First Try with New Camera! A Cyst Excised on the Left Cheek

Author: Dr. Sandra Lee (aka Dr. Pimple Popper)

Dr: so how long have you had this thing here? Patient: Mmmm... This one's been, 4 or 5 years I think. Dr: yeah? Dr: it's probably a... Is this the biggest it's ever been? Patient: mmm, yeah I think so Dr: yeah, just slowly kinda growin on you Patient: Mmm hmm Dr: dab there, thank you Dr: well the nice thing... You're ok? Patient: mhm Dr: ok Dr: good Dr: just gonna try to take it out as gently as I can cause we wanna... Dr: the idea is to try to get it out whole if we can because, um Dr: then we have a lot- you're ok? Patient: umhm Dr: we have less a chance, give me, uh, less chance of making sure we got it all Dr: looks like a little cyst to me so far

I'm gonna see if I can squeeze (CROSSTALK) Patient: and then it was just funny that, um, Patient: I actually saw your videos just a couple days ago for the first time... Patient: and that was after I had made the appointment Patient: and I didn't even realize that you were the same person until I came in Dr: that we were...that this is somebody... Dr: oh! And then you saw, and then you actually saw my husband first though Patient: umhm Dr: see, um, trying to, I think this is pretty thin walled. Dr: You were giving me, you were making me nervous when you were talking to me and kept squeezing on this, Dr: I was like 'oh, don't squeeze it, don't do that, what if it pops?' Dr: so I'm glad we're getting this off of you.

Dr: He actually told me that if I don't get rid of it today, he's gonna go home and do it himself. Dr: you ok? Patient: yep Dr: ok, cause sometimes underneath if it feels [tight], if [you] feel sharp[ness], you just tell me. I'm trying to... It still looks like it's coming out in one piece, but..

Dr: I have a feeling if I let go of this top part here it might open up on us so Dr: oh, it's opening up Dr: (muttering) Alright I'm gonna have to squeeze it now, since... (speaking) Sometimes these are really thin walled that I can't get it out in [one piece] Dr: (sigh) let me put a nick on the top of it Dr: it's gonna explode on me otherwise Dr: (whispering) dab Dr: Well, we got to squeeze it instead of you. And I'll show you that little clip, you might like that Dr: if you like to watch this kind of stuff.

First Try with New Camera! A Cyst Excised on the Left Cheek

Patient: mhm Dr: I don't know if you do yet Patient: I was afraid that if I tried to do it, it was gonna be a lot more fibrous Dr: yeah and you'd have problems. You wouldn't be able to get it all, it would be, I, I can't even imagine you doing Dr: that, it's too deep, it's too...can you girls even imagine that, that'd be like Dr: like Dr: self-torture like, I mean, you can't do that to yourself Dr: let me just put more numbing, I just wanna make sure Dr: head it off at the pass cause I know I just put it on top Dr: gonna put a little more numbing under there, you might feel a little pinch maybe Dr: good Dr: Because this one is so thin-walled Patient: might need a little more numbing there Dr: ok, put more numbing in Dr: because this one is so thin walled, I don't know, there's a chance it could come back, but--better not, but... Dr: sorry Dr: didn't think you felt it at all, all the numbing Patient: no, just a little pinch Dr: ok good Dr: just trying to make sure we get all of this here Dr: ok, let's get underneath there, hold on, almost there Dr: good, dab underneath there (inaudible) Dr: they're always bigger than they look, you got, I mean that was pretty big itself, but it's, it's the... Always looks bigger when you actually take it out Dr: here it comes though Dr: We're tugging, I know. You're doing great Dr: dab the side, it's like all... Patient: does it grow down, like into the fat or into the bone? Dr: it pushes it away, no not to the bone, that's way too deep Dr: but pushes away the fat a little bit and you know, it got, it was raised up on you, like it wasn't like deep underneath things but Patient: is that what caused the, the indent on my nose? From the one when I was younger? Dr: um, I don't really know. It just looks like a enlarged pore there, like that, that could be a scar right now from Patient: mmm Dr: from whatever you had, it's hard for me to tell cause I didn't really see it beforehand, so I couldn't really comment on it Dr: let me just make sure we got it all, I know there was stuff around there so Dr: that's just a little fat here.

