I have an indent and ball of scar tissue on my chin, is this fixable? (Photos)

Question

I broke my jaw two and a half months ago in a car accident. The inner part of my lip detached from the gum area at the base, so I had to get it stitched. However once everything started healing I noticed my chin started to form an indent that is visible on the outside as well as a ball of scar tissue that is quite hard. If I press my lips down it'll poke out more. The scar tissue can move around but the indent won't go away. Will it ever go away completely?

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

When it comes to scars, the objects of treatment are rather straightforward: flatten when elevated and elevate when indented. Although the photos are helpful, an in person examination that allows the scars to be palpated would be the best way to evaluate your problems and tailor a treatment plan for you. From the history and photo it would seem that a dense form of scar tissue has formed under the area you describe as the "ball."  The adjacent indentation likely represents an atrophic scar (depressed scar), which results when scar tissue below grabs like tethers onto the overlying skin and pulls it downward.With this in mind, it would seem reasonable to inject an anti-inflammatory into the "ball" in order to shrink it. Between one and three treatment sessions spaced at monthly intervals are typically needed for optimal improvement.  Once this is done, the indented portion may be addressed via a combination of subcision, to break up the tethering scar collagen and filler to both elevate the area and stimulate new, native collagen and elastic fiber synthesis.For more information on the scar treatments, you can check out the archives of RealSelf.comYou would be wise to seek consultation and treatment by a board certified aesthetic physician with experience and expertise in scar management.

Jason Emer, MD · Answer

Scarring and scar tissue requires a combination approach and sometimes that means surgical removal, lasers, micro needling and fillers. I suggest you see an expert in scar treatment for optimal results.  Best, Dr. Emer.

Jeffrey H. Spiegel, MD · Answer

Hi Azandra,You likely have some scar tissue starting to band inside your chin.There are treatments for this including massage, injections of medications, and minor scar revisions.I'd suggest you come in to see someone experienced with jaw surgeon soon in order to make sure it is treated early.  If you address it quickly it should be no problem - if you wait too long it becomes harder to fix.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you may benefit from either scar massage or a surgical revision.  This can be difficult to assess without an in-person examination.   I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon