It's rare that Dr. Pimple Popper's Instagram videos make me truly scream in horror, hands pressed to the sides of face like the Edvard Munch painting, but this one finally made it happen.

In a new Instagram video posted Monday, celebrity dermatologist Dr. Sandra Lee, MD-aka Dr. Pimple Popper-does something a little different to remove a patient's cyst. We're used to seeing her metal extraction tool, her tweezers, her little scissors...but this time, Lee attacks the ear-adjacent cyst with a tool that has a circular blade on the end. She pressed the tool into the patient's skin, et voila, it works like a hole-punch to cut a perfectly-circular hole right on top of the cyst.

And then, it's cyst-pulling-out time. If the hole-punch tool didn't freak you out enough, you won't believe the size of the thing Lee yanks out of the void. It keeps coming...and coming...and solid mass instead of a liquid-y stream of pus. It's deeply horrifying and deeply satisfying all at once. One commenter called it the best removal they'd ever seen Lee perform.

"Love the hole puncher!!" one commenter wrote.

"Soooo unexpected! My least fav tool but that was a gooddd one!" another person said.

Check out the video here:

View this post on Instagram Mondays are #hard... heres a killer Hard POP to get you through it! #hardpop #cyst #drpimplepopper A post shared by Sandra Lee, MD, FAAD, FAACS (@drpimplepopper) on May 20, 2019 at 3:33pm PDT