Scar revision for lower lip (MaxFax query)
Hi, I am considering having scar revision on my lower lip and I have some questions relating to this. To put my injury in context I need to just explain quickly how it happened...
Seven months ago I was assaulted and left with a quite substantial gaping wound on my lower right lip (cause by one of my front teeth). Due to the negligence of my A&E doctor (accepted by the NHS), the wound was unfortunately not sutured but rather was allowed to heal naturally.
The result is that I am now left with a fairly substantial ball of scar tissue within the lip. Externally it is not as disfigured as I had feared, but the dividing line of my lip has clearly shunted to the left and when I purse my lips there is a bulge at the point of injury. This will on occasion cause some minor speech difficulties when I pronounce the dental fricatives /f/ and /v/.
My problems can therefore be summarised as: i.) a bulbous and distracting mass of internal scar tissue; ii.) a slight misalignment in the physical shape of my lip; and iii.) very slight pronunciation difficulties in informal speech. Seeking to address this, I have the following questions:
1. Is lip scar revision solely carried out for cosmetic purposes, or might it be done to remove bulbous inner scar tissue which the patient finds uncomfortable?
2. If the inner scar tissue were to be removed, would this have to be done by cutting out an entire column (membrane and all)? And if so, is there a real risk that the newly-stitched lip would be as or more disfigured than it already is?
3. Could the inner scar tissue alternatively be removed by invasive surgery that pinpoints it, rather than cutting out a whole column? If so, are there downsides (e.g. excess membrane above the removed region)?
4. If I do not undergo scar revision surgery, is it likely that the midpoint of my lip will ever realign itself to the true centre?
5. If I do not undergo scar revision surgery, is it likely that the bulbous scar tissue will diminish in size to the point where it is barely noticeable (or would this already have happened by now – given that the assault was 7 months ago)?
Because of my negative experience with the doctor who initially treated I am very keen to be as well informed as possible BEFORE my next appointment, so any help would be hugely appreciated.
I was offered immediate corrective surgery as soon as the A&E doctor's error was discovered (a week after the incident), but as the healing process had already begun I followed the medical advice and agreed to wait six months. Now that this time has passed I am still not entirely happy with the result, and I am keen to have it corrected if AT ALL possible.
Many thanks to anyone who is able to offer some help,