It seems that the left peak of my philtrum has healed crookedly where the stitches were located. The peak is split half way up by a depressed line. The top half is disconnected and askew from the bottom half by a few millimeters. Also, the lines and folds of my upper lip that occur through natural facial expression now seem to pull toward the lines of the scar. What are my options for correcting the appearance of my upper lip and minimizing the appearance of the scar which includes atrophic and hypertrophic sections?
March 31, 2014
Answer: Hypertrophic scar, upper lip philtrum My review of your photo reveals a widened, depressed, oblique scar across the left philtrum. You will benefit from a scar revision designed to re-oriented the scar (Z-plasty technique) and evert the edges. This can be performed under local anesthesia by many cosmetic surgery providers (facial plastic surgeons, plastic surgeons, cosmetic dermatologists) as long as they are meticulous in the technique of scar revision. Depending on your healing you may then benefit from injection(s) of fillers to increase the height of the philtrum. Laser resurfacing or micro-needling may be use to improve the texture of the scar and to diminish the suture marks, but in my opinion, you need to undergo a surgical scar revision first. Best of luck.
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March 31, 2014
Answer: Hypertrophic scar, upper lip philtrum My review of your photo reveals a widened, depressed, oblique scar across the left philtrum. You will benefit from a scar revision designed to re-oriented the scar (Z-plasty technique) and evert the edges. This can be performed under local anesthesia by many cosmetic surgery providers (facial plastic surgeons, plastic surgeons, cosmetic dermatologists) as long as they are meticulous in the technique of scar revision. Depending on your healing you may then benefit from injection(s) of fillers to increase the height of the philtrum. Laser resurfacing or micro-needling may be use to improve the texture of the scar and to diminish the suture marks, but in my opinion, you need to undergo a surgical scar revision first. Best of luck.
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March 28, 2014
Answer: Upper Lip Scar Dear Jacob: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. BestDr S
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March 28, 2014
Answer: Upper Lip Scar Dear Jacob: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. BestDr S
Helpful 1 person found this helpful
