38 years old man, underwent bilateral acne scar subcision using Nokor needle. There is significant improvement in acne scars, however after about 6 months, there are 2 cyst like non-tender, non-erythematous soft swelling on both buccal areas with the size of 4x4 cm. Looks like some fluid filled cysts, however aspiration does not return any fluid or blood. No US or MRI is done. 1. What would be the diagnosis? 2. What should be the next step? 3. What would be the treatment? Thanks in advance.
Chronic Facial Swelling After Acne Scar Subcision?
Doctor Answers 1
I assume that I am answering a question from a fellow physician. Nokor needles are very aggressive and can go quite deep. Smaller lymphatic structures or ducts could have been severed. Ultrasound or MRI is a must before proceeding. Having said that you can try a short course of oral steroids to see if the swelling resolves. My nurse also performs Ultrasound and lymphatic drainage after facelifts to improve prolonged swelling. Good luck.
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