Facial Scars: Treatment Options and Recovery Insights

Facial scar issues?

Hello, Doctor.
At the end of last month, I was bitten by a dog, resulting in two wounds.
I have two questions:
1.
One wound is on my nasal bridge and was bitten very deeply.
After the stitches were removed, there is a raised scar about 2-3 cm in size.
I am currently using a silicone gel called Mederma to reduce the scar.
My attending physician mentioned that it might take about a year for it to fade.
Is that possible? If it does not fade, what options do I have for scar removal?
2.
The other wound is on my nasal wing, where only a small piece of flesh remains connected.
There was necrosis of the nasal tissue, and I was hospitalized for ten days, receiving antibiotics and IV fluids to promote blood circulation.
It has been almost a month since I was discharged, and I occasionally feel a slight stinging sensation at the suture site on my nasal wing.
Is this normal? I also noticed that after receiving the IV fluids to promote blood circulation, my nasal wing swelled by almost 10% the next day.
My attending physician said that it might fade within a year.
If it does not fade, are there any remedial options available? Thank you, Doctor.

Jie, 40~49 year old female. Ask Date: 2022/11/29

Dr. Lu Daokuan reply Plastic Surgery

Scars after an injury can only be cared for and reduced; there is no term "scar removal" in the textbooks.
Your injury is complex and requires regular outpatient follow-up rather than a one-time prediction.
Please make sure to return for your appointments!

Reply Date: 2022/11/29

More Info

When dealing with facial scars, especially those resulting from traumatic injuries such as dog bites, it's essential to understand the healing process and the available treatment options. Scarring can be a significant concern for many individuals, both aesthetically and psychologically. Here, I will address your questions regarding the treatment and recovery insights for your facial scars.

1. Understanding Scarring and Treatment Options:
The scar on your nose bridge that has become raised (hypertrophic scar) is not uncommon after deep wounds. The healing process can take time, and while some scars may improve significantly over the course of a year, others may require additional interventions. The use of silicone gel sheets or silicone-based scar gels, like the one you mentioned (Bioscar), is a common first-line treatment. These products can help flatten and soften scars by hydrating the scar tissue and reducing collagen production.

If after a year the scar does not improve to your satisfaction, there are several options available:
- Laser Therapy: Various laser treatments can help reduce the appearance of scars. Fractional lasers, for example, can resurface the skin and promote new collagen formation.

- Microneedling: This procedure involves using fine needles to create micro-injuries in the skin, promoting healing and collagen production, which can improve the texture of scars.

- Steroid Injections: For hypertrophic scars, corticosteroid injections can help flatten the scar and reduce inflammation.

- Surgical Revision: In some cases, surgical intervention may be necessary to excise the scar and reclose the wound in a way that minimizes scarring.

2. Pain and Healing Process:
Regarding the second injury on your nasal wing, experiencing some pain or discomfort at the site of a healing wound is relatively normal. This can be attributed to nerve regeneration and the healing process itself. However, if the pain is severe or accompanied by other symptoms such as increased redness, swelling, or discharge, it would be prudent to consult your physician.

The swelling you experienced after receiving intravenous fluids to promote blood circulation is also not uncommon. Post-surgical swelling can occur as part of the body's inflammatory response to injury and surgery. Over time, this should subside as the healing progresses.

If you find that the scar does not improve significantly within a year, similar treatment options as mentioned above can be considered. Additionally, consulting with a dermatologist or a plastic surgeon specializing in scar management can provide you with tailored options based on the specific characteristics of your scars.

In conclusion, while the healing process can be lengthy and sometimes frustrating, many effective treatments can help improve the appearance of facial scars. It's essential to maintain open communication with your healthcare providers and follow their recommendations for optimal recovery. Regular follow-ups can also help monitor the healing process and adjust treatment plans as necessary. Remember, patience is key, and many scars can continue to improve over time.

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