Can My Lip Scar Only Be Improved By Scar Revision?

Q: Dear Dr. Eppley,  I have seen on your website you are very experienced with scars and would very much appreciate your opinion please. I incurred an injury to my upper lip which caused the lip to split open and require stitches. The scar remaining, now 2 years old, is within the attached picture. It appears to have 3 elements: the line which is indented, discolouration of the red part of the lip and the bump on the lip. The bump on the lip is the element which is concerning me most in terms of my appearance. Is there anything I can do to improve this such as massage or oils? Is surgery the only remedy?

A: What you have is a classic lip vermilion scar. The edges are mismatched which creates the bump and the indentation. This is very similar to a cleft lip scar after a primary repair which I have seen many times. Given that it is two years old, it is a mature scar. Therefore, no external treatment methods will be successful like massage or even injectable steroids. To get improvement, you need a scar revision. The scar must be excised and the vermilion realigned and leveled by suturing. This can be done as a fairly simple procedure done under local or IV sedation, whichever makes you the most comfortable. I would expect good improvement as the scar is oriented parallel to the natural lip lines of the vermilion…which is always a good sign for a favorable lip scar revision outcome.

Dr. Barry Eppley

Indianapolis, Indiana