Pilonidal disease often appears as cysts or abnormal abscesses that develop in the upper part of the gluteal cleft (the upper region of the buttocks.) These cysts or abscesses usually become noticeable when swelling or infection occurs, often causing discomfort and pain.
What Causes Pilonidal Disease?
While the exact cause of pilonidal disease isn’t fully understood, it is widely believed to result from loose hairs that penetrate the skin. Friction and pressure can push these hairs deeper into the skin, while trapped dirt and debris cause the cysts to become inflamed, potentially leading to painful, swollen, and reddened abscesses.
What Are the Symptoms of Pilonidal Disease?
There are several indications that a pilonidal cyst may be infected and could benefit from surgical treatment. The most common symptoms include:
Pain in the affected area
Redness or swelling of the skin
Drainage of blood or pus from an opening in the skin
If you suspect you may have an infected pilonidal cyst, we encourage you to reach out to our specialists at Thrive Reconstructive Surgery. Our team can discuss your symptoms with you and guide you through the treatment options available.
How do we treat a Pilonidal Disease?
Treatment typically involves surgical intervention under generalized or local anesthesia. During the procedure, an incision and abscess are drained. To avoid recurrence and help you get back to your daily life, our surgeons will take the remaining and surrounding areas for surgical debridement and reconstruction, ultimately removing the inflamed tissue from the body.

How Do We Treat a Pilonidal Disease?
Treatment typically involves a surgical procedure performed under local or general anesthesia. During surgery, the abscess is opened and drained to relieve pain and infection. To help prevent recurrence and support lasting healing, our surgeons also perform careful debridement and reconstruction, removing the inflamed tissue and surrounding problem areas so you can return to your daily life with greater comfort.
When Is Surgery a Viable Option to Consider?
If you are experiencing severe discomfort from pilonidal disease or are tired of the recurring pain, surgery may be the best option for you. At Thrive Reconstructive Surgery, our team is here to guide you through your treatment choices and support you in achieving the smoothest possible recovery.
- Dr. Pekarev is AMAZING and his staff is extremely helpful and kind. If you want a doctor that truly cares about your quality of life, then you can trust this team to always do what’s best for you. When I had my motor vehicle accident, I went through the toughest times in my life. Thanks to Dr. Pekarev and his commitment to my outcome, I was able to save my arm from being amputated. He truly cares about all his patients and is extremely reassuring, which helped me pull through this tough time. I forgot the name of his PA but she was also amazing - I trust this team with my life!+ Read moreread lessLewis M.×Lewis M.Dr. Pekarev is AMAZING and his staff is extremely helpful and kind. If you want a doctor that truly cares about your quality of life, then you can trust this team to always do what’s best for you. When I had my motor vehicle accident, I went through the toughest times in my life. Thanks to Dr. Pekarev and his commitment to my outcome, I was able to save my arm from being amputated. He truly cares about all his patients and is extremely reassuring, which helped me pull through this tough time. I forgot the name of his PA but she was also amazing - I trust this team with my life!
- I absolutely cannot say enough good things about Dr. Max and his staff! I suffered from a very unusual case of lymphedema in my abdomen. I'd been fighting for 2 years to get it removed. Dr. Max took one look at me and said he could help. A 67lb mass was removed from my abdomen. I'm still healing but the entire office has been amazing!! They literally changed my life and I could not be more grateful to them!+ Read moreread lessLauren C.×Lauren C.I absolutely cannot say enough good things about Dr. Max and his staff! I suffered from a very unusual case of lymphedema in my abdomen. I'd been fighting for 2 years to get it removed. Dr. Max took one look at me and said he could help. A 67lb mass was removed from my abdomen. I'm still healing but the entire office has been amazing!! They literally changed my life and I could not be more grateful to them!
