Excision of a soft tissue mass is a specialized surgical procedure that involves removing benign growths from the skin or underlying tissues. At our practice, we understand that even benign growths can cause physical discomfort, cosmetic concerns, and anxiety about their nature. That's why we're committed to providing compassionate, expert care while helping you understand each step of your treatment.
This targeted procedure effectively treats several common types of soft tissue masses:
Epidermoid Cysts (previously called sebaceous cysts): These common, slow-growing, benign cysts contain a protein called keratin and are lined with skin cells similar to the epidermis. They typically appear as smooth, round lumps under the skin, commonly on the face, neck, trunk, and genitals.
Sebaceous Cysts: True sebaceous cysts arise from oil-producing sebaceous glands and contain sebum (oil). They're less common than epidermoid cysts and typically smaller, often occurring on the face where oil glands are numerous.
Lipomas: These are soft, doughy, non-cancerous growths of fat cells contained within a thin capsule. They commonly occur on the trunk, shoulders, neck, and arms, and typically feel soft and move easily with slight finger pressure.
Our approach utilizes precise surgical techniques tailored to each specific mass type, ensuring complete removal while minimizing scarring and recurrence risk. We employ careful planning for optimal incision placement, meticulous dissection to preserve surrounding structures, and appropriate reconstruction methods for excellent functional and cosmetic results. Our comprehensive approach includes both thorough preoperative assessment and detailed post-operative care, resulting in effective removal of the mass while providing definitive diagnosis and optimal cosmetic outcomes through individualized treatment of your specific soft-tissue growth.
You may need excision of a soft tissue mass if you experience:
For Epidermoid Cysts:
Firm, round bump under the skin that moves freely
Small blackhead or pore visible at the center (punctum)
Slowly growing lump that may become tender
Foul-smelling cheesy material if the cyst ruptures
Inflammation or infection causing pain and redness
Cosmetic concerns, especially on visible areas
Cyst that interferes with clothing or daily activities
For Sebaceous Cysts:
Small, often yellowish bump on oil gland-rich areas
Growth that may drain oily material
A cyst that becomes infected or inflamed
Tenderness or pain when the cyst is pressed
Cosmetic concerns, particularly on the face
Rapid growth or recent change in appearance
For Lipomas:
A soft, movable lump beneath the skin
Mass that feels rubbery or doughy to touch
Painless growth that may become uncomfortable with pressure
Cosmetically bothersome bump, especially in visible locations
Large lipoma that causes discomfort with movement or clothing
Rapidly growing lipoma requiring diagnosis confirmation
Multiple lipomas causing significant concerns
For All Soft Tissue Masses:
Growth that has changed in size, shape, or color
Mass that causes pain or discomfort
Diagnostic uncertainty requiring tissue analysis
Interference with normal activities or clothing
Recurrent infection or inflammation of the mass
Concern about the nature of the growth
Personal preference for removal for cosmetic reasons
At Lifetime Surgical, our approach to soft tissue mass excision combines precision with personalized care. The procedure begins with a comprehensive evaluation to determine the exact nature, location, and extent of your specific mass. What sets us apart is our expertise in tailoring the surgical approach to each unique soft tissue growth, employing different techniques based on mass type and location:
For Epidermoid Cysts: We perform complete excision including the entire cyst wall (capsule), which is crucial for preventing recurrence. After administering local anesthesia, we make a precise incision directly over or slightly offset from the cyst, carefully identifying the cyst wall. Using meticulous dissection techniques, we separate the cyst from surrounding tissue while keeping the capsule intact to prevent rupture, which could lead to inflammation and recurrence. We take special care around the punctum (central opening) to ensure complete removal of this portion of the cyst wall. For infected cysts, we may initially drain and treat the infection before performing a definitive excision once the inflammation has resolved.
For Sebaceous Cysts: Similar to epidermoid cysts, we employ a complete excision technique, but with particular attention to the more delicate nature of these cysts and their common occurrence in cosmetically sensitive areas. We utilize precise instrumentation and magnification when needed, especially on facial cysts, to maximize cosmetic outcomes. The smaller size of these cysts often allows for more minimal incisions with particular attention to placing incisions in natural skin lines when possible.
For Lipomas: Our approach varies based on lipoma size and location. For smaller, superficial lipomas, we use minimally invasive techniques with small incisions. For larger lipomas, we employ more extensive dissection through carefully placed incisions that follow natural skin lines. We take care to completely remove the lipoma capsule while preserving surrounding structures, particularly nerves that may run close to or through larger lipomas. For lipomas in cosmetically sensitive areas, we use specialized closure techniques to minimize visible scarring.
