Cyst & Lipoma Removal

An epidermal cyst (formerly called a sebaceous cyst) is a subcutaneous pocket with a keratinised wall filled with soft whitish keratin. It can grow progressively, become superinfected (painful abscess) and produce a characteristic odour if ruptured. A lipoma is a benign tumour of encapsulated fat cells, soft and painless to the touch. Both are entirely benign, but removal is recommended in cases of discomfort, recurrent infection, growth or diagnostic uncertainty.

Complete excision of the cyst wall (keratinised capsule) is essential to prevent recurrence. If the capsule is left even partially in place, the residual epithelial cells will reconstitute the cyst within a few months. Similarly for lipomas, the fibrous capsule surrounding the fat cells must be entirely resected. This is why drainage alone (without wall excision) is never a definitive solution.

Removal is covered by French national health insurance when medically justified (functional discomfort, recurrent infection, diagnostic uncertainty, large cyst). Purely cosmetic excision of a small benign asymptomatic lesion may remain the patient's responsibility. Dr. de Clermont-Tonnerre clarifies coverage and provides a clear estimate during the consultation.

An infected cyst (warm, red, painful, with painful tension) should not be operated on during the active infection: first, incision and drainage is performed to relieve pressure and drain the pus, combined with antibiotics if necessary. Complete excision is then scheduled electively, 6 to 8 weeks later, once the inflammation has fully resolved, to guarantee clean removal of the entire capsule and prevent recurrence.

If the cyst is fully removed (wall and capsule included), recurrence is exceptional (less than 3%). Conversely, incomplete excision — often due to a prior infection that weakens and fragments the capsule — can lead to recurrence within 6 to 12 months. For lipomas, recurrence is rare if the fatty capsule is entirely resected. Systematic histopathological analysis confirms the exact nature of the lesion.

Yes, every lesion removed is sent for histological analysis, even if clinically it appears to be a simple benign cyst or lipoma. This analysis confirms the exact nature of the lesion and rules out any associated pathology (rare atypical dermal cyst, well-differentiated liposarcoma for large lipomas). The histological report is available within 5 to 10 working days.

The scar is proportional to the size of the cyst or lipoma: for a 2 cm lesion, the scar measures approximately 3 to 4 cm. It is oriented along the natural tension lines of the skin for maximum discretion. Deep sutures are absorbable and skin sutures are removed at day 7 to 14 depending on location. The scar gradually fades over 12 to 18 months.

No, the procedure is performed under local anaesthesia and takes place without pain. The injection of local anaesthetic (adrenaline-containing xylocaine) causes a brief slight stinging or burning sensation. The surgical procedure itself is completely painless. Post-operatively, mild discomfort for 24 to 48 hours is normal and effectively managed with simple analgesics such as paracetamol.

Yes, most lipomas, even large ones (up to 8 to 10 cm), can be removed under local anaesthesia as a day case. For very large lipomas (> 10 cm), deep (submuscular) lesions or those in areas at vascular-nerve risk, general anaesthesia may be preferred for better comfort and safer excision. The size and location of the lesion are assessed at the pre-operative consultation.

Light activities (walking, desk work) are possible the day after the procedure. High-impact sports, swimming and activities involving the operated area are inadvisable for 3 to 4 weeks, to allow the internal scar to consolidate. Skin sutures are removed at day 7 (face) or day 10–14 (body) before resuming more intense activity. Dr. de Clermont-Tonnerre will provide precise instructions tailored to your location.