The question comes up at the front desk at Southwest Plastic Surgery almost every week. A patient is in for something else entirely, then pauses on the way out: “Could Dr. Agullo also take this off?”
The answer is almost always yes. And most people are surprised by how simple it is.
Many patients do not know that the practice removes moles, skin tags, lipomas, and cysts right in the office, usually under local anesthesia, on a cash basis with a single upfront quote. No insurance, no preauthorization, no waiting weeks for an approval that may not come.
What Patients Bring In
Dr. Frank Agullo, the double board-certified plastic surgeon who founded Southwest Plastic Surgery, describes the three most common requests this way.
Moles first: “One of the most common minor procedures that we do is excision of moles. These are usually on the face, but they can be anywhere in the body. It’s a pretty simple procedure. Most patients are self-aware of these moles. And of course, some moles can be beautiful, like Cindy Crawford is a perfect example. But some patients don’t like their moles, and we can remove these under local anesthesia.”
Then cysts: “These are usually sebaceous cysts, where a hair follicle has been clogged, and the follicle continues to create the oil for the skin. This turns into sebum, which continues to grow. The biggest risk here is that it could get infected, so it is recommended to excise these. If you don’t remove the root of the cyst, then it usually comes back.”
And lipomas: “These are just fat cells that have gone haywire and continue to grow and create a contour deformity on the skin. These are usually benign.”
Skin tags complete the list, and several can usually be removed in a single visit.
Why an Infected Cyst Is the One to Take Seriously
Dr. Agullo is direct about the risk of waiting on a cyst. “A lot of doctors may say, oh, this is not an emergency, you don’t really need to get this taken off, it’s not really medically necessary. Well, if the cyst ends up getting infected, it becomes an emergency.”
What that emergency looks like: a trip to the emergency department, an incision to drain the infection, antibiotics, and in some cases a hospital admission if the infection has spread. “Something very simple that can be treated early can prevent a major complication,” he says. “I always recommend excising the inclusion cyst all the way down to the root, so that we don’t have a recurrence.”
The Southwest Plastic Surgery Difference: the Closure
Any clinic can cut a lesion off. The reason patients choose a plastic surgeon is the scar.
“As plastic surgeons, we usually do a layered closure of the incisions,” Dr. Agullo explains, “which means we approximate the deep layer, the intermediate layer, and the skin level, so that there’s really no tension on the incision itself, and we get the best possible scarring.”
The follow-up matters as much as the stitching, he adds. That includes “taping, silicone sheeting, scar creams like Skinuva, and at certain points for certain patients, we can do steroid injections, laser resurfacing, or microneedling,” all available through the practice and its med spa.
Anesthesia Options
“Most lesions, including cysts, lipomas, skin tags, and moles, can be excised under local anesthesia,” Dr. Agullo says. “The only exception is when these are larger than usual, and the patient may not be comfortable, or they may be anxious about the procedure. That’s when we recommend doing IV sedation. It is rare to have to do general anesthesia for these procedures, but it is possible. And sometimes we do it on small children, because they’re not able to stay still for the procedure itself.”
One Quote, No Insurance
The excision service is cash based by design, and Dr. Agullo considers that the biggest advantage: “There’s no need to pre-authorize with the insurance, which can take time and effort. Once we have a consultation, and often this can be done via email, virtually, or in person, you get a quote which includes the entire treatment, with the scar management products as well as pathology if it’s necessary.”
On cost: “The rough price range for an excision is usually around one thousand dollars, but it could be from five hundred dollars and up, depending on the size and number of lesions, tumors, or skin tags that we’re removing.”
And on the malignancy question: “If there’s any suspicion that the lesion or the mass may be malignant, or we want to rule that out for peace of mind, we send these to the pathologist. And we usually get results within three to five days.” The pathologist can be paid through insurance, or included in the package.
Recovery
Most patients return to work the next day with light duties. Exercise waits a couple of weeks. Sutures, when used, come out in seven to ten days, and the scar reaches its final appearance in about a year with the practice’s scar management protocol.
About Dr. Agullo
Dr. Frank Agullo is a double board-certified plastic surgeon, a Mayo Clinic fellowship-trained specialist, a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center, and a Castle Connolly Top Doctor for thirteen consecutive years. Southwest Plastic Surgery is his El Paso practice, home to both the surgical center and the med spa.
Schedule Your Removal
Send a photo of the spot and the team can often quote it without a visit. Call (915) 590-7900, text 1-866-814-0038, or book online at Southwest Plastic Surgery. #StayBeautiful
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
Dr. Agullo wrote two companion pieces on this topic in his own voice: the case for early removal on drworldwide.com, and a step-by-step clinical walk-through on agulloplasticsurgery.com.
