What Is The Risk Of Scar Revision in Mouth Widening Surgery?

Q: Dr. Eppley, I believe that my mouth is too small for my face and I seek a way of rectifying it. Lateral commissuroplasty seems to be the best approach to solve this issue however I’m seriously concerned about the potential scarring that may arise because of this. From my research the area around the corners of the mouth tend to scar easily . If this is the case can the scarring be diminished or even eliminated with scar revision surgery?

A: Thank you for your inquiry from which your two assumptions are correct; 1) effective mouth widening can only be done surgically by a uniquely designed lateral commissuroplasty design, and 2) the corners of the mouth are uniquely sensitive to scarring. In order to favorably combine the two concepts, 1) get an effective result and 2) not result in undue scarring, I employ two mouth widening strategies. First the amount of surgical mouth widening should be limited to no more than 7mms per side. Secondly it is reasonable to assume that the risk of needing a scar revision for one side (of which there seems to nearly always be a good side and a ‘bad’ side in the patient who may have a scar concern) is 50%. Scar revisions surgery is about diminishing its appearance, there is no such outcome as complete scar elimination.