Pilonidal cyst is the accumulation of hair shafts, lint and debris within a defunctionalized hair follicle within the midline crease skin. The hair enters via the “midline pit”, the orifice at the epidermal level which is grossly visible as a dilated pore. A pilonidal abscess is a pilonidal cyst which has become “infected”, ie the…
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Hair plays a critical role in the development and recurrence of pilonidal disease. For years, hair control has been recommended as part of conservative pilonidal care, but the method of hair removal has often been debated. At the Pilonidal Treatment Center of New Jersey (PTCNJ), our approach continues to evolve as new evidence emerges and…
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Simply put: patients should not be subjected to open-wound excision for pilonidal disease. In my experience as a physician specializing in pilonidal disease at PTCNJ, this operation is most often offered by surgeons who have not taken a focused interest in the condition itself. Pilonidal disease is frequently misunderstood, minimized, or treated as a minor…
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The aimless open-wound pilonidal cystectomy is as pointless as it is morbid. Recovery is painful and lengthy, and if the wound ever does heal, recurrence of pilonidal symptoms is commonplace. Because we at the PTCNJ have so much experience treating these horrid wounds, we routinely recommend immediate repair/closure regardless of the time passed since surgery. Our data…
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Introducing the Alma Soprano Ice Platinum laser hair removal system- the newest addition to our minimally invasive pilonidal treatment program (MiPiT) at PTCNJ. This system allows for virtually painless, quick and permanent gluteal cleft hair removal in fewer sessions. Novel multiple-wavelength technology allows for simultaneous targeting of different structures within the hair follicle. The sweeping…
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I often see people refer to a pilonidal abscess, a pocket of pus that forms beneath the midline gluteal skin, as a “cyst.” This mislabeling is at the core of much of the confusion surrounding pilonidal disease. When the problem is misunderstood as primarily that of this “cyst,” many surgeons who are not well-versed in…
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The surgeon claims a wildly high success rate with their cleft-lift procedure which includes ultra-low longterm recurrence several years out, but strangely doesn’t arrange followup with their cleft-lift patients more than several months after surgery to monitor for this recurrence! In other words, once you are healed, you are discharged forever. More importantly, the surgeon has…
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A good surgeon hears these concerns and does his or her best to address them. At PTCNJ, we have not been willing to alter the technique of our gold-standard cleft-lift to achieve the desired “looks like nothing was done!” cosmetic outcome. Instead, we have introduced a minimally invasive surgical option for appropriately selected patients(Minimally Invasive…
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First, what is meant by the word “flap”? In a flap, a healthy equally-sized equally-shaped segment of adjacent skin and underlying fat is moved in to fill the defect (hole) left following removal or “excision” of pilonidal disease. In line with this definition, our gluteal cleft-lift is one such flap example, in which a flap of adjacent buttock…
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