37, female & cyst removal caused indention, recommendations on next step? (Photos)

Question

Hello. I am a 37yo female that had a large cyst that developed almost 3 months ago on my left cheek. So, I had it drained during two separate procedures recently. In turn, it left me with an indented dimple. The derm was unable to do anything more for me and stated that she felt she would make it worse of she attempted to excise it. I have heard of possible dermal-fat graft, filler,etc. I'm just unsure of what I need to do at this point or who I should see. Thank you for your time

Mats Hagstrom, MD (license on probation) · Answer

Sebaceous cyst needs to be removed entirely, or they are left with a higher rate of potential recurrence. This includes removing the punctum, or the skin opening where the actual sweat gland initially resided. 
You currently are at risk for it recurring and there’s enough scar tissue in the area may prevent restoring the volume or contour with fillers or grafts.
At this point I suggest waiting a full six months since your last procedure. 
At that point you need to have all scar tissue and cyst remnants properly removed. I suggest finding a new provider who is more experienced with facial surgery. Consider consulting with senior Mohs surgeons or plastic surgeons who do a lot of facial reconstruction. Moving forward with attempting to improve the area before the preliminary foundation work has been accomplished first will potentially set you up for worse problems in the future. The key is to find an experience highly meticulous surgeon, who has lots of experience with facial reconstruction. partially exercising the cyst has created a situation that is more complex than it needed to.
You should’ve got a scar tissue to mature a full six months from your previous procedure before having a second intervention, unless you develop rapid recurrence of the cyst or an infection.
Start interviewing providers to have the right provider once the timing is correct. For this, I think a proper reconstructive approach by someone who is exceptionally talented. It’s going to be much better than attempting temporary solutions that may set you up for a more complex situation in the future.
This was not managed, ideally from the beginning, so it is very important. You get in the hands of the right provider for any future work.
It may be unfair of me to make judgment calls without complete information. I’m sure your provider did the best they could but as things stand, you have a highly visible scar contraction with possible cyst material still in your cheek.
Good luck,
Mats Hagstrom MD

37, female & cyst removal caused indention, recommendations on next step? (Photos)

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37, female & cyst removal caused indention, recommendations on next step? (Photos)

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