- Dr. Max and his team are top notch! I have been dealing with hidradenitis suppurativa for 12 years in my bikini area after being misdiagnosed by many other dermatologists. Dr. Max took 1 look at me and said surgery would be the best option. I am only 2 days post-op, and I already have so much more confidence. I am so grateful for Dr. Max and his entire team. They have truly changed my life for the better!+ Read moreread lessBrooke D.×Brooke D.Dr. Max and his team are top notch! I have been dealing with hidradenitis suppurativa for 12 years in my bikini area after being misdiagnosed by many other dermatologists. Dr. Max took 1 look at me and said surgery would be the best option. I am only 2 days post-op, and I already have so much more confidence. I am so grateful for Dr. Max and his entire team. They have truly changed my life for the better!
- Dr. Max is brilliant!+ Read moreread lessStephanie a.×Stephanie a.Dr. Max is brilliant!
- Dr. Pekarev has done two surgeries on me. I will only trust him and his team to do anything on me! Dr. P is so knowledgeable and has such a great bedside manner, not to mention, he is very easy on the eyes! 😁 I definitely recommend him to anyone needing his services!+ Read moreread lessAlysia S.×Alysia S.Dr. Pekarev has done two surgeries on me. I will only trust him and his team to do anything on me! Dr. P is so knowledgeable and has such a great bedside manner, not to mention, he is very easy on the eyes! 😁 I definitely recommend him to anyone needing his services!
- Very friendly and helpful staff. Dr. Max is the best!+ Read moreread lessDeborah C.×Deborah C.Very friendly and helpful staff. Dr. Max is the best!
- I absolutely LOVE Dr. Max and his staff. My first surgery with Dr. Max was after I was attacked in the face by a golden retriever dog that ripped my bottom lip off. It was on an early Saturday morning that I was rushed to an ER to find out Dr. Max was one of the top specialist to work on lips and cheeks and he was on call. He did facial reconstruction and really took care of me. I was only 24 years old and I lived in OK.. I was visiting TX for the weekend. So I was very scared and he reconstructed my face beautifully. Fast forward a few years and he’s now become my Go-to plastic surgeon because he truly cares about his patients. His communication is like none other.. I was in a lot of pain having suture spit over a weekend and he met me and my husband at his office (within an hour) on a Saturday to take out stitches so I wasn’t in pain all weekend. His office staff always answers the phone, returns phone calls, sends faxes within minutes... They are truly on their game and his work is incredible. Also, I’ve never waited longer than 5-10 minutes in the waiting room. My favorite thing about Dr. Max is you can tell he enjoys his job. He’s not just in it for the money.. He told me in an appointment that after this last procedure I have done there is absolutely nothing else I should feel I need to have done. Which tells me he’s not in this for the money. He’s a great man, and I’m thankful for their practice! They’ve always taken such great care of me!+ Read moreread lessSam D.×Sam D.I absolutely LOVE Dr. Max and his staff. My first surgery with Dr. Max was after I was attacked in the face by a golden retriever dog that ripped my bottom lip off. It was on an early Saturday morning that I was rushed to an ER to find out Dr. Max was one of the top specialist to work on lips and cheeks and he was on call. He did facial reconstruction and really took care of me. I was only 24 years old and I lived in OK.. I was visiting TX for the weekend. So I was very scared and he reconstructed my face beautifully. Fast forward a few years and he’s now become my Go-to plastic surgeon because he truly cares about his patients. His communication is like none other.. I was in a lot of pain having suture spit over a weekend and he met me and my husband at his office (within an hour) on a Saturday to take out stitches so I wasn’t in pain all weekend. His office staff always answers the phone, returns phone calls, sends faxes within minutes... They are truly on their game and his work is incredible. Also, I’ve never waited longer than 5-10 minutes in the waiting room. My favorite thing about Dr. Max is you can tell he enjoys his job. He’s not just in it for the money.. He told me in an appointment that after this last procedure I have done there is absolutely nothing else I should feel I need to have done. Which tells me he’s not in this for the money. He’s a great man, and I’m thankful for their practice! They’ve always taken such great care of me!
- Dr. Max is the absolute best! He is so kind and genuinely interested in getting to know his patients. The staff is incredible. They treat you like family. I’ve learned from talking to him that his passion lies in traumatic reconstruction and he serves many of the Fort Worth hospitals. You are most definitely in great hands with Dr. Max!+ Read moreread lessKylie H.×Kylie H.Dr. Max is the absolute best! He is so kind and genuinely interested in getting to know his patients. The staff is incredible. They treat you like family. I’ve learned from talking to him that his passion lies in traumatic reconstruction and he serves many of the Fort Worth hospitals. You are most definitely in great hands with Dr. Max!
