Q: Dr. Eppley, I just got stitches above my top lip. The stitches go across the ridges under my nose. I’m so worried it’s going to leave a ugly scar. My dog jumped on the couch and his hind foot landed on my face. He felt like he was losing his balance and used his claws and that is how I got the cut in my face. The ER doctor did a good job on stitching up the cut. The cut goes from my lip to my nose. What can be done to keep the scarring down?
A: What you want to do to get the best lip scar result is the following. First, get the lip sutures removed in no more than 5 to 7 days after surgery. I don’t know if the doctor used a layered closure or what size the skin sutures are. If there is no dermal buried sutures below the skin sutures, then have a glue dressing (e.g., Dermabond, Indermil) applied once the sutures are removed. Second, beginning three weeks after surgery begin to apply a topical scar treatment twice a day. There are many type of scar gels and strips but on the lip a scar gel is far more practical. Continue twice a day scar gel application until three months after the injury. At three months after injury it is time to evaluate the scar. If it is quite narrow and flat and the redness is fading fast then I would only consider scar gel for another month. If the scar is fairly narrow and flat but still very red, then I would do BBL (broad band light) therapy to work out some of the redness sooner. If the scar is irregular in contour or slightly wide then I would have some fractional laser resurfacing done to even it out. Only if the scar edges are widely separated and irregular would actual surgical scar revision be necessary. Expect the final scar result to take a full 9 to 12 months until the final and best scar outcome is seen.
Dr. Barry Eppley