Any suggestions on scar revision to my upper lip? (photos)

Question

I was bitten by a dog 16 years ago. The asymetrical lip line and swollen appearance have always bothered me.

Robert H. Hunsaker, MD · Answer

This type of "trap door deformity" of scar is tricky to deal with. It requires a combination of very small precise manuevers, occassionally staged, and some good karma afterwards to get significant improvement. Having said that, I think it would be worth doing with an experienced surgeon.

Stephen Weber MD, FACS · Answer

Your scar has developed a pin cushion or trap-door deformity. Basically, the circular scar contracts and pushes the skin in the center outward creating the mound of skin. This can be improved be revising the scar and debulking some of the scar tissue from beneath the flap of skin. Seek a consultation with a scar revision expert as there is a risk of this issue recurring after revision.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Tae Ho Kim, MD · Answer

The excessive fullness from the dog bite injury can be treated.  It will require finesse work.  An elliptical area of skin and scar tissue need to be removed and the vermillion (pink part of the lip) will be everted out to match the opposite side.  Then, the contour can be improved prior to closing the wound.  I would advise you to find a plastic surgeon board certified by the American Board of Plastic Surgery, who has a lot of experience with cleft deformities.  We do a lot of work similar to the kind of problems you have.  Good luck!

Sean Freeman, MD · Answer

Blaw2, due to the concentric nature of your scar the area inside your scar looks swollen.  I would handle this by doing geometric excision and closure of the 2 vertical components of your scar.  May even consider adding the horizontal portion later on.  I would follow this with aggressive scar care as it matures.  And lastly consider a ablative resurfacing procedure to get the final aesthetic result.  visit with several aesthetic facial specialists who have at least 10 years experience. look at their websites for examples of scar revision. Hope this helps good luck!

Samir Shureih, MD · Answer

Based on the pictures posted, you have two problems1: Trap door deformity (Swelling)2: mal-allignement of the white roll line.This can be improved by scar revision. It will require artistic planning to correct both problems.

Any suggestions on scar revision to my upper lip? (photos)

Answers (5)

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