- As a nurse, I’m asked a lot about what physician I would recommend, Dr Pekarev is by far my surgeon of choice! His bedside manner is exceptional, explaining everything, and setting you at ease. If you are needing a minor or major cosmetic procedure, this is who you want to take care of you!+ Read moreread lessAnna G.×Anna G.As a nurse, I’m asked a lot about what physician I would recommend, Dr Pekarev is by far my surgeon of choice! His bedside manner is exceptional, explaining everything, and setting you at ease. If you are needing a minor or major cosmetic procedure, this is who you want to take care of you!
- Was so impressed with this office! Dr. Pekarev was such a kind and skilled doctor, the front desk, ma’s, nurse all had a wonderful personality. My face needed stitches and it was taken care of promptly and with great care. My face healed wonderfully due to the doctors skilled hand. I would go back for any procedure.+ Read moreread lesslisa p.×lisa p.Was so impressed with this office! Dr. Pekarev was such a kind and skilled doctor, the front desk, ma’s, nurse all had a wonderful personality. My face needed stitches and it was taken care of promptly and with great care. My face healed wonderfully due to the doctors skilled hand. I would go back for any procedure.
- Everyone here was so nice! Excellent care from excellent people!+ Read moreread lessKyndal M.×Kyndal M.Everyone here was so nice! Excellent care from excellent people!
- The man is a genius and sewed my ear back on and it looks good. GREAT WORK, DOC+ Read moreread lessjason s.×jason s.The man is a genius and sewed my ear back on and it looks good. GREAT WORK, DOC
- Dr. Max is a fantastic doctor! I am very happy with his services and his attention to detail and well-being of patients. It was a long journey for me but we finally got through it. Monica was a great nurse and assistant too and was always attentive, knowledgeable, and kind. The rest of the staff were great too, always friendly, smiling and well knowledgeable. If I had to get another surgery, I would definitely come back here. 5 out of 5 stars+ Read moreread lessJohn J.×John J.Dr. Max is a fantastic doctor! I am very happy with his services and his attention to detail and well-being of patients. It was a long journey for me but we finally got through it. Monica was a great nurse and assistant too and was always attentive, knowledgeable, and kind. The rest of the staff were great too, always friendly, smiling and well knowledgeable. If I had to get another surgery, I would definitely come back here. 5 out of 5 stars
- Dr. Max is the best!! My daughter is only 13 and was in a accident that crushed her hand and fingers and he was AMAZING with her before, during, and after surgery. Plus all her appointments he has been so positive and encouraging too!! The staff in his office are so sweet too!!+ Read moreread lessKaren P.×Karen P.Dr. Max is the best!! My daughter is only 13 and was in a accident that crushed her hand and fingers and he was AMAZING with her before, during, and after surgery. Plus all her appointments he has been so positive and encouraging too!! The staff in his office are so sweet too!!
- Dr. Pekarev is a true professional! He is extremely knowledgeable and was beyond patient with the questions I asked of him. I am very pleased with the work he did. His staff was amazing and helped a mom in need by soothing my crying baby boy! I truly couldn’t have asked for a better visit. I have already recommended Dr. Pekarev to family, friends and co-workers. You will not be disappointed!+ Read moreread lessRochelle D.×Rochelle D.Dr. Pekarev is a true professional! He is extremely knowledgeable and was beyond patient with the questions I asked of him. I am very pleased with the work he did. His staff was amazing and helped a mom in need by soothing my crying baby boy! I truly couldn’t have asked for a better visit. I have already recommended Dr. Pekarev to family, friends and co-workers. You will not be disappointed!
- Dr. Max and his staff are fantastic. I would highly recommend them to anyone needing any type of plastic surgery.+ Read moreread lessRandy B.×Randy B.Dr. Max and his staff are fantastic. I would highly recommend them to anyone needing any type of plastic surgery.
