Dog bite lip scar revision (photo)

I'm so sorry that happened to you. I have sewn up quite a few faces due to dog bites throughout my career.
In general, the red lip heals very well, so that site that appears whitish, like an ulcer, will likely heal imperceptibly with time.
As for the laceration portion, my concern is that the scar is depressed (dented down). There is some surrounding swelling currently accentuating this, but I feel strongly that it will heal with a depression.
My recommendation would be to see a well-regarded facial plastic or plastic surgeon near you for an early correction. They will open the area, freshen the edges, and do a nice, everted closure of the wound to minimize the chance of it healing with a depression.

The other option is to allow for maturation over the next year and then consider a revision at that point. My concern with this approach is that you have to "live with it" until then and then have another healing period where it will be a step back before a step forward.
Additionally, you may find it VERY challenging to get insurance coverage for it at that point.
As you're likely aware, insurance companies can be a nightmare when it comes to coverage, and they often consider delayed scar revision purely cosmetic in nature. Your, and your surgeon's, arguments will likely be more easily made at this time versus a year later.

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

Thank you for your inquiry! A scar revision to the lip would be an option. We would love to meet with you to discuss your options. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

So sorry that this has happened to you.
In spite of the continued recommendations by many doctors to "wait a year until the scar has matured," It has been known since the late 1980s that the actual ideal time for intervention to achieve the best outcome is between the end of week four after the injury (or surgery or infection), when the scar is strong enough to withstand treatments, and the end of week twelve (after which the scar is considered "mature," and the chances for optimal improvement in appearance are greatly diminished.
Dermastamp manual microneedling (no need for the added expense or risks of RF microneedling) performed during that critical interval would be a very reasonable treatment approach.
Bearing the above time-frame above, you would be wise to make sure to consult with an experienced, board certified cosmetic dermatology scar treatment expert. Hope this helps and best of luck.

I'm sorry to hear about your injury. For a dog bite scar on the lip, particularly one that is relatively recent, there are several options for scar revision and management. Here are a few recommendations:

Consultation with a Specialist: It's important to consult with a dermatologist or a plastic surgeon who specializes in scar revision. They can assess the scar's current state and recommend the best course of action.

Topical Treatments: In the early stages, topical treatments such as silicone gel or sheets can help minimize the appearance of scars. These products can be effective in reducing redness and improving texture.

Laser Therapy: Laser treatments, such as fractional laser therapy, can help improve the appearance of scars by promoting collagen production and evening out skin texture.

Steroid Injections: If the scar is raised or hypertrophic, steroid injections may help flatten and soften it.

Surgical Revision: In some cases, surgical scar revision might be necessary. This involves removing the scar tissue and rejoining the skin in a way that minimizes scarring.

Microneedling: This procedure can also help improve the appearance of scars by stimulating collagen production.

Massage and Moisturization: Regularly massaging the scar with a gentle moisturizer can help keep the skin supple and may improve the appearance over time.

It's important to follow up with a healthcare provider to discuss these options and determine the best treatment plan based on the scar's characteristics and your personal preferences. Early intervention often yields the best results, so don't hesitate to seek professional advice.

I’m truly sorry to hear about your injury — dog bites to the face, especially the lips, can be traumatic both physically and emotionally. I want to share some insights based on my clinical experience, especially since I’ve treated a similar case, published & presented it at international medical conferences.

A few years ago, I cared for a 47-year-old woman who was bitten by her own dog on her lower lip. It was a complex, deep wound — and understandably, she was terrified about the possibility of permanent disfigurement. I treated her within 24 hours using a topical application of placental-derived exosomes. These are cell-free, extracellular vesicles involved in intercellular communication, and they’ve shown promising potential in enhancing wound healing, reducing inflammation, and reducing the incidences of hypertrophic scarring.

In her case, the results were quite remarkable: she was fully epithelialized in nine days, had no visible scar, and even after several years, she has not developed hypertrophic scarring or loss of function even after 3 years.

It’s important to understand that facial dog bite injuries are uniquely challenging. Research shows that out of over 1,300 reviewed cases ( published in September 2022), 75% required surgical intervention, 19% needed revision surgery, and complication rates were higher in patients treated in emergency rooms than those treated in surgical settings. Common complications include infection, scarring, nerve injury, and psychological impact.

While my case report highlights a positive outcome, I want to be very clear: this is not a promotional post, and I am not endorsing any specific brand or claiming that exosomes are a guaranteed solution. The use of exosomes is still investigational. The FDA has NOT approved any Exosomes. and more controlled human studies are needed before we can make broad claims.
The link for my published case report is attached.

That said, over the past five years, I’ve used topical exosomes (from various sources, including adipose, placental, umbilical, and platelet-derived) in more than 500–600 cases for nonsurgical aesthetic procedures, especially after ablative and nonablative lasers. I believe they have a role when applied post-laser for reducing downtime and expediting wound healing. Their effects in wound healing span all four phases: reducing inflammation, accelerating epithelialization, supporting collagen remodeling, and potentially preventing Hypertrophic scar formation by controlling myofibroblast conversion.

My goal with that patient—and with every patient—is always to explore every ethical, science-backed method available to promote optimal healing. If we have safe, noninvasive, cell-free, readily available regenerative tools, why not use them to minimize long-term consequences like scarring?

Again, this is just a single case report, and I’m sharing it purely to inform, not to sell or promise outcomes. I encourage you to research and consult with experienced plastic surgeons familiar with advanced wound healing options. Scars don’t have to be inevitable, and sometimes, early intervention makes all the difference.

Wishing you a smooth and complete recovery.
Warmly,
Dr. Shanthala