Raised area on face

[Renee74]

Hi.  I have battled acne scars for years, and this may be useful info for my question.  I had laser surgery a few times in 1997.  In 2001 I got micro-droplet silicone inject. by Dr. Orientreich in New York (who invented it I believe), but I only did it once, so I wasn't alot of silicone(> 1 cc).  
  Now for my question...Over the past 2-3 years I have noticed a small area near my nose on my cheek that is slightly raised outwards (maybe 3/4 in in length and 1/8 in. width - not very big), which creates a ugly shadow in certain lights, especially because I have some small scars right under it.  The area is soft because I can push it down and it slowly comes back up.  It is also sort of longer and the skin looks a little lighter there, almost like there is some liquid under it.  I have my own speculations, but a derm in LA recently thought it was just some face fat that has fallen this way as I have gotten older.....I am only 30 (look young too) and I DO NOT have this on the other side of my face, so I am skeptical of what he said.  I have three ideas of what this could be: 1). excess collagen development; 2) maybe excess scar tissue, but I didn't have a big scar exactly where it is raised; 3) or inflammation from the silicone injections or something else, but the LA derm said the micro-droplet technique is safe; or 4) maybe an after-effect of the laser surgery I had years ago.  
  I had some collagen injected in the area right under the raised area to make it look even, but the whole area sort of looked raised (higher than the rest of my face), which is what led me to believe that this was a raised area, and NOT that the scars directly below it were creating a sunken-in area on my face. I hope this isn't too hard to follow.  I can email pictures.  Anyway, instead of using a filler, is there anything else that can be done?  What comes to my mind is having a doctor either use a needle to do an aspiration in the epidermal layer or maybe a small surgery (removing stuff through a small niche in the skin).  Are either of these techniques a possibility.....depending on what is causing this raised area (excess collagen, scar tissue, inflammation, or fat)???  

Thanks for your help.  I can email pictures if necessary.

[Alan Rockoff, MD]

Since I don't use collagen myself, I'm afraid I'm not sure.

Dr. Rockoff

[Renee74]

Before spending money to see a derm is it even possible for a doctor to remove excess collagen (if this is what it is) through fine needle aspiration? I can almost see the outline of this small raised area and it is lighter in color.....almost looks like it is filled with something.

[Alan Rockoff, MD]

I'm afraid I am not familiar enough with silicone injection and related techniques to answer you.  Wouldn't it make sense to put this question to Dr. Orentreich, or to one of his associates?  In any case, the person to speak with about possibly treating this would be a plastic surgeon or cosmetically oriented dermatologist who is familiar with filler techniques and surgical procedures used in this connection.

Sorry I can't be more specific.

Dr. Rockoff