Pilonidal Sinus Expertise in Munich – Trusted Experience from Over 9,000 Procedures
One Focus. Specialists in Pilonidal Surgery since 2004
Do you have a pilonidal cyst and are looking for a gentle, effective treatment? Then you’ve come to the right place! At our specialist practice for pilonidal sinus surgery, Dr. Hofer and Dr. Liebl—both of whom are highly experienced specialists in visceral surgery and proctology—combine the highest level of professional expertise with state-of-the-art, minimally invasive methods such as pit picking, laser therapy, and optimized local anesthesia.
Our goal: to treat your symptoms gently, effectively, and with minimal pain—for shorter healing times, fewer restrictions in everyday life, and a quick return to what is important to you. The effectiveness of this approach is confirmed by our excellent Google reviews from numerous satisfied patients.
Our mission: No unnecessarily extensive surgery. No long hospital stays. Individualized therapy with the best chances of success.
- Over 20 years of specialization in coccyx fistulas
- Over 15 years of experience in laser surger
- More than 9000 successful operations
- Minimally invasive procedures for less pain and faster healing
Experiences and reviews
What is your current situation?
Not sure if you have a pilonidal sinus? Already advised to undergo surgery? Or dealing with a recurrence that affects your daily life? Wherever you are right now — we are here to help.
I have symptoms, but no confirmed diagnosis.
Do I actually have a pilonidal cyst?
- What is a pilonidal (tailbone) cyst?
- What are the typical symptoms of a pilonidal sinus?
- What does a pilonidal cyst look like?
Surgery has been recommended to me.
Ignore it? Operate? And if so, how?
- Options for treatment without surgery
- Surgical methods
- Advantages of laser treatment and laser surgery
Facing a recurrence?
I’ve already had surgery. The fistula is back. What should I do?
- Why does a relapse (recurrence) occur?
- What gentle alternatives are available?
- When is Karydakis surgery advisable?
The original: Pilonidal Sinus Center Munich since 2012
A diagnosis such as pilonidal sinus often raises many questions and can be unsettling. Since 2004, we have been working intensively on innovative therapies and have built up special expertise in this field. Even in complex cases or after multiple relapses, we can often help with gentle methods where other clinics would recommend more invasive procedures. Even though many now turn to the treatment of tailbone fistulas, we offer you the invaluable advantage of decades of experience in diagnostics, surgical techniques, and targeted support during the healing process.
Pilonidal sinus is a simple condition.
Recognizing and avoiding hidden pitfalls
What appears to be a harmless routine procedure can have serious consequences. These problems should be avoided:
- Long healing times
- Painful, time-consuming wound care
- Wound healing disorders
- Recurrence rates of up to 57% (Deutsches Ärzteblatt 2019)
- Scar tears and reoperations
- Hospital stays instead of outpatient care
- Loss of working time, income, and career opportunities
- Giving up sports, lack of exercise, weight gain
- Disturbances in body image with effects on intimate life
Our goal: Treatment that preserves your quality of life.
That's the difference:
8 good reasons why patients choose us
9000
Pilonidal surgeries (as of 14.01.2026)
11328
Surgical and conservative treatments
Laser
Laser experience 2012
1. Experience counts: Over 9,000 minimally invasive surgeries
Although pilonidal sinus is a skin condition, most patients first consult their family doctor, who then usually refers them to a surgeon.
In Germany, around 50,000 patients undergo surgery for pilonidal sinus every year. Statistically speaking, each surgeon treats an average of only 1.4 cases per year—a number that is hardly sufficient to gain in-depth experience with modern surgical methods.
That is why it is crucial to consult a specialist who focuses on the treatment of pilonidal cysts and has extensive experience.
Our experienced doctors, Dr. Hofer and Dr. Liebl, have been using minimally invasive procedures such as laser therapy and optimized local anesthesia for over a decade. These methods enable gentle, effective, and painless treatment.
Choose our practice to receive optimal care for your health from experienced specialists using the most modern surgical methods!
2. Modern treatment methods – because less is often more
The pit picking technique, developed in England and established in the USA, is a gentle method that impresses with its minimally invasive approach. At our specialist practice in Munich, we combine pit picking with other innovative procedures to ensure fast and effective healing.
