Pseudocyst of the neck after facial augmentation with liquid silicone injection

Abstract

Injection of liquid silicone was performed illicitly in the 1950s to 1960s and was subsequently prohibited. Many complications arise from silicone injection, and liquid silicone migration is a complication that has not been widely reported. The 55-year-old woman was admitted with a palpable mass on her neck; her symptom started 2 weeks ago. Two years previously, she had received bilateral cosmetic silicone fluid injection in the multiple regions of her face. On physical examination, a 6 × 8-cm palpable mass was seen on anterolateral aspect of the right sternocleidomastoid muscle. On enhanced facial computed tomography, multiple abscesses were in the right malar, cheek, and preauricular region with abscess tract sequelae. The author prescribed cephalosporin intravenous antibiotics and performed 2 cm of incision line on the lower one-third neck with local anesthesia, and then drain tube was applied. After 5 days, mass on the neck was not palpated, and right buccal swelling was significantly diminished in size and reflected the resolution of the surrounding inflammatory reaction. Bacterial culture reported growth of some gram-negative rods, Burkholderia gladioli. All injectable dermal fillers can cause complications. Immediate reactions are transient and can include edema, erythema, nodularity, and pain. Late averse events also include immunologic phenomena such as late-onset allergy and nonallergic foreign body granuloma, autoimmune responses, or both. So in this case, the author guessed that silicone fluid causes abscess and then pseudocyst formation on the neck. The key to an accurate diagnosis is asking the patient specifically about his/her history of receiving cosmetic filler injections.