Atheroma removal

Removal of atheroma is considered a simple procedure that is performed on an outpatient basis.

Atheroma is a benign neoplasm or, more precisely, a sebaceous gland cyst that forms for various reasons. The neoplasm can be localized in almost any area of the body except for the palms and feet. Atheroma is characterized by a specific property - it is impossible to get rid of it without surgical intervention, conservative or alternative treatment does not give results and only contributes to the recurrence of blockage of the sebaceous gland.

Depending on the location of the cyst, the operation is performed in various ways, usually minimally invasive and virtually painless.

Indications for enucleation (removal) of atheroma:

• A pronounced cosmetic defect.
• Inflammation of the cyst.
• Suppuration of the cyst.
• Physical discomfort caused by a large atheroma (cyst under the arm, in the groin, on the neck, behind the ear).
• Localization of atheroma in the area of large blood vessels and the risk of their compression.
• Abscess, phlegmon caused by suppurating atheroma.

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Is it painful to remove an atheroma?

The procedure of enucleation of sebaceous cyst is practically painless. Is it painful to remove atheroma - this question worries many, but those who have already got rid of the unpleasant lump can share their experience and say that everything happens quickly and with minimal trauma.

In 90% of cases, removal is performed using local anesthetic. General anesthesia is used very rarely, mainly for small children who need to be operated on for vital indications. In all other cases, general anesthesia is irrational and does not correspond to the scope of the procedure.

The anesthetic is injected directly into the skin, deep into the tissue right at the base of the cyst. The effect of the anesthesia lasts up to half an hour, during which time the surgeon has time to perform total enucleation of the cyst. If the atheroma is large, the patient is given an additional dose of anesthetic so that the patient does not experience discomfort.

Before anesthesia, a reaction test in terms of drug tolerance may be performed. For local anesthesia, lidocaine, novocaine, and less often bupivacaine or marcaine (a prolonged anesthetic) are used. Anesthetics are aimed at temporarily blocking the development and transmission of a pain nerve impulse; almost all drugs have specific contraindications:

• Pregnancy, breastfeeding.
• Malignant tumors.
• Meningitis.
• Use with caution in case of blood diseases.
• Anemia.
• Ascites.
• Marked hypotension.

Is it painful to remove an atheroma? Most often, the procedure is performed with minimal discomfort, but everything depends on the complexity of the operation. A purulent cyst will be more difficult to remove, accordingly, its neutralization may be accompanied by moderate pain. A simple small atheroma is removed very quickly, almost unnoticeably, especially if laser or radio wave technology is used.

Removal of atheroma in children

A sebaceous gland cyst in children can be congenital, but most often it is diagnosed as a retention neoplasm at the age of 5 to 16-17 years. The causes of atheroma in childhood are associated either with heredity (skin type and metabolism) or with age-related changes, including hormonal ones (puberty). A cyst rarely causes discomfort to a child, rather it is a cosmetic, irritating factor. The doctor decides whether to remove or observe the atheroma, everything depends on the condition of the neoplasm, the age of the child and the possible risk associated with the localization of the formation.

Removal of atheroma in children is not performed in the following cases:

• The atheroma does not exceed 1-1.5 centimeters in size.
• The neoplasm is located on the shoulder, back or chest and does not interfere with the child’s life at all.
• Atheroma does not become inflamed and does not increase in size.
• A sebaceous cyst does not compress nearby large blood vessels as it grows.
• Atheroma does not have nearby lymph nodes.
• A simple, small cyst is not removed until the child reaches the age of 3-4 years, and possibly even later – 7-10 years.

Removal of atheroma in children is mandatory for the following indications:

• The cyst is located on the face, in the groin, in the armpit.
• The atheroma quickly grows to gigantic sizes.
• The atheroma becomes inflamed and suppurates, therefore posing a risk of developing an abscess and even phlegmon.
• The neoplasm interferes with the development and function of nearby important organs of the body (cyst in the nose area, above the eyebrow, near the eye, ear, in the groin).
• The cyst compresses blood vessels and provokes inflammation of the regional lymph nodes.

Before removing a cyst from a child, the doctor will definitely conduct a differential diagnosis and make sure that the tumor is an atheroma and not another skin disease with similar external symptoms. The child may be prescribed the following tests and examinations:

1. Ultrasound of the neoplasm and the surrounding area.
2. Blood test (complete blood count).
3. X-ray.
4. Computed tomography or MRI as indicated (atheroma in the head, groin, neck).