Our distinctive approach includes careful preoperative planning for optimal incision placement, meticulous hemostasis to reduce bruising, and layered closure techniques that minimize tension and scarring. Throughout your treatment, we provide comprehensive education about your specific mass type, expected recovery, and strategies to optimize healing. This personalized strategy ensures the effective removal of your specific soft tissue mass while maximizing both diagnostic clarity and aesthetic outcomes.
Immediate Post-Procedure (1-3 days)
Return home the same day in virtually all cases
Keep the surgical site clean and dry for 24-48 hours
Maintain bandages as directed by your surgeon
Take prescribed pain medications as needed, though discomfort is typically mild
Apply cold compresses intermittently to reduce swelling
Monitor for excessive bleeding or drainage
Limit activity that stretches or puts tension on the incision
Avoid lifting heavy objects, particularly for larger excisions
Sleep with the surgical site elevated if possible
Monitor for signs of infection (increasing redness, warmth, pain)
Contact your surgeon if you have concerns about healing or discomfort
Begin the transition to over-the-counter pain relievers as comfort allows
For Facial or Neck Excisions:
Keep head elevated to minimize swelling
Avoid facial movements that stretch the incision
Follow specific care instructions for exposed areas
For Trunk or Extremity Excisions:
Limit the range of motion that stretches the incision
Wear loose clothing that doesn't rub against the wound
Support the area during movement if needed
Short-Term Recovery (4-14 days)
Attend your follow-up appointment for suture removal (typically 7-14 days)
Begin gentle cleansing of the incision once approved by your surgeon
Monitor the healing incision for proper closure
Apply any recommended scar treatments once the incision is fully closed
Return to most normal activities as comfort allows
Gradually increase activity level while being mindful of the healing site
Protect the incision from sun exposure, which can darken scarring
Resume work based on your surgeon's recommendation and job requirements:
Most patients return to sedentary work within 1-3 days
Physical jobs may require 7-10 days for larger excisions
Continue to avoid activities that place excessive tension on the healing incision
Expect some mild itching as the wound heals, which is normal
Notice gradual fading of bruising and resolution of swelling
Monitor for any signs of wound separation or infection
Report any fever, increasing pain, or spreading redness promptly
For Epidermoid and Sebaceous Cysts:
Observe the site for any signs of remaining cyst material
Watch for small amounts of natural drainage as healing completes
For Lipomas:
Note that a depression may temporarily be visible where the lipoma was removed
This typically improves as surrounding tissues adjust
Long-Term Recovery (2-6 weeks)
Experience complete healing of the incision, typically within 2-3 weeks
Resume all normal activities without restrictions
Begin more aggressive scar management if recommended:
Silicone sheets or gel for raised scars
Massage of the healed incision to soften scar tissue
Specialized treatments for hypertrophic scarring if it develops
Monitor for any signs of recurrence or incomplete removal
Observe gradual fading of the surgical scar
Return to all physical activities, including swimming once the incision is completely healed
Notice continued improvement in the appearance of the surgical site
Address any cosmetic concerns about the healed incision with your surgeon
Maintain sun protection of the scar for at least 6-12 months
Attend any recommended follow-up appointments
For Epidermoid and Sebaceous Cysts:
Healing is typically complete with minimal chance of recurrence when the entire cyst wall has been removed
Monitor for the development of new cysts in patients prone to them
For Lipomas:
Contour of the area continues to improve as tissues remodel
Watch for the development of new lipomas in other locations, particularly if you have a history of multiple lipomas
Long-Term Expectations
Successful removal with minimal scarring for most soft tissue masses
Recurrence rates vary by type:
Epidermoid cysts: <5% when completely excised
Sebaceous cysts: <5% with complete removal
Lipomas: <1% at the same site with complete excision
Most patients experience excellent cosmetic results, particularly when incisions are placed in natural skin lines
The scar typically continues to fade for up to 12-18 months
Complete resolution of symptoms associated with the mass
Definitive pathological diagnosis of the removed tissue
No long-term functional limitations
Most patients can prevent noticeable scarring with proper wound care and scar management
Sun protection of the scar remains important to prevent darkening
For patients with tendencies toward certain growths, monitoring for new lesions in different locations is recommended
Regular skin examinations help identify any new growths early
Most patients report high satisfaction with both functional and cosmetic outcomes
Excellent long-term prognosis for benign soft tissue masses
Common Side Effects
Mild pain or discomfort at the surgical site
Temporary swelling and bruising around the incision
