Can An Involuted Area of Hemangioma Below The Lower Lip Be Excised?

Q: Dr. Eppley, I do have an area of spongy tissue centered below lower lip vermilion c/w involuted hemangioma tissue. Tissue with some irregularities and Mild transverse crease between involuted tissue and vermilion. I hate it.. It’s residual from hemangioma from when i was infant. Told by numerous plastic surgeons in Beverly Hills that surgery is dicey because it may not look good enough.

A: I don’t know what that area below the lower lip looks like when you are not pursing your lips (as seen in the current picture) but it is already an irregular tissue area….which is typical for an involuted hemangioma. Thus the issue  is whether an open excision would make the area look better (less projected and smoother), heal with the same irregularities in the long run but not as full or projected or look worse (more irregular). If you were only looking at these three potential outcomes on an even statistical basis only one of them makes it really better. This is what the term of ‘dicey’ really means.

But beyond a theoretical even statistical basis for each potential outcome I suspect that making it look worse is unlikely. The real debate  is how much better in appearance can surgery make it…..a little or a major improvement in appearance. Unfortunately that is a question that no one can really answer. The only way to know for sure is to actually do the surgery.

Dr. Barry Eppley

Plastic Surgeon