If the doctor decides to remove the cyst, the operation is performed under general anesthesia for children under 7 years of age, and under local anesthesia for children aged 7-8 years and older. Most often, the procedure does not take much time, and the most gentle medical technologies are used for children - laser removal of atheroma or vaporization of the cyst using a radio wave method. The laser works well if the atheroma is very small and has no signs of inflammation. Enucleation of atheroma with a scalpel also takes place in pediatric surgery, this method is well suited for the treatment of a large cyst or in the case of the development of an inflammatory process, suppuration. The atheroma is opened, conditions are created for the outflow of purulent contents (drainage), local anti-inflammatory agents are used (ointments, solutions, sprays). After the evacuation of all the contents of the cyst and the subsidence of the symptoms of inflammation, the atheroma is completely enucleated, along with the capsule, so as not to leave a single chance for relapse and not to subject the child to another, repeated operation. Children tolerate the rehabilitation period much better than adults, as their body's reparative properties are more developed. As a rule, after 2-3 months, possibly earlier, the scars are completely absorbed and become practically invisible.

Laser removal of atheroma

To completely remove a sebaceous gland cyst, it is completely enucleated, otherwise a relapse and repeated surgery are inevitable. The most radical method is considered to be the removal of atheroma with a scalpel, during which the top of the formation is opened, incisions are made in the skin and all components of the cyst are available for enucleation. Removal of atheroma with a laser is a more gentle method, it is considered low-traumatic and leaves virtually no postoperative scar. However, this technology is used to treat small neoplasms that do not have signs of inflammation. Advantages of laser removal of sebaceous gland cysts:

• A clearly expressed cosmetic effect, virtually without seams and scars.
• Suitable for removing atheroma on the face and scalp.
• A short period of time in terms of the procedure – no more than 20-25 minutes.
• Absolute absence of pain, the operation is performed under local anesthesia.
• Simultaneous coagulation of tissues and vessels, resulting in the procedure becoming anemic.
• High antiseptic effect.
• Accuracy. The procedure is carried out within healthy tissues with maximum preservation.

Laser removal of atheroma and other neoplasms with similar symptoms falls into the category of "minor surgery" or "one-day surgeries". The essence of the manipulation is the targeted action of a laser scalpel on the cyst, during which the atheroma cavity is destroyed, and the detritus (contents) evaporates. Thus, the need for scraping disappears, as well as possible relapses when performing surgery with a simple scalpel. After removing the contents of the cyst, the wound is treated with special preparations (antiseptics), ointments with regenerative, absorbable properties are applied to it.

Radio wave removal of atheroma

Among the latest achievements of medical science, it is worth noting the radio wave method, which is successfully used to remove various neoplasms, both benign and malignant.

Radio wave removal of atheroma is a simple, painless procedure that uses the Surgitron device, or as it is often called, a “radio wave knife.” The technology is based on the ability of electricity to transform into waves, which are “collected” into a specific beam with the help of the device and sent to the site of the neoplasm. This unique “knife” cuts soft tissues, which would be more correctly described as spreading rather than cutting. The mechanism of such “passing” of the wave is based on the heat emitted by the human body. Radio wave removal of atheroma has many advantages, among which are the following:

• Absolute absence of pain.
• Preservation of tissue integrity and no need for sutures.
• No scars after surgery.
• The operation is virtually bloodless.
• The use of a radio knife allows for parallel coagulation of tissues and vessels.
• The procedure is very quick - 15-20 minutes.
• The radio wave method has all the advantages of laser technology, but is faster and therefore more affordable in terms of the cost of the procedure.
• The healing process of the tissue separation site lasts 14-20 days.

The use of a radio knife is effective, but has its own contraindications, which include the following diseases and conditions:

• History of epilepsy.
• Oncological diseases.
• Diabetes mellitus.
• Infectious diseases.
• Glaucoma.
• Presence of a pacemaker.
• Any disease that is in the acute stage of development.
• Dental implants made of metal.

Laser removal of atheroma

Laser method of removing atheroma is considered one of the safest and most effective methods. However, this technology can only be used to treat small sebaceous gland cysts; large atheromas are excised with a scalpel.

Laser removal of atheroma is the use of an erbium or carbon dioxide laser. Most often, cosmetologists and dermatologists use a CO2 laser, which is called so in accordance with the type of medium that generates the beam flow (concentrated carbon dioxide). This method was first used in the last century, in 1964, and is still considered reliable and effective in the treatment of dermatological and cosmetological problems.

How does laser removal of atheroma occur?

