Whether it is an accident or surgery, cuts or lacerations to the facial regions can be a difficult thing to manage for doctors and patient’s alike. As oral and maxillofacial surgeons, all of the doctors in our practice are trained in the cosmetic repair of lacerations and treatment of all varieties of facial trauma. We also do surgical procedures which require us to make incisions on or around the face. The main goal of the treatment of cuts and lacerations to any part of the body is the control of bleeding and closure of the wound. The cosmetic outcome is a secondary concern to the treatment of the actual injury. The techniques we use during the repair are designed to minimize the appearance of scars but are not guaranteed to hide all marks related to the injury. We cannot make the injury not happen but we can help make it look less noticeable.
Several things can be done at home to help the skin heal will and minimize scarring after the sutures are placed. The main thing is to keep the area clean, which means cleaning the area with soap and water at least once per day. The use of antibiotic ointment during this initial healing time also helps minimize the appearance of scars. The use of petroleum based antibiotic ointment helps to keep the inflammation to a minimum and prevents scabs from forming which allows the area to heal more rapidly and fully. The area does not require coverage with a bandage but if you choose to cover it you should remember to change the bandage twice a day. Depending on the area the sutures should be removed in 5-10 days. Once the sutures are removed several OTC products can help soften the skin and improve the healing time. These “scar reducing” creams and oils have been shown to decrease scar appearance and improve redness more quickly but the long term appearance (2+ years) after the injury is typically unaffected. It is very important to protect the newly repaired skin from sun exposure as the area will be hypersensitive to sunburn for the first few months. Sunblock or sunscreen or coverage is important during the first few weeks after sutures are removed to prevent prolonged discoloration and scarring.
If, despite the appropriate repair of the injured tissue, a significant cosmetic deformity remains after allowing full healing for 4-6 months, additional options for improvement of the scar are possible. Laser scar revision is usually the least invasive way to surgically improve the appearance of scars. This involves using a laser to resurface the skin in the area of the scar to improve the appearance. This mostly helps with discoloration and raised scars. Another surgical option is a procedure called dermabrasion. This procedure removes the surface layer of the scar tissue and surrounding skin allowing it to heal at the same level and is therefore used mainly for raised scars. Finally, a scar revision procedure can be performed which excises the scar tissue and repairs the skin defect. This procedure can be done using many techniques which allow for reorientation and improvement of the overall appearance but does require placement of additional sutures and is more invasive than the other procedures. If you have questions or concerns about a scar or previously repaired laceration a consultation with one of our doctors at Pottstown Oral and Maxillofacial surgery may give you additional information and insight on your options to improve the problem.