Pilonidal cyst - can this be reversed?

Question

I had surgery for a pilonidal cyst about 3 weeks ago and lost half of my crack. It looks awful. I think its the z plasty procedure. Can it be reversed?

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

Unfortunately, reversal of a Z-plasty will just result in a opposite direction Z-shaped scar. The best thing to do is to give this at least six months to heal and see what the outcome is at that point. It is likely that your butt crack will remain permanently effaced. At that point, your best option for recreating a buttock crack valley, will likely be to create relatively larger, buttock cheek mounds on each side of the buttock crack. The most reliable, relatively safe and permanent way to do this would be to place anatomic shaped buttock implants, such as Stanton Anatomic®️ gluteal implants.

Please note that an extremely few number of board certified plastic surgeons specialize in buttock or hip implants, so you may need to travel far and away from home to find this particular surgeon.  Glad to help.

Mats Hagstrom, MD (license on probation) · Answer

It’s unfortunate. Your surgeon did not describe the procedure properly before you had your operation.
The treatment of recurrent infected pilonidal cyst is fairly difficult and complex.
Based on your pictures, your surgeon used an appropriate approach.
The alternative is to deal with ongoing infections.
I’m not sure what your history is, but that’s kind of what the procedure looks like.
Best,
Mats Hagstrom MD

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