Plastic Surgeon or General Surgeon for Cyst/Lipoma Removal?

Lipomas are benign fatty tumors that occur under the skin and less commonly within the muscle. They are associated with mild discomfort and a lump underneath the skin. It is always best to talk to an expert plastic surgeon to determine whether the lipoma is possibly a cyst or a tumor or hernia. We would have to remove the lipoma to be sure that it is not something else and we usually do this by sending it to a pathologist for evaluation. If a lipoma is painful, then an exam is needed to make sure it is not compressing on a nerve or whether the diagnosis is different. Aftercare for a lipoma includes gentle compression and Plato’s Scar Serum twice daily on the wound.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hello and thank you for your question. I agree with your dermatologist that for an accurate diagnosis you need a biopsy  of the lesion. The scalp is a tricky area such that the tissue does not have much laxity. If the cyst is big and closure might require a flap or rotation of surrounding tissue I recommend that you see the plastic surgeon. That is a common procedure that we plastic surgeons perform. I hope that helps and wish you all the best. 

Either a general surgeon or a plastic surgeon would be fine to remove a cyst on the scalp.

I am a plastic surgeon and I feel we are best to do these smaller excisions with the best aesthetic result

Among your dermatologist, general surgeon or plastic surgeon, they should all be well qualified to remove the cyst. If your dermatologist does not want to remove the cyst and you're left to choose between a plastic surgeon and general surgeon they will probably both do a great job. The aesthetic result provided by the plastic surgeon should be superior given their unique skillset and attention to detail. Similarly, dermatologists usually provide very pleasing results with this type of soft tissue procedure. I hope this information is helpful.Stephen Weber MD, FACS

I am surprised your dermatologist wasn't comfortable doing this himself as this is something that dermatologists typically do. I remove all different cysts from the scalp routinely.  Occasionally, I will request the patient get imaging done first to check the cyst and the size before removing it.  So to answer your question, I think either should do a good job and it should be routine for either a dermatologist, plastic surgeon or general surgeon.