Pulsating Facial Vessels: Causes, Treatments, and Concerns

Pulsatile vascular point on the face?

1.
Hello, doctor: About 2.5 cm from my mouth, a slight protrusion suddenly appeared 3 to 5 months ago.
I thought it was a pimple or comedo, so I ignored it.
However, two weeks ago, it suddenly started pulsating, measuring approximately 1 cm x 1 cm, with a rhythm similar to my heartbeat.
Could this be what is referred to as an arterial hemangioma? What treatment options are available?
2.
If the treatment involves vascular ligation combined with a sclerosing agent, will this require facial surgery? After ligating the artery, will the blood flow be obstructed, potentially leading to facial muscle atrophy or facial nerve damage? Additionally, since this is facial surgery, will there be noticeable scars or marks from the sclerotherapy in the future?
3.
The methods mentioned above are treatments I found online.
Are there any non-surgical alternatives available? Please assist me, Dr.
Lu.
Thank you for your help.

Niming, 30~39 year old female. Ask Date: 2013/07/29

Dr. Lu Daokuan reply Plastic Surgery

In adults, a pulsatile mass should be classified as a vascular malformation (a type of hemangioma).
Sclerotherapy is generally not recommended, as the one-year recurrence rate can be as high as 50%.
Additionally, sclerotherapy can result in the formation of a hard lump.
Surgery (consulting a plastic surgeon) is the correct option, as other methods are likely to be even less effective.

Reply Date: 2013/07/29

More Info

Understanding pulsating facial vessels can be quite concerning, especially when they manifest as a noticeable protrusion that pulsates in sync with your heartbeat. Based on your description, it seems you may be dealing with a vascular anomaly, possibly an arteriovenous malformation (AVM) or a vascular tumor, rather than a simple acne or cystic lesion.
1. Pulsating Facial Vessels: The presence of a pulsating mass on your face that has increased in size and has a rhythmic pulse could indicate an abnormal connection between arteries and veins, leading to increased blood flow in that area. This could be due to various causes, including congenital vascular malformations or even trauma that may have led to the formation of a vascular lesion. It is essential to have this evaluated by a healthcare professional, preferably a dermatologist or a vascular surgeon, who can perform imaging studies like an ultrasound or MRI to determine the exact nature of the lesion.

2. Treatment Options: If the diagnosis confirms a vascular lesion, treatment options may vary. The methods you mentioned, such as vascular ligation and sclerotherapy, are common approaches. Vascular ligation involves tying off the blood vessels supplying the lesion, which can reduce blood flow and potentially shrink the mass. Sclerotherapy involves injecting a solution that causes the vessel to scar and close off. While these methods can be effective, they do carry risks. Concerns about facial muscle atrophy and nerve damage are valid, especially if the blood supply to surrounding tissues is compromised. However, skilled surgeons take great care to minimize these risks. Scarring is also a concern; however, advancements in surgical techniques have improved cosmetic outcomes significantly.

3. Non-Surgical Alternatives: If you are apprehensive about surgical interventions, there are non-invasive options available. Laser therapy is one such method that can target vascular lesions without the need for incisions. Certain types of lasers can effectively reduce the appearance of vascular lesions by coagulating the blood vessels, leading to their gradual disappearance. Additionally, there are newer techniques like cryotherapy or radiofrequency ablation that may be considered, depending on the specific characteristics of the lesion.

In conclusion, it is crucial to seek a thorough evaluation from a qualified healthcare provider to determine the nature of the pulsating facial vessels. They can provide a tailored treatment plan that considers your concerns about scarring and potential complications. Early intervention can often lead to better outcomes, so don’t hesitate to reach out for professional advice. Remember, understanding the underlying cause is key to determining the most appropriate treatment strategy.

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