Stop Your Pilonidal Pain.
For Good.
Dr. Yosef Nasseri and Dr. Moshe Barnajian have perfected an advanced flap-based outpatient procedure that removes the cyst completely — so you heal quickly, sit comfortably, and stop worrying about it coming back.
- ✓Outpatient — home the same day
- ✓Quick recovery, minimal downtime
- ✓Dramatically lower recurrence
- ✓Most PPO insurances accepted
- ✓Patients fly in from across the U.S. & around the world
Same-week consultations are often available — don’t wait for another painful flare-up.
“I was constantly in tears from the pain… Within a few days I was no longer in excruciating pain and was starting to feel like myself again.”
— Mila B. · Yelp · patient of Dr. Barnajian“Dr. Nasseri resolved the cyst my son had in no time. His approach is precise — it resolved the issue from the core.”
— Patty C. · Google review“These surgeons have a level of knowledge and skill that rival the best institutions in the nation. Their surgical results — patients like me — speak for themselves.”
— Joshua S. · Google review
Cutting Edge Pilonidal Treatment
Dr. Nasseri and Dr. Barnajian are experts in the Los Angeles area in the treatment of pilonidal cysts. They have perfected a cutting-edge flap-based outpatient treatment technique to relieve symptoms and minimize the chances of the disease redeveloping.
When you come to the Pilonidal Institute, we first evaluate whether there is an associated abscess. If so, the area is numbed in the office and drained under sterile conditions, with careful wound-care instructions and follow-up within a week or two.
If no abscess is present, our surgeons perform an elective outpatient procedure in which the pilonidal cyst and sinus are completely removed and the wound is reconstructed and closed in a cosmetically favored fashion using their unique flap-based technique.
Learn about our cutting-edge flap technique →Not All Pilonidal Surgery Is the Same
Most pilonidal operations still leave an open wound to pack for weeks, or move the scar off the midline. Our bilateral fasciocutaneous flap with ECM closes the wound inside the natural cleft and rebuilds the anatomy that caused the problem in the first place.
| What’s different | Open-wound excision(most common locally) | Cleft lift(most specialists) | Bilateral fasciocutaneous flap + ECM(our technique) |
|---|---|---|---|
| Wound at the end of surgery | Open — packed daily for 6–12+ weeks | Closed off-midline | Closed in the midline |
| Where the scar sits | Midline, but with prolonged open-wound healing | Off-midline (lateral to the cleft, by design) | Midline, blending into the natural cleft |
| What changes about your cleft anatomy | Tissue contracture from open-wound healing | Mechanical flattening or asymmetry possible | Cleft anatomy reconstructed and preserved |
| Recurrence mechanism (if it happens) | Wound never closes, or closes and reopens | Closure tension or scar contracture pulls open | Flap dehiscence — addressed pre-op by patient selection and ECM tissue support |
| Surgeon training behind the technique | General surgery | Mixed (cleft lift specialists) | Colorectal subspecialty + flap reconstruction experience |
Recurrence rate
Recurrence after full healing is 2% or less.
No open-wound packing
The closed flap eliminates daily gauze changes and local wound-care visits.
Sitting and driving
Minimal pain on waking. Cushioned sitting begins after 48 hours.
Cosmetic outcome
The scar sits in the midline where the cleft already runs — far less visible than an off-midline scar.
Patients Fly In From Around the World
Pilonidal disease is all we do — and that focus is why patients travel to Los Angeles from across the United States and from abroad, many after one or more failed surgeries elsewhere. Every part of the journey is coordinated for the traveling patient: a virtual consultation before you book a flight, surgery and follow-up sequenced into a single trip, and remote check-ins once you are home.
Nationwide and international
Patients come from across the U.S. and overseas for our flap-based repair.
Virtual consultation first
Review your case with the surgeon from anywhere before you travel.
One trip, fully coordinated
Consultation, outpatient surgery and key follow-up visits in a single stay.
Cedars-Sinai based team
Board-certified colorectal surgeons at Cedars-Sinai Medical Towers, Los Angeles.
Pilonidal Disease,
Explained.
A pilonidal cyst is a small pocket that forms under the skin near the tailbone, usually containing hair and debris. It can look like little more than a pimple — until it becomes infected and turns into a deeply painful abscess that makes sitting, driving and working unbearable.
Our surgeons remove it at the source — so it never comes back.
Learn more about pilonidal cysts →
0101Infected Pilonidal Cysts
Redness, swelling and severe pain when sitting are warning signs. Learn how to recognize an infected cyst — and when to seek expert care.
Learn More →
0202Pilonidal Sinus Tracts
Understand how tunnels form beneath the skin, why they keep draining, and how flap surgery removes them completely.
Learn More →
0303Preventing Recurrence
Why cysts return after drainage or basic excision — and how our flap-based technique achieves near-zero recurrence.
Learn More →Pilonidal Care, End to End
From the first infected flare-up to a closed, healed wound — every step handled by surgeons who do this every week.