1. The cyst area is treated with an antiseptic.
2. An anesthetic is injected into the top of the atheroma (by injection, less often externally).
3. The cyst cavity is opened using a laser scalpel; there is practically no incision, but one way or another, the tissues must be moved apart.
4. The contents of the cyst are literally evaporated by the action of directed carbon dioxide without the need to remove the capsule.
5. At the same time, coagulation of the vessels occurs, therefore the laser method is considered bloodless.
6. The site of the atheroma opening is treated with an antiseptic without applying stitches.
7. A sterile bandage is applied to the surgical area and should be kept in place for 2-3 days.
8. The advantage of laser technology is that when removing atheroma in the scalp, the area for manipulation is not shaved, thus the patient gets rid of an unpleasant feature that is standard for a regular operation using a scalpel.

Removal of sebaceous cysts with a laser scalpel is not only an excellent cosmetic effect, but also the absence of pain, scars, and relapses.

Electrocoagulation of atheroma

Electrocoagulation is a method based on the use of electric current of different magnitudes (direct or alternating current). As a rule, this method is used to neutralize a retention neoplasm that does not have signs of inflammation or suppuration. How does electrocoagulation of atheroma occur? •

• Local infiltration anesthesia is administered.
• Using a special electrode, similar to a surgical scalpel, the top of the neoplasm is dissected (the skin is cut).
• Next, the electroscalpel dissects the atheroma capsule.
• The surgeon carefully squeezes the contents of the cyst onto a sterile napkin.
• Tweezers and a scraping instrument are inserted into the resulting hole, and the cavity is completely cleaned out (excised), thus removing the capsule itself.
• The cavity is treated with an antiseptic.
• The surgical wound is sutured with cosmetic sutures.
• A sterile bandage and napkin are applied over the suture.

It should be noted that electrocoagulation of atheroma is currently used extremely rarely, since most manipulation rooms in medical institutions are equipped with laser devices, in addition, the use of electric current, although painless, quite often leads to relapses.

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Surgery for atheroma

How is standard surgery performed for atheroma?

After the initial examination and palpation, the doctor determines the method of removing the sebaceous gland cyst. If the patient is prescribed the traditional method - removing the atheroma with a scalpel, it is worth familiarizing yourself with the rules for preparing for the procedure:

• On the day of the planned operation, it is best not to eat or drink anything. The day before, you need to follow a gentle diet.
• Before the operation, the doctor will definitely conduct a test for tolerance to the anesthetic.
• The cyst enucleation area is treated with an antiseptic. If the atheroma is localized in the scalp, the area for the operation is shaved.
• The surgical area is anesthetized using injections of novocaine or lidocaine.
• The doctor makes an incision over the top of the cyst.
• Atheroma can be enucleated in several ways - without forming a lumen or with complete enucleation of the capsule after squeezing out the detritus (for a better cosmetic effect). An incision when removing the neoplasm is inevitable, but the maximum skin dissection does not exceed 4-5 millimeters.
• The atheroma tissue is necessarily sent to the laboratory for histological examination. This confirms the diagnosis of atheroma and excludes the possibility of malignancy of the cyst.
• After the atheroma has been enucleated, the incision is sutured with small cosmetic stitches using special materials that have the property of self-absorbing.
• The stitches are usually not removed, since the suture material can dissolve within 5-7 days (catgut, glycolide-lactide, polysorb).
• A small scar remains in the area of tissue dissection, but it disappears within 1.5-3 months, the tissues of the back and chest heal especially well. Scars on the face and head dissolve more slowly.

Surgery for atheroma is performed at any time of the year, it is believed that small subcutaneous cysts are removed more easily and without consequences. Inflamed, purulent atheroma requires more careful preparation and preliminary treatment of pathological symptoms, therefore, when opening the abscess, an incision is made, it is also needed secondarily - during surgery. The consequence of such tissue trauma is a scar that not only takes a long time to heal and resolve, but is also noticeable to both the patient and others.

Consequences of atheroma removal

The operation to enucleate a sebaceous cyst is a simple surgical procedure. The consequences of atheroma removal are the usual postoperative sutures if the neoplasm was removed with a scalpel. If a laser or radio wave method was used, then sutures are not applied in such cases, therefore, there should be no cosmetic defects on the skin in principle.

The consequences of atheroma removal in the form of complications are very rare, which are most often associated with improper skin care and failure to follow medical recommendations. What can worry a patient after surgery?

