What are my options for correcting upper lip (philtrum) appearance and minimizing a scar after an accident (photo)
Doctor Answers 4
What are my options for correcting upper lip (philtrum) appearance and minimizing a scar after an accident?
Your photos demonstrate some scarring down to the underlying soft tissue/muscles, which is causing some indentation to the area. I agree, your philtral column is not well-aligned as well. The good news is that your scar hides within the hair-bearing area and may be hidden. Depending upon how long ago your injury occurred makes a difference for recommendations. If greater than a year ago, the only thing that would likely ameliorate your concerns would be for a scar revision to fix the aforementioned things. If more recently, I would continue with scar massage to hopefully soften, disrupt scar tissue, and hopefully produce the finest scar that you can, given the injury. Scar revision still may be in order afterwards, but theses conservative measures will help.
Thank you for your question and photos. Hope that this helps! Best wishes!
Hypertrophic scar, upper lip philtrum
Upper Lip Scar
It looks like whatever original repair you had did not reorient the muscle fibers along your philtrum, and also inverted causing the central depression. When you smile, the muscle known as the orbicularis oris is likely pulling at an improper angle, causing the pull toward the scar direction.
A couple of options to improve the scar: A surgical option would be what is known as a Z Plasty. The goal would be to re-orient the muscle and the deep tissue to its normal position, then evert the edges of the wound so that you no long have a depression.
A nonsurgical option would be the Lumenis Utraplus laser using Total FX. The goal would be to remodel the depression with new collagen and then resurface the overlying skin so that the actual line is gone. This laser has been extremely effective in scar treatment by a process known as wound remodeling.
Though filler can be excellent for some scars, I am not confident that filler would be of great benefit in this type of scar. If the scar is adherent to the underlying muscle which is pulling at an oblique angle, the filler will have a difficult time achieving a good result and correcting the depression.