Dr Pimple Popper made people want to vomit when she removed what was described as a "mullet" of hair from a man's suspicious head bump.
Her fans were only just starting to recover after she teased them with footage of a giant blackhead like "Brussel sprouts" being popped.
In the clip, uploaded on Friday (November 12) the dermatologist Sandra Lee MD gets to work on the strange lump which is near the crown of her patient's head and which he says he's lived with for 20 years.
She checks he can't feel anything other than a "tugging" sensation due to the local anesthesia and then makes an incision.
A clear yellow liquid comes dribbling out and Dr Lee wipes it away, before noticing a weird black shape in the middle of the hole.
The incision is made wider with the reverse side of pair of scissors and Dr Lee then cuts away the mass and pulls it out.
She reveals it is a "hairball" growing underneath his skin and jokes it is something "like my cat coughs up".
Weirdly, the patch of hair is encased in a piece of flesh and had been growing the reverse way around.
Dr Lee cuts it open so you can look at the impressive ball of hair which was winding around itself with nowhere to go for the two decades it was in the man's scalp.
The video was watched more than 1.4 million times and racked up thousands of comments on her @drpimplepopperTikTok account, with one viewer confessing: "I think I just threw up."
"He had a whole ponytail waiting to erupt," commented a second user.
A third person asked: "Did no one want her to stretch it out to see how long it was? Just me?"
Someone else joked: "That's a tuck-away mullet. You're supposed to pull out and open it up. He had the business but forgot the party."
Another user quipped: "Note to self: grow hair outward."
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