Dr. Pimple Popper treated a man with a deep cyst on the back of his neck.
The patient said the bump had been growing for 25 to 30 years, with multiple failed attempts at removal.
To get rid of the cyst for good, Dr. Pimple Popper had to cut away layers of built-up scar tissue.
Dr. Pimple Popper pulled a cyst she compared to a Bloomin' Onion from the back of a man's neck that she said had deep roots due to multiple failed attempts at squeezing it.
The patient said the cyst was "about 25, maybe 30 years in the making," and multiple doctors had attempted to squeeze out its contents in the past. However, the lump always came back.
Failed attempts at popping cysts can create scar tissue buildup under the skin, Dr. Pimple Popper explained in a recent video on her YouTube channel. She made sure to cut out all of the cyst's sac and the surrounding scar tissue, which can act like "superglue," she said.
Cysts can present in a variety of ways, and the dermatologist didn't specify what kind she was working on in this procedure. She noted that it was filled with clumps of skin cells, which could indicate a common pilar cyst based on her previous videos.
To treat the man in the video, Dr. Pimple Popper, whose real name is Dr. Sandra Lee, first numbed the area off-camera. She then made a large incision across the cyst.
A watery liquid spurted out as she sliced into the sac under the skin, narrowly missing one of the doctor's assistants.
After a few more snips, Lee warned the patient that she was going to squeeze out some of the cyst's contents before she numbed under the surface. Thick, whitish pillars crowned from the incision as she applied pressure around its edges.
"Oh, it's like a Bloomin' Onion!" Lee exclaimed, referring to the Outback Steakhouse's famous fried onion appetizer.
She wiped away chunks of semi-solid gunk as she continued to squeeze the cyst, leaving behind a gaping hole.
Dr. Pimple Popper cut it out in pieces until the 'cyst tomb' was empty
The dermatologist administered several rounds of injectable anesthetic each time she cut deeper into the man's neck.
Some cysts are easier to remove than others, she remarked, and failed attempts at popping can make them extra stubborn. The patient said the bump began as an ingrown hair and became more irritated over time.
"He's definitely got his little roots in there," Lee said, referring to the cyst. "He's like the guy who got a trailer, and then a double-wide, and then maybe decided to plant some trees and put in a built-in patio … and then all of the sudden, you can't move it anywhere."
The doctor initially wanted to remove the cyst in one piece, but she had trouble getting at the underside of the sac. Eventually, she decided to snip it out in bite-sized chunks.
She pulled out the final bits with a pair of tweezers, wiping away the pooling blood to get a clear look inside the cavernous hole. It's OK to leave a so-called "cyst tomb" like this as long there are no bits of cyst inside, she said.
After Dr. Pimple Popper closed the wound with a subcuticular stitch - a "fancier" technique that can stay in place for up to two weeks with minimal scarring - the patient's neck was entirely flat.
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