Q: Greetings. I have a problem that I hope Dr. Eppley can address. I had a light therapy treatment (IPL) to my face that ended up too deep or too hot. It not only burned my skin but I also developed underlying fat loss as well. My skin is a series of pockmarks, holes, scars, lines. The problem that bothers me the most, however, is around my mouth. It appears to be scarred and my mouth has gotten smaller. It concerns me that may still be getting smaller. I have found that Dr. Eppley does many mouth revisions and am hoping he will take interest in my case. I am in need of help. Thank you in advance.
A: Such a reaction from a pulsed light facial treatment is certainly unusual. While I have seen some superficial skin burns from IPL or BBL treatments, deeper or more partial thickness burns have not been previously reported that I am aware.
Like all burn injuries around the mouth, the most restrictive area is usually around the corners or commissures. This is the side union between the upper and lower lip and needs to be the most flexible of any area on the lips. Tightness in this area makes mouth opening more difficult and may actually make it look smaller if there is scar contraction.
Early mobilization or physical therapy is important in the initial phases of healing after any burn injury around the mouth. It can help scar contraction from significantly tightening the commissures. In established commissure scar or restriction, surgical help may be needed. This could consist of scar release or a commissurotomy. This procedure can help open up the corners, making the mouth a little wider and lessen the tightness on opening.
Dr. Barry Eppley