Lip Scar help? (Photo)

Question

My dog sliced my lip open on Dec 24th 2023. I immedietly went to the ER and for 2 stitches in which I got removed 1 week later per doctors orders. It has healed okay I would and it has only been 3 1/2 weeks since the incident. But I am extremely worried about the scar that I have on my lip not flattening. I’ve done research and think it is hypertrophic which I heard do go through a raised phase and then maybe flatten over time. I need a pro’s advise/insight. Also, what options do I have

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

Sorry this has happened to you. It was known already back in the late 1980s that there is a window of time following an injury or surgical repair--between the end of weeks four to twelve, after which a scar is considered "mature"--where appropriate intervention offers the greatest chance for improvement. You would be wise to seek consultation with a board certified cosmetic dermatologist to determine the best approach to your scar. If indeed it is elevated, it can be flattened with intralesional injections of an anti-inflammatory agent. If it remains discolored, i.e hypopigmented, professionally performed Dermastamp microneedling (no need for the added expense or risks of RF microneedling) may prove useful for blending the area with the surrounding normal lip tissue. Hope this helps and best of luck.

Dallas Buchanan, MD · Answer

Sorry to hear about this. Hope you and the pup are on better terms now. The correct answer here is to wait, wait, and wait. Scars on the pink portion of the lip tend to heal very very well with enough time and usually are not even visible by one year. In the meantime, I would use a silicone based scar gel (I like Biocorneum), manual massage of the scar, and protect it from sun exposure (SPF lip balm etc.). 
Best of luck!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Randal Haworth, MD, FACS · Answer

It’s not uncommon for scars, especially on the face, to go through various stages of healing. Hypertrophic scars can initially appear raised and may flatten over time. It’s important to follow any post-care instructions given by your healthcare provider.

If you have concerns about the appearance of your scar, it’s recommended to consult with a dermatologist or a plastic surgeon. They can provide a professional assessment, discuss potential treatment options such as scar creams, silicone sheets, or even in-office procedures if necessary.

Best of luck !

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