Before & After


 

Please be aware that the following before and after photos of patients may be considered graphic by some.  If you do not wish to view surgical photos of patients please go to another screen.

Please note, that except where indicated, patients are photographed lying on their stomachs with their buttocks in view.  So the left side of the photo represents the left side of the patient.

In this photo the patient’s buttock cheeks are spread apart to reveal a deep cleft or valley.  The shaded area is the natal cleft.  Multiple dilated midline pits and a sinus draining to the top right (better seen in other, non-shaded photos below) are revealed.

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Here is a classic example of very symptomatic, primary pilonidal disease. This patient, a male in his early 20s, has developed several large dilated midline pits (previously infected hair follicles) and a draining sinus off to the upper portion of his natal cleft.

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These photos show a patient who has suffered for 6 years with pilonidal disease. He has undergone 3 operations by other surgeons, all of which have broken down resulting in a much worse pilonidal problem.

Dr. Sternberg performed a cleft lift procedure and he rapidly recovered. The post-op photo was taken only 3 weeks after surgery. For the first time in years, he was able to return to athletics.

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Here is an example of college student who has suffered from pilonidal disease since mid high school.

He had 3 previous operations from other surgeons, all of which failed. You can see that he developed a huge chronic open wound very close to the anus. His natal cleft is very scarred from the prior operations, which involved a wide excision and midline closure.

Dr. Sternberg performed a cleft lift procedure. He ends up with an excellent post-op result.

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This photo demonstrates the island of skin that is typically removed during a the cleft lift procedure (outlined on the right).

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Here is a photo of the debris and hair commonly removed from the chronic abscess of a chronic pilonidal sufferer at the time of cleft lift surgery.

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This is an excellent demonstration a pilonidal sinus.  Here it’s demonstrated that the hole closest to the anus connects to the top draining sinus hole.  It is why operations that don’t address this lowest hole will result in failure and a recurrent abscess/sinus.


This is a 21 year old who has suffered from pilonidal disease for 6 years.  Another surgeon performed two wide excisional operations, both of which have failed.  He was left with a complex pilonidal wound with a number of midline openings, the largest of which was close to the anus.  Photo 3 demonstrates the outline of the island of skin on the left side, which will be eventually removed during the procedure.  Photo 4 shows that the lowest opening connects through a long abscess cavity to the top draining sinus.  In photo 5, the skin island has been removed and the abscess is revealed.  It is filled with hair.  That hair and debris has been removed in photo 6.  The white abscess cavity wall is preserved and used in the wound closure.  The last two photos show the immediate final result with the drain in place.

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Here’s an immediate post-op photo of a patient with steri-strips and drain in place. This is the drain configuration that I use now. The drain comes through the lower portion of the skin incision and passes through a skin opening that I create near the top of the flap. The drain is a loop and can be rotated.

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Location
The Sternberg Clinic
77 Van Ness Avenue, Suite 300
Civic Center, Hayes Valley

San Francisco, CA 94102
Phone: 415-821-8000
Office Hours

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415-821-8000