- All of the staff were absolutely wonderful, from the young lady at the front all the way up to the doctor. I felt welcomed and taken care of. The procedure was smooth and well done and they all have a fantastic bedside manner, which really helped me not be nervous.+ Read moreread lessJenna J.×Jenna J.All of the staff were absolutely wonderful, from the young lady at the front all the way up to the doctor. I felt welcomed and taken care of. The procedure was smooth and well done and they all have a fantastic bedside manner, which really helped me not be nervous.
- My experience with Dr. Max has been spectacular. At 50 years old I decided to treat myself to a mommy makeover. The office staff is helpful and kind. Dr. Max and his staff are very positive, caring and willing to answer all my questions. Their exceptional care along with my dedication to following the healing protocols have given me results I could never have imagined. I highly recommend MP Plastic Surgery!+ Read moreread lessDenise S.×Denise S.My experience with Dr. Max has been spectacular. At 50 years old I decided to treat myself to a mommy makeover. The office staff is helpful and kind. Dr. Max and his staff are very positive, caring and willing to answer all my questions. Their exceptional care along with my dedication to following the healing protocols have given me results I could never have imagined. I highly recommend MP Plastic Surgery!
- Everyone is super friendly! The doctor is professional and kind. Highly recommend!+ Read moreread lessErika×ErikaEveryone is super friendly! The doctor is professional and kind. Highly recommend!
- I personally recommend this Dr. To anyone and everyone.. He's very professional, honest, and detailed, about his work. He has performed 2 surgeries on me, with no complications at all. He has hands down the best office staff. Very friendly And professional. I love Dr. Pekarev he is an amazing person+ Read moreread lessLinda a.×Linda a.I personally recommend this Dr. To anyone and everyone.. He's very professional, honest, and detailed, about his work. He has performed 2 surgeries on me, with no complications at all. He has hands down the best office staff. Very friendly And professional. I love Dr. Pekarev he is an amazing person
- Overall experience was great! Dr. Max is very reassuring and the rest of the staff are so nice! Dr. Max works hard and makes a big effort into whatever you want to do. Everytime I walk through the door, everyone gleams and says "Hey girl!" They are also very professional and are very excited about these procedures like the awesome medical nerds they are. 😉 This environment makes me excited for my future Nursing Career.😆+ Read moreread lessAmy P.×Amy P.Overall experience was great! Dr. Max is very reassuring and the rest of the staff are so nice! Dr. Max works hard and makes a big effort into whatever you want to do. Everytime I walk through the door, everyone gleams and says "Hey girl!" They are also very professional and are very excited about these procedures like the awesome medical nerds they are. 😉 This environment makes me excited for my future Nursing Career.😆
- Every time I went to the office, the first thing I saw when going in was a big smile from the young ladies at the desk. I always got in fast. Dr. Max did a wonderful job on my foot. I would like to recommend him to anyone who needs surgery and want a professional job. Also I'd like to recognize miss Monica. She was a true professional in every way and showed real concern for her patients. I enjoyed having her there. 🌹🌹J. Sparks+ Read moreread lessJimmie S.×Jimmie S.Every time I went to the office, the first thing I saw when going in was a big smile from the young ladies at the desk. I always got in fast. Dr. Max did a wonderful job on my foot. I would like to recommend him to anyone who needs surgery and want a professional job. Also I'd like to recognize miss Monica. She was a true professional in every way and showed real concern for her patients. I enjoyed having her there. 🌹🌹J. Sparks
- I love Dr. Alex. He took the time to understand what I wanted and also gave professional feedback. He took the natural look of my lips and accentuated them. Couldn't be happier with the results.+ Read moreread lessJen J.×Jen J.I love Dr. Alex. He took the time to understand what I wanted and also gave professional feedback. He took the natural look of my lips and accentuated them. Couldn't be happier with the results.
- My wife had surgery with Dr. Max and we couldn’t have chosen a better office or surgeon! They are always so welcoming and kind. Definitely our go-to guy for everything going forward.+ Read moreread lessJohn W.×John W.My wife had surgery with Dr. Max and we couldn’t have chosen a better office or surgeon! They are always so welcoming and kind. Definitely our go-to guy for everything going forward.