• Local increase in skin temperature as a reaction to the penetration of the scalpel.
• Very rarely – general increase in body temperature. This happens if the patient was operated on for atheroma during an exacerbation of the underlying disease. Such cases are difficult to imagine, since before the manipulation the doctor not only examines the patient, but also conducts preliminary examinations to exclude such consequences.
• Slight swelling in the area where the cyst was removed.
• Accumulation of tissue fluid in the subcutaneous tissue during removal of a giant atheroma. In such cases, a special pressure bandage or insertion of a drainage tube is indicated.
• Secondary infection of the postoperative suture due to failure to observe basic rules of personal hygiene.

The consequences after removal of atheroma in most cases are simple procedures associated with either dressings or application of absorbable ointments to the scar. Within 2-3 months, sometimes earlier, the scar disappears and is completely absorbed, and the use of new high-tech methods (laser, radio knife) completely eliminates any negative complications after removal of atheroma.

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Atheroma after removal

The procedure for removing a sebaceous cyst falls under the category of “one-day surgery”, meaning that all manipulations are performed on an outpatient basis and do not require specific post-operative care.

Atheroma after removal - these are the actions of medical personnel:

• It is possible to apply sutures using a surgical scalpel. The laser method, as well as the radio wave method, does not involve rough cutting of the skin, therefore, sutures are not applied.
• Dressings in case of suturing. This happens during enucleation of giant atheromas, which most often develop in the scalp.
• Aseptic treatment of the scar if signs of inflammation appear. Such situations may occur when removing a large atheroma or when enucleating a purulent cyst.
• The stitches are removed 5-7 days after the procedure, depending on the scope of the operation and the size of the cyst.
• The healing process of postoperative sutures lasts about two weeks. During this period, it is necessary to follow the doctor's recommendations for caring for the area of the operation. External medications with anti-inflammatory, resolving and healing properties may be prescribed.

Atheroma after removal. Care rules:

• The area where the cyst was removed must not be wetted for two days.
• The wound surface should be treated daily with an antiseptic prescribed by the doctor.
• A bandage should be worn on the site of the removed atheroma for a week to avoid the risk of infection. If the cyst was located on the scalp, a clean hat should be worn.

The cosmetic effect after the manipulation is associated not so much with the surgical method, but with the size of the atheroma, the use of the correct algorithm and the experience of the doctor. Also, the rate of healing and resorption of the postoperative scar is directly related to the characteristics of the patient's skin and his health in general.

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Complications after removal of atheroma

What complications may occur after sebaceous cyst enucleation?

• Minor swelling in the area of the operation, especially if the atheroma was large, more than 3-5 centimeters. When removing such cysts, tissue incisions are inevitable, and therefore, the violation of their integrity leads to subsequent local inflammation and swelling.
• Increased skin temperature in the area of the operation, up to 37-38 degrees. This happens when the cyst is located in the groin area, in the armpits, on the scalp.
• Small hematoma. Such bruises are possible when performing enucleation with a scalpel, most often in the face area. As a rule, they try to operate this area with a laser or radio wave method, but purulent atheroma requires a traditional method of treatment, in which access to the cavity of the neoplasm is maximum. Accordingly, hematomas in the area of skin dissection are almost inevitable, but quickly resolve. Also, small hemorrhages can be when removing a neoplasm in the eye area, since the vessels in this area are very fragile and are located very close to the skin.
• Hyperemia, redness of the skin in the area of the procedure is not considered a complication, however, if it does not subside within 5-7 days, you should consult a doctor and exclude the risk of secondary infection.
• Slow healing of a postoperative scar. Such cases occur if an infection gets into the wound or if there is a circulatory disorder in the area of the operation.
• Relapse, formation of a new atheroma. This is possible if the cyst was partially removed. As a rule, treatment of atheroma is its radical enucleation, but an inflamed or purulent neoplasm is very difficult to eliminate due to the fact that under the influence of infection, the tissues "melt" and the atheroma loses its clear outlines. In such cases, repeated treatment of inflammation is indicated and after the symptoms subside, another operation is performed.

Removal of atheroma is rarely accompanied by complications, and the tissue regeneration process is fast - in 2-3 months. This is due to the benign course of the disease, which never degenerates into a malignant process. However, atheroma must be removed as early as possible, preventing its growth, inflammation or suppuration, to which it is prone, only in this way can unpleasant consequences after surgery be avoided, as well as a visible cosmetic defect in the form of a scar.

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Where to remove atheroma?

