Lumps and bumps: late postsurgical inflammatory and infectious lesions

Late postsurgical infectious or inflammatory complications after facial surgery present a difficult challenge. These complications occur at least 2 weeks after surgical procedures and are often attributable to unique causes, in contrast to complications within the first postoperative week. The most worrisome complications in this period are caused by mycobacterial infections, because these infections can be severe and require a protracted treatment course. A high degree of suspicion is required early in presentation because these lesions can be subtle and similar to other infectious or inflammatory lesions. The authors discuss the clinical manifestations and diagnostic and treatment rationale for late postoperative infectious and inflammatory lesions. The authors also demonstrate and compare the clinical manifestations of mycobacterial infections, bacterial infections, and sterile inflammatory reactions. In addition, the treatment rationale for mycobacterial infections is reviewed. Late postoperative infections caused by mycobacteria are reported with increasing frequency in the cosmetic literature. These cases illustrate diverse challenges in the identification and treatment of late postoperative lesions.