Dr. Sam Lam Plastic Surgery Forum

Hi, Dr Lam.

Glad that I found this forum and I can tell how many people appreciate your advice.
Hope you can advice me as well.

About two weeks ago, my face was kicked while I was sparring with someone in Tae kwon do gym. The kick pushed my upper lip against one of my tooth and it resulted in split lip from inside to outside.

The stitches were done by Emergency dept doctor after a specialist in the hospital examined my condition. (I am writing from Australia. excuse me if some therms are a bit different. Also English is my 2nd language)

Some of things that worry me are

- the hard feeling inside the lip where the cut was (wondering if it is temporary or permanent)
- the pressure between my teeth and the lump when I smile and talk
- uneven alignment of the horizontal line from side way and
- the swelling which makes the scar line more obvious.

Hope the photos I included would make my explanation more sense. External stitches removed.


Would these symptoms still the same after a month or two?
If that is the case, are there any medical options to rectify the issues?


Also I've been applying vitamin E oil everyday. I read an article on the internet that 9 out of 10 times it worsen the appearance of scar. One the other hands, some people say it helps to minimize scars and soften the hardness of scars. Would it be good idea to use it?

I am also planning to use a silicon gel sheet hoping this would minimize the visual appearance of the scar by evening out the appearance. Would this also help to soften the hardness and swelling? What are the chance of the scar evening out with the surrounding without further medical treatment?

I am still alive but somehow it does affect my confidence to think that it might be permanently reside there whenever I look at mirror. Also the dissoluble stitches are still there internally. Is that normal? Is the pressure caused because the stitches are still there? Thanks for sharing your knowledge with people and god bless you Dr Lam.

Regard
Woo

as you probably know, i cannot directly give you medical advice. however, i can give general comments as to swelling after a lip injury. here are typically the things that can cause that:
1. lymphatic obstruction- just the part of our body that typically drains any swelling is still bothered and not healed yet. that typically resolves by itself but could be aided by a person trained in lymphatic massage who would not hurt the wound itself.
2. scar tissue- the problem is that obstructed lymph glands and scar tissue can both be very firm so hard to distinguish. scar tissue typically does not develop for several weeks but could be earlier in some cases. the best way to handle this if the swelling does not go away is 5-FU injections (not steroid which i think is risky). hard to find someone who does that though since most docs don't know about it. also, most do not know how to do a good dental block so you feel no pain during the injection. i have managed scar tissue very effectively with 5-FU in those cases that persist with thickness.
3. mucocele- a trapped saliva gland that is injured. typically this occurs in the bottom lip but can also be in the upper lip but much more rarely. typically it feels softer than scar tissue but in some cases can be hard. a skilled doctor feeling for it like an ENT doctor could tell you if that is what you have. if it is a mucocele, some spontaneously resolve. some require surgical excision. that advice should be given to you by an examining physician not by me.

i personally do not believe silicone or vitamin e will do that much for a lip injury but you can ask a local physician what he thinks. i do use silicone for skin injuries. i stopped using vitamin e a few years ago based on the same reports you are quoting. hope that helps.
best,
sml

Thank you so much for the advice. I will follow up your advice.

one last question is would you categorize my scar as red and raised scar? because the silicon sheet I am after says it is designed for red / raised scar. Is there any known side effect of these product? ei-like it changes the tonality of my lip color where it is applied?

Thanks
Woo

again, i cannot give you direct advice. but generally i do not think lip scars get red and raised. by definition they are red and they tend not to have the same wound issues that a skin wound would. there is less collagen and more lip tissue consisting of salivary glands. that is why in general i do not believe silicone is effective for lip scars. also, i do not really know of negative effects with silicone. in general, it is pretty safe.
best,
sml

Thank you so much Dr. Lam.
It does make me feel positive since I know there are ways i can try.
Your intro flash movie tells how passionate surgeon you are.
I like it very much.

All the best!

best wishes!
sml