Mr. Onur Gilleard
Qualifications & Experience
Mr Onur Gilleard is a distinguished consultant plastic surgeon on the GMC specialist register. He previously held an NHS consultant post at St Bartholomew’s Hospital in London, specialising in skin cancer and microsurgical reconstruction. In 2021, Mr Gilleard transitioned from the NHS to dedicate himself fully to private practice, allowing him to focus exclusively on providing personalised, high-quality care to his patients. He is recognised as an expert in laser treatments, having conducted research and developed advanced treatment protocols using cutting-edge laser technology to optimise both clinical outcomes and cosmetic results.
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A dermoid cyst is the cyst you were born with: a small pocket of skin cells sealed under the surface during development, most classically at the outer end of the eyebrow. It grows slowly through childhood and is often only addressed in adulthood, for cosmetic reasons or because it has become more prominent. Treatment is complete excision with the capsule intact — through an incision concealed within the eyebrow itself, so the scar hides in the hairs. At London Skin Clinic the procedure is done under local anaesthetic in adults, takes 30 to 45 minutes, and costs £1,000 after a £100 consultation. One honest rule sits above everything: midline dermoids — on the nasal bridge or scalp midline — are never removed without an MRI first, because a small minority extend deeper than they appear.
What a Dermoid Cyst Is
Unlike the acquired skin cysts that appear in adulthood, a dermoid forms before birth: along the lines where the facial skin fuses during development, a small island of skin cells can be trapped beneath the surface. Sealed in, it does what skin does — sheds keratin, grows hair-like elements, produces oil — and slowly inflates into a firm, smooth, painless lump. Because the trapping happens along embryonic fusion lines, dermoids appear in predictable places: the outer eyebrow above all, followed by the midline of the nose and scalp. They are benign; the question is never “is it dangerous?” but “where exactly does it sit, and how neatly can it come out?”
The Classic Eyebrow Dermoid — and the Hidden-Scar Operation
The lateral eyebrow dermoid is the textbook case, and the operation is designed around one cosmetic idea: the incision is placed within the eyebrow itself, so the resulting fine line lives among the hairs rather than on open skin. Under local anaesthetic, the cyst is dissected free and removed with its capsule completely intact — an intact capsule is what prevents recurrence, exactly as with every cyst in our capsule explainer. The procedure takes around 30 to 45 minutes, and with complete removal the recurrence rate is under 5%.
Recovery
This is among the lighter recoveries in minor surgery: back to work the next day is the norm. Fine facial sutures are removed at 7 days (or dissolvable stitches are used and simply disappear). Some bruising around the eye is possible for a few days — eyelid and brow skin bruises expressively, as readers of our chalazion healing guide will recognise — and settles without intervention. Scar care follows our standard playbook: sun protection, and patience while the line inside the brow fades from view.
The Midline Rule: When MRI Comes First
Here is the piece of information that matters more than any pricing detail on this page. Dermoids on the midline — the bridge of the nose, the midline of the scalp — are anatomically different from the eyebrow variety: a small proportion extend inward through the developing skull, with a tract running towards the lining of the brain. Removing one without knowing that in advance is how a minor cosmetic procedure becomes a serious problem. Our rule is absolute: a midline dermoid is never excised without an MRI first. A classic lateral eyebrow dermoid with typical features, by contrast, does not routinely need imaging — the location itself is reassuring. This is precisely the kind of judgement a consultation exists to make.
Dermoids in Children
Most dermoids are noticed in childhood, and parents understandably want them dealt with early. Where a young child would need a general anaesthetic for removal, we refer to a paediatric surgical setting — that is where children’s anaesthesia belongs, and we say so plainly. Adults and older teenagers who can comfortably have the procedure under local anaesthetic are treated at the clinic. In the meantime, an uncomplicated dermoid can safely wait: it is benign and slow-growing, and surgery when the patient is ready beats surgery under pressure.
Cost
- Consultation: £100 (separate, not redeemable)
- Dermoid cyst excision: £1,000
- MRI, where required (midline lesions): arranged before surgery, quoted separately
- Histology, where indicated: £180
Full written costs at the consultation — see our pricing page or book an assessment.
Frequently Asked Questions
- What is a dermoid cyst?
- A benign cyst present from birth, formed when a pocket of skin cells is sealed beneath the surface along the lines where facial skin fuses during development. It grows slowly, feels firm and smooth, and appears in predictable places — most classically the outer end of the eyebrow.
- Are dermoid cysts dangerous or cancerous?
- No — dermoids of the skin are benign. The one genuine caution is anatomical, not cancerous: midline dermoids (nasal bridge, scalp midline) occasionally extend deeper than they appear, which is why those are imaged with MRI before any surgery.
- Will eyebrow dermoid removal leave a visible scar?
- The incision is deliberately placed within the eyebrow, so the fine resulting line sits among the hairs rather than on open skin. Fine facial sutures come out at seven days, and the concealed line fades progressively over the following months.
- Do dermoid cysts come back after removal?
- Rarely — under 5% when the capsule is removed completely intact, which is the entire technical goal of the operation. Recurrence is essentially the story of a retained capsule fragment, which careful, unhurried excision is designed to prevent.
- I’ve had mine since childhood — is it too late to remove it as an adult?
- Not at all; adulthood is when many dermoids are finally removed, under straightforward local anaesthetic. A long-standing, slowly growing dermoid loses nothing by having waited — the operation and the concealed-scar approach are the same.
- How much does dermoid cyst removal cost in London?
- At London Skin Clinic, £1,000 for excision under local anaesthetic after a £100 consultation. Midline lesions have an MRI arranged first, quoted separately; histology, where indicated, is £180.
Dermoid Questions from the Parenting and Skin Threads
“Paediatrician said our baby’s eyebrow lump is ‘just a dermoid, wait and see’. Is waiting really safe?”
For a classic lateral eyebrow dermoid — yes, genuinely. It is benign and slow-growing, and delaying surgery until a child is older (or until adulthood, under local anaesthetic) is standard, sensible practice rather than neglect. The exception that changes the conversation is location: anything midline gets imaged, whatever the age.
“Mine was removed as a kid and there’s still a bump. Did they leave it behind?”
Possibly a fragment, possibly scar tissue — the two feel similar from outside. A recurrence would typically have grown slowly over years, exactly like the original. An examination (and occasionally an ultrasound) separates the two; if it is a recurrence, re-excision aiming for the complete capsule settles it properly this time.
“Can I have it removed at the same time as other stuff — I don’t want two rounds of local anaesthetic?”
Often, yes. A dermoid excision combines comfortably with other minor procedures in one visit, within the safe limits of local anaesthetic — the same session-planning logic we use for multiple seborrheic keratoses. Raise it at the consultation and the session is planned around it.
More on cysts: every cyst type explained · why the capsule matters
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