Q: Dr. Eppley, Can you do surgery or a procedure to remove this facial cyst, which is by my eye on the right side? It’s small now. It has previously gotten infected and the whole side of my face swelled up. I worry that it could get infected again.
A: Most facial cysts are known as dermoid cysts. They come from the skin and have a small pore associated with them if one looks close enough on the overlying skin. This is the pathway by which they get infected. Their internal shedding of their skin lining accounts for why they gradually enlarge.
Infections are common behaviors in facial cysts and speaks to the need for their removal. Once infected they become more adherent and harder to remove because of the scar that is created around them that becomes attached to the cyst capsule. The location of your facial cyst at the mid portion of the zygomatic arch is also in the path of the frontal branch of the facial nerve so greta care must be taken in its removal to prevent injury to the nerve that is responsible for moving your forehead an brows. For this reason, its removal in the operating room even under local anesthesia nye be advised.
Dr. Barry Eppley
What Is The Best Way To Remove A Cyst From My Forehead Without A Prominent Scar Or Leaving an Indentation?
Q: I have a cyst like lump right in between the eyebrow. In stead of cutting the cyst off with the knife vertical to the skin, is it possible to make a cut right underneath the frown lines and slice the lump off from the cut? Is it possible to transfer some fat to that area if the area is dented after the lump is sliced off?
A: Those are two very good insights into how to remove your forehead (glabellar) cyst while leaving the most aesthetic outcome. Using a close wrinkle or frown line would be preferable to making an incision directly over the cyst. That would make for a far better scar. Even if the scar turned out less than ideal, it is more favorable area in which to perform scar revision. It may also be possible to remove it by an endoscopic technique, although I would have to see pictures of it to be sure that is a possibility.
Also, placing a fat graft at the time of a facial cyst removal is almost a standard technique that I do since indentations may follow later due to a mass removal effect. An indentation may now appear initially, due to fluid fill of the cyst removal space, but will appear once that fluid is absorbed weeks to months after surgery. If the cyst is more than just the size of a pea, I would recommend that at the same time rather than waiting for it to appear later. It is just as simple to do it at the time of cyst excision.
Dr. Barry Eppley