Pit picking involves the targeted removal of affected hair roots as small skin cylinders (2–5 mm in diameter). In addition, the fistula tract is thoroughly cleaned of hair fragments and deposits. The more precisely this procedure is performed, the lower the risk of a new pilonidal cyst forming.
✔ Pit picking: Minimally invasive removal of the affected hair roots
✔ SiLaC™ (laser treatment): Gentle treatment of the fistula tract with laser
✔ EPSiT (endoscopic surgery): Precise excision with video technology
✔ Sinusectomy: Removal of the fistula capsule without excessive tissue loss
Your advantage: These methods mean less pain, a shorter healing time, and a quicker return to everyday life.
3. Cutting-edge medicine for all
At our practice, we are particularly committed to making modern medicine accessible to everyone—regardless of whether you have public or private health insurance. Thanks to our full accreditation for outpatient surgery and integrated care, all our patients benefit from our advanced surgical methods. Since the beginning of 2024, laser surgery has also been included in the range of services covered by all public health insurance providers thanks to the Hybrid DRG.
The only exception is laser hair removal, which continues to be offered as an IGeL self-pay service. However, we offer fair and transparent prices here too, because health and well-being should be affordable for everyone. Further information on billing and cost coverage—including for patients from other European and non-European countries—can be found on this page.
Good decisions are based on experience.
4. Pain-free, outpatient treatment under local anesthesia on the day of the examination
General anesthesia and hospitalization? Not with our minimally invasive procedures. Local anesthesia using the proven tumescent technique is sufficient to perform the treatment safely and comfortably. Complications during pit picking surgery are extremely rare, and serious problems are virtually impossible. This is why we can confidently offer this outpatient procedure even to patients who have a long journey home.
For your safety and well-being, the surgeon is available by phone around the clock after the procedure. In 99% of cases, we are able to perform completely pain-free treatment with local anesthesia. In exceptional cases where this is not sufficient, or for more complex procedures, we perform the treatment under general anesthesia in our outpatient surgery center (Iatros Clinic) – in most cases, you can still go home on the same day.
Painkillers such as ibuprofen are usually only needed as needed during the first two weeks. Our patients do not normally need stronger medication.
5. Making appointments easy
Making an appointment at our practice is particularly easy and flexible.
- If you are experiencing acute pain, you can come to us at any time after sending an informal email to [email protected] – we will treat you immediately.
- If you would like an examination and consultation with time to consider your options, you can conveniently arrange an appointment via our online calendar.
- For patients who want to save time, we offer an all-in-one appointment: send us photographic documentation of your symptoms in advance and get everything done in just one day. This way, you will receive the best possible treatment quickly and efficiently.
6. Care after surgery: Wound consultation office hours and via the ArztDirekt app
We won’t leave you alone after the operation. A successful operation alone does not guarantee smooth healing. We will advise you in detail about aftercare at the time of your operation appointment. With our support, a family member can become your personal wound specialist. We use the secure Arzt-Direkt messenger for this purpose.
Our information brochures will tell you what to expect during the healing process.
During follow-up treatment at the practice, your surgeon will personally ensure that your healing process is optimal.
During our wound and laser consultation hours, your wound will be professionally cared for by a trained and experienced therapist.
7. Odds of success
The modern surgical techniques of pit picking and sinusectomy have proven to be superior methods for treating pilonidal cysts. With success rates of over 90%, they are clearly the better alternatives to conventional procedures. In comparison, traditional surgeries such as the “Butcher’s” procedure have a high recurrence rate of up to 40%.
8. Recurrence prevention: Why laser hair removal is beneficial
Studies show that removing hair from the affected area using laser epilation significantly reduces the likelihood of recurrence. “Laser hair removal has proven to be an effective method of reducing the recurrence rate in patients with pilonidal cysts,” explains Dr. Hofer, founder of the Pilonidal Sinus Center in Munich.
A large meta-analysis from the Netherlands confirms: “Patients who underwent postoperative laser hair removal had a 50% lower probability of recurrence.” This makes laser hair removal a valuable part of follow-up care for pilonidal sinus surgery.c
Any questions about our treatment center for pilonidal cysts? FAQ
How can you tell if you have a fistula on your tailbone (pilonidal sinus)?
Typical symptoms include pain, swelling, small openings, and discharge of blood or pus in the area of the buttock crease.