Two large cysts were recently treated at City Dermatology Clinic by Dr Amir Sadr: a 4 × 4 cm cyst on the upper back and another positioned at the base of the left posterior neck. Both had reached a size where they were causing discomfort, pressure and cosmetic concern. These are common areas for cysts to form, especially when they have been present for several years or have grown steadily over time.
Cysts in these locations often become irritated by clothing, sleeping positions, gym activity, backpacks or repeated friction. Once they reach a certain size, removal is usually the most effective and predictable solution. At our clinic, cyst excision is carried out under local anaesthetic using precise surgical techniques that aim to remove the full capsule to prevent recurrence and promote a clean, controlled healing outcome.
The following explains how upper-back and neck-base cyst removal is performed, what patients can expect on the day, and why surgical excision remains the gold standard.
Cyst Removal on the Upper Back
The upper back is one of the most common sites for large epidermoid and sebaceous cysts. These cysts often go unnoticed until they enlarge, become tender or interfere with sleep or exercise. When a cyst reaches several centimetres in size, excision is typically recommended because drainage alone will not remove the capsule.
In this case, Dr Amir Sadr performed an elliptical excision directly over the cyst, allowing the entire lesion and capsule to be removed intact. This is important because leaving any part of the wall behind significantly increases the chance of the cyst returning. The back is also a highly mobile area, so meticulous closure is essential to avoid stretching of the scar during movement.
The treatment was completed using 3/0 Monocryl for dermal and skin closure, followed by Steri-Strips and brown Micropore tape. Patients usually keep this in place for a few days before moving on to basic wound care. Most back cyst excisions settle over several weeks, and scarring tends to fade steadily as the area heals.
Cyst Removal at the Base of the Neck
Cysts located at the posterior neck often cause local pressure and can be irritated by shirts, collars or turning the head. Because this is a visible and mobile site, technique and wound planning are particularly important.
The cyst at the left base of the neck was excised using the same elliptical approach, ensuring complete removal of the capsule. Once the cyst was freed, haemostasis was achieved with the Hyfrectator before the wound was carefully closed. The goal in neck cyst removal is to achieve a smooth contour, avoid tension and protect the wound from movement while it begins to settle.
Patients normally notice immediate relief from the pressure once the cyst has been removed. The scar in this area is generally fine but should be protected from sun exposure and friction during the early stages of healing.
How Elliptical Excision Works
Elliptical excision is the most reliable method for removing cysts on the back, neck, face and other high-movement sites. Instead of puncturing or squeezing the cyst, the surgeon creates a controlled incision shaped to match the natural skin tension lines. This approach allows the capsule to be lifted out in one piece, reducing the chance of recurrence and allowing the skin to close neatly.
Dr Sadr commonly uses this technique for large or recurrent cysts, as it provides predictable results and strong cosmetic outcomes. Once the capsule is removed, the area is cauterised if needed, and the wound edges are approximated using dissolvable sutures to support a flat, even scar.
What Patients Can Expect During the Procedure
Cyst removal at City Dermatology Clinic is performed under local anaesthetic, so the area is fully numbed before any work begins. Most patients only feel light pressure. The procedure time varies depending on size and location, but large back and neck cysts typically take around 20–40 minutes.
Once the cyst is removed and the wound is closed, patients receive simple aftercare instructions. Strenuous exercise, steam rooms, heavy lifting and stretching over the area should be avoided for a short period, especially for upper-back and neck procedures where movement can place tension on the healing scar.
Our Expertise in Cyst Removal
City Dermatology Clinic performs cyst removal every week, ranging from small lesions to large, long-standing cysts. All procedures are carried out by experienced doctors who manage these conditions daily. Techniques are selected to minimise recurrence, reduce downtime and support predictable cosmetic results.
Our minor surgery department is equipped for cysts on the back, neck, scalp, face and body, with a focus on safe, effective removal tailored to each patient.
Aftercare and Healing
Dressings such as Steri-Strips and Micropore tape help protect the incision during the initial phase. Patients are usually advised to keep the area dry for the first day, then follow gentle washing instructions.
Most cyst excision scars improve gradually over several months. If the cyst was very large, the area may feel slightly firm at first, but this softens as the tissue remodels. Patients are encouraged to avoid friction, direct sun and unnecessary pressure during the early healing period.
