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Small Procedures, Done Well: Mole, Cyst, Lipoma, and Skin Tag Removal at Southwest Plastic Surgery

Prepared minor procedure tray at Southwest Plastic Surgery in El Paso for in-office removal of moles, cysts, lipomas, and skin tags by Dr. Frank Agullo, MD, FACS.

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.

Keloid and Mole Removal at Southwest Plastic Surgery: Small Spots, Careful Scars

Minor procedure room at Southwest Plastic Surgery in El Paso, soft daylight. Keloid and mole removal consultation with Dr. Frank Agullo.

Plenty of appointments at Southwest Plastic Surgery are not about a whole region of the body. They are about one spot: a raised scar on the ear after a piercing, a mole on the cheek, a lesion a patient just wants gone.

Dr. Frank Agullo tells patients that the difference between a plastic surgeon doing these and someone simply removing the spot is that he is thinking about the final scar the entire time. The spot is temporary. The scar is permanent. The questions below are from real consultations, anonymized.

Can a Keloid on the Ear Be Removed?

Yes, and Dr. Agullo says it is one of the more straightforward things he does. Ear keloids almost always trace back to a piercing. He numbs the spot, cuts the keloid out, and re-closes it, then lays in a little Kenalog, a steroid, to discourage it from returning. The procedure runs about twenty minutes under local anesthesia, and the only real ask afterward is that the patient skip the gym for roughly ten days.

Will the Keloid Come Back?

There is always some risk, and Dr. Agullo gives patients the actual numbers rather than a vague reassurance. Across the board, recurrence sits around ten to twenty percent. But once the keloid is cleaned up and closed well, most people are simply done with it, so the odds of it coming back the way it was probably drop under five percent. The moment it starts to feel hard or look like it is trying to return, the patient comes straight in and a touch more steroid is placed to shut it down early.

Where Do Keloids Actually Form?

This matters, Dr. Agullo notes, because patients worry about keloids in places they almost never occur.

Common Keloid Sites Rare or Essentially Never
Ears Face (rare)
Shoulders Eyelids (he has never seen one)
Sternum and chest Genital area (different tissue, never seen one)
Joints, like knees and ankles

Keloids set up shop wherever there is tension and movement. They are genuinely rare on the face, and on the eyelids Dr. Agullo has never seen one. The genital area is a different material entirely, more mucosa than skin and not under tension, so he has never seen one there either. So a patient bracing for a keloid before eyelid surgery or a labiaplasty can set that worry down.

What About a Mole or Spot on the Face?

Here is where having a plastic surgeon do it earns its keep. Anyone can take a lesion off, Dr. Agullo says. The reason to have him do it is that he is building toward the final scar the whole time, choosing where the incision sits and how it closes so that what remains is as close to invisible as possible, instead of just lifting the spot and moving on.

Med Spa Scar Care After the Procedure

Careful closure is only the first half. At Southwest Plastic Surgery, old or healing scars can be softened with microneedling using PDGF, a platelet derived growth factor that is like PRP but more powerful and helps renew collagen. It takes a few sessions and is done at the Med Spa. For certain marks and discoloration, laser treatments can refine the result further. The surgery sets up the scar, and the Med Spa work polishes it over time.

About Dr. Frank Agullo

Dr. Frank Agullo is the founder of Southwest Plastic Surgery in El Paso, Texas. He is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, completed a plastic surgery fellowship at the Mayo Clinic, and has been named a Castle Connolly Top Doctor for thirteen consecutive years. A keloid or a mole is a small thing, he tells patients, but the scar it leaves is permanent, so it is worth doing right the first time.

For the surgeon’s candid editorial take, see Dr. Agullo’s essay on drworldwide.com, and for the full patient walkthrough, see the companion post on agulloplasticsurgery.com.

Ready to Talk?

If there is a spot, a bump, or a keloid you want handled with the scar in mind, the team is ready. Call (915) 590-7900, text 1-866-814-0038, or book online at swplasticsurgery.com. #StayBeautiful.

@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.

Location Marker
Southwest Plastic Surgery
1387 George Dieter
Dr. Bldg C301
El Paso, TX 79936
Tel: (915) 590 7900
Fax: (915) 590 7902
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The MedSpa Southwest Plastic Surgery West
5925 Silver Springs Dr.
Suite C
El Paso, TX 79912
Tel: (915)590-7907
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