epidermoid cyst removal in a woman in her 50s. Minimal pain or bleeding, with epithelialization progressing well.
Postoperative day 9: The wound shows excellent progress with minimal pain, no bleeding, and good epithelialization.

1 Year 10 Months Postoperatively

Long-term follow-up revealed:

  • No pain

  • No discomfort

  • The scar was almost invisible

Even in highly visible areas of the face, punch excision combined
with the Natsui Moist Method achieves excellent cosmetic results.

Postoperative 1 year 10 months photo after punch excision of a right-temple epidermoid cyst in a woman in her 50s. No pain, no discomfort, and the scar is barely visible.
1 year 10 months after surgery. There is no pain or discomfort, and the scar is barely noticeable.

Postoperative Care
— Natsui-Style Moist Wound Healing

  • No disinfection was performed

  • Showering and bathing were allowed daily

  • Moist environmental management promotes healing and reduces pain

  • No antibiotics were prescribed,
    as the wound healed smoothly without any signs of infection


Summary

  • Epidermoid cyst of the right temple treated with Punch Excision

  • Complete capsule removal → extremely low recurrence risk

  • Minimal, barely visible scarring

  • Natsui-Style Moist Wound Healing →

    • No disinfection

    • No antibiotics

    • Shower/bath permitted from the first day

→ This is a safe and effective option for patients concerned
about visible facial scars.

▶ View more epidermoid cyst case reports
▶ View Punch Excision case list


💬 Frequently Asked Questions (FAQ)

Q1. Can recurrent cysts be treated with punch excision?
Yes. Recurrence is usually caused by residual capsule tissue.
Complete capsule removal significantly reduces this risk.

Q2. Is the surgery painful?
Local anesthesia ensures that the procedure is almost painless.Most patients experience only mild postoperative discomfort.

Q3. Are disinfection or antibiotics necessary?
No. With the Natsui Moist Healing Method,
neither disinfection nor antibiotics are required.

Q4. How can recurrence be prevented?
Thorough removal of the entire capsule is essential.
Our technique allows complete capsule extraction through
a very small incision.


Our Wound Care Philosophy:
Natsui-Style Moist Wound Healing

Developed by Dr. Makoto Natsui,
a leading figure in wound care in Japan,

this method emphasizes:

  • no disinfection,

  • no gauze,

  • maintaining a moist environment to promote rapid and painless healing.

We follow this evidence-based approach to optimize surgical outcomes.
▶ Dr. Natsui’s Official Website: “New Wound Treatment”


✒️ Author

Dr. Hirotaka Kohrita
Director, Kohrita-Hiro Orthopedic & Plastic Surgery Clinic
Shin-Osaka, Osaka, Japan

Specialties: Orthopedics, Plastic Surgery, Burns,
Epidermoid Cysts, Moles, Warts, Ingrown Toenails

Experience: Over 6,000 cyst and skin-related surgeries;
More than 1,000 documented case reports and
all procedures performed personally.

▶ View Doctor’s Profile

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