What to expect from pilonidal cyst surgery – On the day of surgery

You should arrive about 90 minutes prior to your scheduled operation. This will allow for time to meet various members of the team who will be taking care of you, including nurses and anesthesiology. You will have time to change into a hospital gown and have an IV line started. Bring a book or something to entertain you in the rare case that your surgery may be delayed.

Surgery can take anywhere from 2-3 hours depending on the complexity of your pilonidal cyst. After surgery is finished, you will be taken to the recovery room where you will stay for approximately 2 hours to recover from anesthesia before going home. The cleft lift procedure is done using general anesthesia under the care of one of our wonderful anesthesiologists or CRNAs.

Most patients have numbness in the area of surgery afterwards rather than pain, so you will likely be relatively comfortable when you leave the hospital. You may take tylenol as needed for any discomfort. We also give you a prescription for vicodin, which is a narcotic pain medication, although the majority of our patients do not need to take this after surgery. Please avoid aspirin, ibuprofen (advil, motrin), or any other NSAID for the first 2 weeks after surgery.

Keep in mind that you may not sit down for a full week after surgery (with the exception of using the restroom). We suggest that you either lay down in the back seat of the car on the way home, or recline the passenger side fully to avoid tension to the area.

You will leave with a drain from the site of the operation that will collect excess fluid so that it does not accumulate. One of the nurses in the recovery room will teach you how to care for this drain at home. Please record the amount of output from the drain and bring these numbers with you to your first post-op appointment.

What to expect for the 2 weeks following pilonidal cyst surgery

The first few days after pilonidal surgery should be very low key. Your surgery will typically be on a Thursday morning, and you should take it easy until your first post-op appointment on either the following Monday or Tuesday. You will need to refrain from exercising and heavy lifting for 4-6 weeks after surgery. Walking after surgery is encouraged, especially after your first post-op appointment. You should not shower until you are seen in the office. You do not need to change any of the dressing, leave that in place until we remove it.

At that first appointment, we will also remove your drain as long as the output is at a satisfactory level. Please remember to bring the recordings of the output with you. Afterwards, you may shower, and should start washing with hibiclens. There will be steri-strips, little pieces of tape that provide extra protection to the incision, that remain in place. You should scrub the area over top of the steri-strips with hibiclens while in the shower.

Once you are a week out from surgery, you may start sitting down. We recommend you sit for shorter amounts of time at the beginning (30 min to 1 hour), and slowly start increasing how long you sit. It is also best to start by sitting on softer surfaces (couches, recliners, gel pads).

At your 2 week post-op appointment, we will remove the steri-strips and examine the incision for the first time since surgery. There are also 2 small stitches that will be removed. As long as the incision is healing perfectly, we will see you back in 2 weeks for a 1 month post-op appointment. You should avoid exercising, heavy lifting, and prolonged sitting until somewhere between 4-6 weeks after surgery.

You should continue with hibiclens and hair removal of the area until you are 1 year out from surgery. We try to check in at 3 months, 6 months, and 1 year post-operatively to ensure you are continuing to recover appropriately.

We are interested in providing you the best experience possible. It is very helpful to us if you provide a review of your experience on vitals.com and healthgrades.com. If you have suggestions on how we can better serve you, we welcome them. If you are dissatisfied with your care, please call us directly and ask to speak to our office manager.

The above information is provided for educational purposes only. This information is not intended as a substitute for professional evaluation by an experienced surgeon.

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