Private Cyst Removal Surgery on Harley Street, London

The Questions Patients Actually Ask

Will the NHS remove my cyst?

Sometimes, but the criteria are narrower than most people expect. In Mr Gilleard’s words: “The reality is that cysts are usually removed on the NHS only if they are causing functional problems or cancer is suspected. Functional issues include pain, nerve compression or recurrent infections. One big issue is that even if the NHS agrees to remove the cyst the waiting times at the hospital are often very long and can be over one year.” Patients here report waits of six to twenty-four months, and around 80% have already seen an NHS GP or dermatologist before coming to us.

Should I see my GP first?

Yes, it is still worth doing. Even where the NHS cannot arrange removal, your GP may be able to arrange an ultrasound — which confirms the lump is not cancerous and gives the surgeon genuinely useful information: it confirms the diagnosis, gives the size, and shows whether the cyst is encased in blood vessels.

My cyst is red and painful. Is it infected?

Probably not, and this is the most common misunderstanding we see. When a cyst wall leaks or ruptures, keratin escapes into the surrounding tissue and the body reacts to it as a foreign body — producing a red, hot, painful lump with no bacteria involved. That is inflammation, not infection, and it is why antibiotics alone often fail to solve it. Roughly one patient in five arrives during or just after a flare of this kind.

Something came out of it. What does the colour mean?

White, cheesy, toothpaste-like material is the cyst’s normal contents — keratin. It frequently smells unpleasant and that alone does not mean infection. Yellow or green, thicker, foul-smelling discharge does need assessing; a distinctly green tint comes from pyocyanin, a pigment produced by Pseudomonas aeruginosa.

Can an injection avoid surgery?

It can settle an inflamed cyst, and it is the fastest non-surgical option: response typically begins at around five days, occasionally as fast as two, and in some cases there is no effect at all. But it treats the inflammation, not the cyst — about half of injected cysts still need excision later, because the sac remains. Injection is declined where the cyst looks infected, or where the diagnosis is uncertain and the tissue needs examining.

Why did my drained cyst come back?

Because drainage empties the cyst but leaves the sac behind, and the sac is what refills. Drainage is the right treatment for a collected abscess — antibiotics diffuse poorly into walled-off pus, so it has to come out — but it was never the operation that ends the cyst. Complete excision of the wall is what prevents recurrence.

When do I need to be seen the same day?

“If your cyst is rapidly enlarging, hot, with redness spreading out into the surrounding skin, or you have a fever or feel generally unwell — or it’s on your face near the eye or nose — do not wait for an appointment: go to A&E the same day.” The facial exception matters because infections around the eye and nose can track backwards into the eye socket.

Why a plastic surgeon rather than a GP or dermatologist?

Experience, and where the incision goes. A plastic surgeon’s primary work is removing lesions, reconstructing and operating for appearance, so the techniques for complete cyst removal and optimal wound closure are core skills rather than an occasional extra — including judging where to place an incision so it is as inconspicuous as possible. GPs and dermatologists do perform minor surgery, but not at the same volume.

When is the best time to have it removed?

Earlier and smaller. Removal is quicker, technically easier and gives a better cosmetic result while a cyst is still small — and if it has recently flared, surgery is easier and the scar better once the inflammation has completely settled, typically around ten days on.