Diagnosis & EvaluationA focused exam confirms pilonidal disease, stages the sinus and rules out an abscess — so treatment is planned around your anatomy, not a template.Learn More →
Drainage & Wound CareInfected abscesses are drained in-office under local anesthetic, with clear wound-care instructions and follow-up within a week or two.Learn More →
Advanced Flap-Based RepairOur bilateral fasciocutaneous flap removes the disease completely and closes the wound off-midline — no packing, near-zero recurrence.Learn More →
Comparing Surgical OptionsWide excision, cleft lift or flap repair? We walk through recovery time, recurrence rates and scarring so the choice is informed, not rushed.Learn More →
Revision After Failed SurgeryRecurrence after a prior repair is routine here. We rebuild the area with healthy tissue and close it properly the second time.Learn More →
Scars & RecoveryWhat the scar looks like, and when you can sit, drive and train again — discussed before surgery, not after.Learn More →Meet The Pilonidal Specialists
Two nationally recognized colorectal surgeons, one dedicated institute for pilonidal disease.
Dr. Yosef Nasseri
Yosef Nasseri, MD, FACS, FASCRS, is a distinguished double board-certified surgeon specializing in both general and colorectal surgery. Renowned for his leadership in minimally invasive and robotic surgical techniques, Dr. Nasseri has earned recognition as one of the foremost innovators in his field. He serves as an Associate Professor of Surgery at Cedars-Sinai Medical Center — the top-ranked hospital in California and second-ranked nationwide.
Meet Dr. Nasseri
Dr. Moshe Barnajian
A highly regarded, board-certified colorectal surgeon, Moshe Barnajian, MD, is recognized for his expertise in minimally invasive and advanced laparoscopic surgery. Dr. Barnajian combines clinical precision with a patient-centered approach, ensuring compassionate and comprehensive care. He is widely respected for managing both routine and complex colorectal conditions, delivering the highest standards of safety, innovation, and long-term outcomes.
Meet Dr. BarnajianReal Pilonidal Patients. Real Relief.
Rated 5.0 on Google by pilonidal patients of Dr. Nasseri and Dr. Barnajian.
THANK YOU EVERYONE AT THE PILONIDAL INSTITUTE. I was at my limit when I had my appointment. I was hopeless, dealing with my 6th cyst within 8 months…
Erica P. · Google reviewI recently had surgery for a pilonidal cyst with Dr. Nasseri, and I truly can’t say enough good things about the experience. From start to finish, Dr. Nasseri was amazing.
Maral · Google reviewof pilonidal patients treated by our surgeons
I came to the Pilonidal Institute with a chronic pilonidal cyst that had been severely inhibiting my life for the previous 1.5 years. I’m so glad I found them.
Jeffrey B. · Google reviewDr Barnajian is a complete class act. He was very thorough and professional during the pre and post surgery process. I recommend Dr B. wholeheartedly for anyone.
Antonio F. · Google reviewrecurrence rate with our published flap technique
I had pilonidal cyst surgery with Dr. Yosef Nasseri, and I had a very positive experience. He was professional, skilled, and took the time to answer all of my questions thoroughly.
Aerielle M. · Google reviewFrom start to finish Dr. B was informative and took his time in explaining the procedure and healing process — never did we feel rushed or not well informed.
Vasthi · Google reviewA good doctor is one who is compassionate and supports his patients in the worst moments of the disease process. That’s why I consider him an excellent doctor.
Darlin P. · verified patientImagine Sitting, Driving & Working Out — Pain-Free
Conditions in this area are hard to talk about — we get it. Dr. Nasseri and Dr. Barnajian have guided thousands of patients from painful flare-ups back to comfortable, active, pain-free living. They listen, answer every question, and build a personalized plan around the fastest possible recovery.
Start My RecoveryThe Pain Is Real. So Is the Cure.
If you’re reading this while shifting in your seat to avoid the pressure — we’ve met you a thousand times. That searing tenderness at the base of your spine, the swelling that flares just when life gets busy, the dread of another infection: this is what pilonidal disease does.
The pain of a pilonidal flare-up is unlike anything else — a deep, throbbing pressure at the tailbone that turns everyday life into a series of calculations. How long is the drive? How hard is the chair? Will sitting through a meeting, a class, or a flight make it worse? Many of our patients tell us they quietly rearranged their whole lives around their cyst — skipping the gym, avoiding travel, sleeping on their side, dreading every recurrence.
And because of where pilonidal disease occurs, too many people suffer in silence — embarrassed to talk about it, hoping it will go away on its own. It rarely does. Flare-ups tend to return, each one more disruptive than the last.
You don’t have to live this way. Pilonidal disease is completely treatable — and with the right surgical technique, it almost never comes back.
How the Pilonidal Institute Can Help
- ✓Immediate relief — infected abscesses are drained in-office, under local anesthetic, often the same week you call
- ✓A permanent solution — our published flap-based technique removes the disease completely, with a near-zero recurrence rate
- ✓Outpatient & quick recovery — home the same day, minimal pain, and back to your life fast
- ✓Discreet, judgment-free care — two board-certified colorectal surgeons who treat this condition every week and understand exactly what you’re going through
Learn About Pilonidal Cysts
Can a Pilonidal Cyst Cause Back Pain?
Many patients ask whether pilonidal cyst back pain is a real connection or just a coincidence — here is what our surgeons say.
Read More →
Returning to Exercise After Pilonidal Surgery
Knowing when to resume exercise after pilonidal surgery is one of the most common questions our Los Angeles patients ask.
Read More →
How Much Does Pilonidal Cyst Surgery Cost in Los Angeles?
Researching pilonidal cyst surgery cost in Los Angeles? The honest answer depends on several key factors.
Read More →