Can lip piercing be closed by suturing the area from the inside? (photos)

Question

I have 2 piercing holes under my lip that I’ve had for about 10 years. The holes look like they’re fresh and I could still put a piercing in but it’s only because the scarring is deep.I’ve been denied by most plastic surgeons or have been told to just do micro needling but that’s not what I want and won’t suffice. I was wondering if you can suture the holes from the inside of my lip and close it that way instead of the outside.

Anna Chacon, MD, FAAD · Answer

Hi there,

I completely understand your frustration—after 10 years, it makes sense that you want a solution that truly closes the piercing holes rather than relying on surface treatments like microneedling.

Suturing from the inside of the lip is technically possible in some cases, but it has important considerations:

Depth of the scar: If the piercing tract has been there for a long time, the tissue may be more fibrotic, which can make closure more challenging. Simply suturing from the inside may not fully address the visible hole on the outside.

Risk of recurrence: Because the tract has been present for years, there’s a chance it could reopen if the scar tissue isn’t fully excised.

Aesthetic outcome: A combined approach—removing the fibrotic tract and carefully suturing both the inside and outside—often gives the best cosmetic result. Purely internal closure may leave residual indentation or unevenness.

Healing considerations: The inside of the lip heals differently from the external skin, and suturing from inside alone might result in puckering, uneven texture, or prolonged healing.

While micro-needling and laser resurfacing can improve surface appearance, they usually don’t fully close longstanding piercing holes. A small surgical revision that addresses the tract internally and externally tends to provide the most reliable and aesthetically satisfying result.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

I have personally had success in treating lip piercing holes (and umbilical ones, as well) employing TCA CROSS. From the size of the piercing holes, several treatment sessions are likely to be needed to achieve optimal results. Surgical excision or punch excisions would likely result in unsightly scars. Manual Dermastamp microneedling (no need for the added expense and added risks of RF micrneedling), which I have been performing for nearly a quarter of a century, is best reserved for blending very superficial surface color or textural irregularities with the surrounding normal skin--so may be useful AFTER the holes are closed and filled in. You would be wise to consult with a board certified cosmetic dermatologist with experience in the use of TCA CROSS.  Hope this helps and best of luck.

Can lip piercing be closed by suturing the area from the inside? (photos)

Answers (3)

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