LAM FACIAL PLASTICS

Hello Dr. Lam

About 9 months ago my 2 year old daughter fell against a low coffee table, catching it fully on her left cheek. The surface of the skin was not broken. After the bruising subsided she was left with a small internal lump which we assumed to be a haematoma. This resolved itself over about 8 weeks but she is now left with a dimple approxiamtely 4mm in diameter at the site of the accident. This is not visible at rest but is when she is talking. I assume that this is a result of the scar tissue tethering to something else in her cheek.

On this brief description would you think that wire subsicion would be something we could consider in the future to correct this? If the indentation is too close to one of the nerves that run down to her mouth would that mean the procedure would not be viable? At what age would we be able to consider booking her in with you for the procedure?

I appreciate that many people find natural dimples cute, but this is asymetrical and fairly close to where her lips join so it's not in a natural position, and we would be keen to remove it if possible so it doesnt impact on her confidence as she grows up.

Thank you for your time if you are able to answer this,

John

as you know, i cannot directly give you medical advice on this forum. however, speaking in generalities, a subcision should manage a dimple well. sometimes, one needs a few subcisions to get it all gone. the nerve damage risk for a subcutaneous subcision is practially zero. nerves run very deep on the underside of the deep muscle so this is generally not a practical risk at all. timing is a harder issue. if it is very obvious, kids can be cruel about unusual differences in other person's face. generally, this is the case after 2 years of age when a child can distinguish self from non-self. however, also your child can also have discomfort and have scarring emotionally from this. find a caring doctor who can do it as painlessly as possible. i hate when docs hold down kids to do something. there is no right timing. you need to speak with a doctor in person for better advice on that.
best,
dr. samuel lam

Thanks for taking the time to answer. It's reassuring to know that we can do something in the future for her.

my pleasure. just make sure that i do not serve as a physician in this case. your child should have a real physician seeing her for a consultation. perhaps obvious, i cannot take responsibility by answering questions of this nature. this forum is meant to be general in nature.
best,
sml

Hello,
My daughter also fell on a coffee table when she was 2 but it was a cut [upper cheekbone] and then in the night she picked at it and now that she's 9 she has a pretty strong dimple [ever since] where that hole was and I was wondering if such a dimple could be minimized or "filled in" if she ever wanted to? It's cute but she might not think so as a teen. Thanks for "general advice" or at least what's available for such cases.

sure, permanent options like silicone micro can be done if it is an isolated small area. i am always worried about how a permanent filler though would age over one's lifetime for someone that young. i would probably recommend restylane, which is temporary but would probably be safer. also, it tends to last quite a long time especially after a couple of rounds when you are talking about the cheek area.
best,
sml