Infected sialocele: complication in masseter reduction using radiofrequency coagulation

Radiofrequency coagulation was introduced to reduce the volume of masseter muscle. Radiofrequency procedure causes focal necrosis in masseter muscles, which leads to muscle hypoplasia and a slender lower face. We present a case of a 24-year-old woman who underwent radiofrequency coagulation to reduce masseter muscles. The patient experienced progressive erythematous swelling and noticed the mass around the right cheek 5 days after the procedure. On radiologic evaluation, a round cavity of 4-cm diameter containing air and fluid was observed. Incision and drainage was performed, and antibiotics were administrated intravenously. Blood-tinged purulent fluid was obtained, which was subsequently found to have a high amylase level. The swelling subsided, and there is no relapse up to 6 months after drainage. There are several complications of radiofrequency coagulation reported such as mucoserous fluid collections, late bleeding, infections, long-lasting pain, Stensen duct injury, facial nerve injuries, and limitation of temporomandibular joint movement. A well-designed operation plan and skilled technique are required to avoid these complications.