You feel ok? Patient: mhm Dr: can I get a little bit of... Dr: little saline in there to clean it off, that's ok, yeah? This good? Patient: yeah when I first went to see a dermatologist about this like a year and a half ago I think Patient: the doctor was saying that these are really uncommon on the face, usually they're on the scalp or somewhere else on the body Dr: mmm Patient: but then I know you were saying that there was a 16 year old kid or somebody who came in Patient: so do you think they're getting more common on the face? Dr: no, they're pretty common on the face. I think, I mean a pilar cyst...can you dab that right in there? Let me see, I wanna Dr: and another Dr: See I'm trying to get under there. Dr: Even if I... I don't think I see any more cyst in there but I'm trying to buzz it a little bit because if I do that there's a... Dr: Maybe I can like make sure it doesn't come back if there's any little part in there. It looks pretty good. Dr: Let me take one more look in here.

Patient: would it continue to grow if I just leave it? Dr: umm Patient: I mean like if I didn't get it removed Dr: It... Yeah, yeah. You have to remove the sac because you might have gotten infected Dr: and your body got rid of it, like absorbed it, but the problem is with that you get a scar most likely from that, wouldn't be pretty Dr: I think I got all of it girls, what do you think? Dr: last little chance to... Dr: like I said it looks pretty darn good Dr: I think that's like the thing that you never really know. Let me put a little suture there and then you're done Dr: and then I can show it to you Dr: I think you'll get a kick out of seeing that little part of the video Dr: every time I always get ready to close, I'm always like looking again, see you already know that, you know that I need to Dr: (barely audible) Just take a look in there Dr: (barely audible) I think all that's just fibrous tissue Dr: Okay Dr: sorry we're pulling, I know you can kinda hear it, but it's just a suture being placed Dr: I'm putting a suture deep underneath the skin that doesn't come out, like, actually your body absorbs it over time Patient: what is a suture versus stitches? Dr: a suture, that's a stitch, those are stitches Patient: ok, gotcha Dr: And this one doesn't come out, actually-- your body just absorbs it over time. Dr: but the ones on top will come out, and that I'm gonna give you 7 days, ok? Patient: ok Dr: Just be gentle.

You know when you take, when we take those top sutures out, there's still, you know, a level of... Dr: it's not... It's never... I think they showed that even 3 months, 1 month after surgery, Dr: you've only [recovered] 70% of the original strength, you know? Any time you make a cut that becomes the weakest point. Patient: mhm Dr: so you know, the sutures underneath there, that give it strength over time. Dr: But there's only one, so, you know..

If you are really aggressive and get hit in the face or something or you know you can split right there Dr: do you know what I mean? Patient: so no bar fights... Dr: yeah. I mean just be gentle with this, even after you take out that top suture, there's a suture underneath there Dr: but if it breaks, they'll, it will spread open Patient: would it help if I put like aloe on it? Dr: um, more like don't leave your, you know, try to not futz with it and like even steri strips across it sometimes, you know? Dr: like that kind of thing to keep it from being jostled around a lot or anything Patient: ok Patient: I usually sleep on my stomach, would it be better if I sleep on my back? Dr: that's a lot easier said than done if you sleep on your, if you're used to sleeping on your stomach Patient: yeah Dr: I don't think I could, I'm a stomach sleeper too, I could not sleep on my back Dr: are you kidding me? Dr: plus if you live with anybody, you'll snore up, snore like mad, you know? Dr: all that happens, um Dr: let me just take a little clean up here and we'll take this off you Dr: I might put one more stitch in there Dr: no, it looks pretty darn good actually Dr: there you go, we're gonna, keep your eyes closed, we're gonna take a little "after" photo of it Dr: ok, good? Patient: nice and symmetrical Dr: yeah good Patient: now people can focus on my... Dr: and I'm gonna show, hmm? Patient: now people can focus on those baby blues Dr: that's right, they can Dr: I'm gonna have you close your eyes again and I'm just gonna take it from the angles here Dr: like this angle here so cause I took it from that before (off camera) right here? Dr: this is the sack it was in Patient: yeah Dr: all that stuff squeezed out like, let me see if I can squeeze some [more] of it out Dr: see some it coming out of that little hole right there? Patient: yeah, what's that actually in the sack? Dr: that's all macerated keratin, wet skin cells Dr: it's been tucked under there, and it's like, you've been flaking off into the sack Patient: you said wet? Dr: you're skin has been flaking off into the sack, so wet skin cells Patient: wet skin cells Dr: yep, just mashed up wet skin cells, was very white.

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