Ganglion cysts are the most common soft tissue tumors of the hand. They are benign growths but can cause pain, restrict movement, and produce compression syndromes when they enlarge. Anatomically, ganglion cysts arise from a joint or from the sheath of a flexor or extensor tendon. The cyst itself contains a clear mucinous gel-like material — and because the contents are translucent, ganglion cysts will glow when light is applied to them in a dark setting. Each cyst is typically attached to a stalk that originates from a deep bony joint, and identifying that stalk is essential for effective surgical removal. Approximately 70-80% of ganglion cysts occur on the dorsal aspect of the wrist joint — most commonly over the scapho-lunate ligament — with the next most common location being the volar wrist over the scaphoid tubercle. At Los Angeles Plastic Surgery, Dr. John Anastasatos diagnoses and surgically removes ganglion cysts of the hand and wrist with the depth of training this anatomically intricate procedure specifically rewards.

Dr. Anastasatos performs ganglion cyst removal with the most directly relevant academic credential possible: he completed a fellowship in Hand and Upper Extremity Surgery and Microsurgery at the University of Alabama at Birmingham — formal subspecialty training in the deep anatomy and surgical technique of the hand that few cosmetic plastic surgeons possess. He has been an invited lecturer at the Royal Society of Medicine in London on advanced surgical techniques, with an invited 2026 return as featured speaker. With over two decades of facial and hand surgical expertise in Beverly Hills since 2007, he is board certified by the American Board of Plastic Surgery, a Fellow of the American College of Surgeons (FACS), a member of the American Society of Plastic Surgeons (ASPS) and American Society for Aesthetic Plastic Surgery (ASAPS), and named by The Luxe Insider as one of the Top 10 Plastic Surgeons in the World.

Symptoms and When Treatment Is Needed

Many ganglion cysts are entirely asymptomatic. They can enlarge over time, but they can also regress spontaneously. For asymptomatic patients, observation alone is a reasonable approach — and Dr. Anastasatos offers this option to patients once the diagnosis has been made.

Treatment is appropriate when:

• Pain develops as the cyst enlarges or compresses surrounding structures
• Compression symptoms develop — particularly compression of the median or ulnar nerves at the wrist, producing numbness and tingling of the fingers
• Aesthetic concerns — some patients elect surgical removal because the cyst is not aesthetically pleasing, even when it is asymptomatic
• Functional limitation — the cyst restricts wrist motion or grip

Why “Popping” a Ganglion Cyst Doesn’t Work

A persistent myth holds that ganglion cysts can be effectively treated by “popping” them with a needle or by applying intense pressure. This approach can deflate the cyst temporarily — but the cyst will refill over time because the underlying cyst wall and stalk remain intact. Definitive treatment requires complete surgical removal of all three structures: the cyst contents, the cyst wall (lining), and the connecting stalk.

Surgical Removal of Ganglion Cysts

Effective ganglion cyst therapy consists of operative resection of the cyst lining, the cystic contents, and the stalk. Specifically:

• Small wrist incisions — performed through very small incisions that heal well with proper plastic surgery technique and delicate tissue handling
• Complete cyst removal — including the cyst wall, contents, and the stalk that originates from the underlying joint
• Thorough exploration — careful examination to ensure no residual cyst tissue or stalk remains, since incomplete removal leads to recurrence
• Delicate closure — fine sutures placed for the best possible scar outcome
• Recovery — sutures removed at 10-14 days, with most patients returning to work within a few days depending on their job’s hand demands

Recurrence is possible if any portion of the stalk or cystic lining remains — which is why thorough surgical exploration is essential. Hand fellowship training matters meaningfully for the complete removal that prevents recurrence.

Schedule a Ganglion Cyst Consultation in Beverly Hills

Dr. Anastasatos welcomes patients to the Beverly Hills office at 436 North Bedford Drive, Suite 202, Beverly Hills, CA 90210, for a private consultation evaluating your specific anatomy and outlining the appropriate treatment approach — whether observation or surgical removal. Contact Los Angeles Plastic Surgery to schedule your appointment with Dr. Anastasatos.