Small amount of clear or blood-tinged drainage initially
Mild redness along the incision line during early healing
Temporary numbness or altered sensation around the surgical site
Itching as the wound heals
Visible scar that fades over time
Temporary firmness of the healing tissue
Slight depression or contour irregularity at the excision site
Mild tightness or pulling sensation during healing
Less Common Complications
Infection requiring antibiotics or wound care
Wound dehiscence (separation of the wound edges)
Hematoma (collection of blood) requiring drainage
Seroma (collection of clear fluid) requiring drainage
Hypertrophic or keloid scarring, especially in prone individuals
Incomplete removal leading to recurrence
Damage to nearby structures (nerves, blood vessels)
Allergic reaction to suture material or dressings
Persistent pain or discomfort beyond the expected healing period
Widened or stretched scar due to tension or location
Suture spitting (suture material working its way to the skin surface)
Persistent numbness or altered sensation
Poor cosmetic outcome requiring scar revision
Recurrence due to incomplete excision (more common with cysts)
When to Seek Immediate Medical Attention
Excessive bleeding that doesn't stop with gentle pressure
Severe, increasing pain not controlled by prescribed medications
Spreading redness, warmth, or significant swelling beyond the surgical site
Pus or foul-smelling drainage from the incision
Fever over 101°F (38.3°C)
Opening of the incision beyond minor separation at the edges
Significant swelling that appears to be increasing rather than decreasing
Red streaks extending from the surgical site
Increasing rather than decreasing pain after 48 hours
Severe itching, rash, or hives that might indicate an allergic reaction
Significant numbness or weakness that wasn't present before surgery
Any symptoms suggesting the wound is not healing properly
Development of new masses near the surgical site
Unusual hardening or discoloration of the surrounding skin
From your first consultation through your complete recovery, we provide:
Thorough evaluation and explanation of your condition
Clear discussion of all treatment options, including non-surgical alternatives when appropriate
Detailed pre-operative instructions to help you prepare
Compassionate care during your hospital stay or outpatient procedure
Comprehensive follow-up care and support during recovery
Ongoing availability to address questions or concerns
We understand that facing head and neck surgery can be intimidating, but you don't have to navigate this journey alone. Our team is committed to providing expert care with a personal touch, ensuring you feel supported, informed, and confident every step of the way.
Your health and wellbeing are our highest priorities, and we're honored to be part of your care team.
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All our laparoscopic procedures are performed by our highly trained surgical team using state-of-the-art equipment and techniques.
We're committed to providing you with the most advanced, minimally invasive options because we believe you deserve:
Less pain after surgery
Shorter hospital stays
Faster return to work and activities you enjoy
Smaller, less visible scars
Lower risk of complications
Better overall outcomes
Dr. Richard Nguyen is a board certified General Surgeon and is fellowship trained in Minimally Invasive and Bariatric Surgery from Vanderbilt University. He has helped to pioneer single incision laparoscopic procedures as well as being da Vinci Robot Certified. He currently trains other surgeons in both of these fields, contributing to the further innovation of surgical techniques. Dr. Nguyen has been practicing in San Jose since 2007 and a surgeon since 2001, working with the most cutting-edge techniques available.
I would refer Doctor Nguyen to anyone, in fact I have and they have all had the same experience as me. He is truly great. I owe all my success to Doctor Nguyen and I thank him for all the work he has done for me and continues to do so. He is extremely amazing, and I am very grateful to him.
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At 50, I now have a life I had only dreamed of a year before. My body tells me if I am done eating. This surgery is a tool that I have used to the fullest. It is not an easy way out. It still took work. But I honestly know that I would not be living this amazing new life if I didn’t step forward to embrace this life-saving surgery.
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Dr. Nguyen has changed my life completely. I feel so much better and I also feel like I’ve got control of my life again…I had high blood pressure, diabetes and cholesterol. I took at least 5 different medications for the past 30 years. NOW, after surgery I take no medications only vitamins!
Wondering if laparoscopic surgery might be right for you? We're here to help you understand your options and develop a personalized treatment plan. Contact our office today to schedule a consultation with one of our specialists.
Your journey to healing may be gentler than you think—with smaller incisions leading to a faster recovery and better quality of life.
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