Atheroma is diagnosed by a dermatologist or cosmetologist. It can also be detected and differentiated from other skin and subcutaneous tissue neoplasms with similar symptoms by a surgeon. Where to remove atheroma? This is a question many patients ask themselves after hearing the diagnosis. Since sebaceous gland cysts are treated only by surgical methods, it is possible to get rid of it only in a specialized medical institution. The operation is usually performed on an outpatient basis, less often - in a hospital setting and involves the following options for choosing the location of the procedure:

• Outpatient clinic, treatment room in the surgical department.
• Dermatological clinic, hospital, treatment room.
• A cosmetology center that has the appropriate license to carry out such procedures.

Where atheroma cannot be removed:

• In hair salons, even if such establishments offer such a service. The operation should be performed by a doctor, and not by an aesthetician, makeup artist or visage specialist.
• At home. The contents of the cyst can be squeezed out, but such amateur activity is fraught with an inflammatory process, suppuration of the atheroma and consequences in the form of phlegmon.

Where to remove the atheroma can be decided after the initial consultation with the local doctor or, alternatively, you should immediately contact a specialized clinic - a center for cosmetology, dermatology. A sebaceous cyst is not a malignant tumor, so it does not require long-term treatment or inpatient conditions. However, it should be removed as early as possible and only using surgical methods.

Price of atheroma removal

Most likely, atheroma removal will be paid. The price depends on many factors:

• Patient location. The price of atheroma removal may vary from city to city.
• The size of the atheroma. A small cyst is removed very quickly, so the cost of the procedure will be low. A large atheroma requires more careful preparation, more time, and the cost of the operation will increase.
• The area of the neoplasm location. The most difficult to remove cysts in terms of access and close location of large blood vessels, lymph nodes, is in the face, lower neck, groin and armpit area.
• Atheroma condition. A cyst with signs of inflammation, purulent atheroma is first subjected to opening, drainage and treatment. Its enucleation is more difficult, therefore, the price of atheroma removal will be high.
• Age and health of the patient. General anesthesia is indicated for children under 5-7 years old. Also, various concomitant pathologies can complicate the removal procedure.
• Level, type, category of medical institution. State medical institutions, as a rule, perform most procedures free of charge. It is possible to pay for some specific drugs or tests. Commercial medical centers are a priori paid, the price of enucleation of a sebaceous gland cyst depends on the level of the institution, the complexity of the operation and the qualifications, category of the doctor.

What is the cost of the entire procedure for removing atheroma in a private cosmetology or medical center?

1. Initial appointment, consultation and examination of the patient.
2. Ultrasound examination of the atheroma projection.
3. Cito tests for RW, hepatitis, HIV, sugar.
4. Test for anesthetic tolerance.
5. The actual removal:
   1. Anesthesia (usually local).
   2. Removal of a sebaceous gland cyst – the cost depends on the size (up to 1 cm, up to 2 cm, over 2.5 cm).
   3. Choice of removal method - using a scalpel, laser or radio wave technology, electrocoagulation.
   4. Application of sutures.
6. Postoperative services – dressings, possible prescription of external medications, removal of stitches (if the procedure is performed using a scalpel).
7. Postoperative counseling, which depends on the histology results.

As a rule, the atheroma is removed within 30-40 minutes, in a planned manner, which doctors aptly call “one-day surgery”.

Reviews of atheroma removal

Neutralization of sebaceous cysts is usually well tolerated by patients. Reviews of atheroma removal can vary from positive to claims. Dissatisfaction can be associated with the following situations:

• Scar after the procedure. Indeed, despite the fact that the operation is low-traumatic, in any case it is accompanied by a dissection of the skin. Otherwise, it is impossible to remove the cyst, even the advertised radio wave method involves a small incision. Accordingly, the larger the atheroma, the larger the postoperative scar will be. As a rule, the suture material quickly dissolves, within 1.5-2 months, everything depends on the localization of the neoplasm, its size and condition (simple cyst or purulent). In this sense, the sooner the surgical removal is performed, before the atheroma has increased, the lower the risk of getting a large, visible scar.
• Inflammation of the postoperative suture. This is possible only if the patient does not follow certain rules for suture care. It is necessary to visit a medical institution for dressings, if prescribed, and a follow-up visit to the doctor is also necessary, even if the suture has dissolved and does not hurt.
• Recurrence of atheroma. This happens in case of incomplete removal of the cyst, when access to it is difficult due to suppuration.

Otherwise, reviews about atheroma removal are usually positive and can serve as a good argument in favor of timely contacting a specialist to solve the problem with the neoplasm.

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