- Dr. Pekarev and his office personnel are awesome, friendly and caring. I would highly recommend his services to anyone. He is very knowledgeable in his field of practice. Ronnie Bane, patient+ Read moreread lessmargaret b.×margaret b.Dr. Pekarev and his office personnel are awesome, friendly and caring. I would highly recommend his services to anyone. He is very knowledgeable in his field of practice. Ronnie Bane, patient
- Great staff and great doctor!!!!! Highly recommend!+ Read moreread lessKelly M.×Kelly M.Great staff and great doctor!!!!! Highly recommend!
- Dr. Max and his staff are second to none! I always receive top notch service and desired results at each visit. I always feel at ease right when I walk in and am greeted by his lovely staff! Would most definitely recommend for all plastic surgery and cosmetic needs!+ Read moreread lessPaige T.×Paige T.Dr. Max and his staff are second to none! I always receive top notch service and desired results at each visit. I always feel at ease right when I walk in and am greeted by his lovely staff! Would most definitely recommend for all plastic surgery and cosmetic needs!
- I highly recommend MP Plastic Surgery. I love Dr. Max and his wonderful team. Dr. Max is very professional, personable, kind and takes the time to listen and advise you of all your concerns. His staff is always friendly and welcoming. It’s been 1.5 years and I have been very pleased with the outcome of my breast reconstruction. He’s the best for botox and fillers too! 😊 I’ve seen other doctors and visited other clinics over the years. Dr. Max provides good and consistent results.+ Read moreread lessMarie W.×Marie W.I highly recommend MP Plastic Surgery. I love Dr. Max and his wonderful team. Dr. Max is very professional, personable, kind and takes the time to listen and advise you of all your concerns. His staff is always friendly and welcoming. It’s been 1.5 years and I have been very pleased with the outcome of my breast reconstruction. He’s the best for botox and fillers too! 😊 I’ve seen other doctors and visited other clinics over the years. Dr. Max provides good and consistent results.
- Dr. Max and his AMAZING office are top notch! Very informative, kind, caring and professional. I had to have a wound vac from a post surgical issue from another doctor and I was him on a Tuesday and five days later he had me in and taken care of. He is very personable and will give you the straight facts. His office staff and nurses are kind and knowledgeable; they treat you like family. My home health nurses were able to work with the whole office with no issues and said they loved how easy they are to work with.+ Read moreread lessJosephine R.×Josephine R.Dr. Max and his AMAZING office are top notch! Very informative, kind, caring and professional. I had to have a wound vac from a post surgical issue from another doctor and I was him on a Tuesday and five days later he had me in and taken care of. He is very personable and will give you the straight facts. His office staff and nurses are kind and knowledgeable; they treat you like family. My home health nurses were able to work with the whole office with no issues and said they loved how easy they are to work with.
- Wouldn't go anywhere else for my Botox and filler! An amazing doctor with a gentle touch.+ Read moreread lessMonica M.×Monica M.Wouldn't go anywhere else for my Botox and filler! An amazing doctor with a gentle touch.
- Dr. Max is great! After years of thinking it through, I decided to get a lift and new implants. Everyone, from the staff in the office to the surgery center he is associated with for the procedure, is top notch. The waiting room is stylish and sophisticated. I will refer anyone asking about plastic surgery to Dr. Max. You will love his bedside manner. I am so pleased I found him. He explained every possible scenario to me. I was well informed and felt very comfortable with my decision and now outcome. Thanks Dr. Max!+ Read moreread lessStephanie C.×Stephanie C.Dr. Max is great! After years of thinking it through, I decided to get a lift and new implants. Everyone, from the staff in the office to the surgery center he is associated with for the procedure, is top notch. The waiting room is stylish and sophisticated. I will refer anyone asking about plastic surgery to Dr. Max. You will love his bedside manner. I am so pleased I found him. He explained every possible scenario to me. I was well informed and felt very comfortable with my decision and now outcome. Thanks Dr. Max!