Concerns About Scar Appearance After Emergency Chin Sutures

The chin emergency suturing is not aesthetically pleasing?

Hello, doctor.
I was in a car accident on May 9th and received stitches for a laceration on my chin measuring 4 x 1.5 x 0.9 cm in the emergency room.
I had the stitches removed on May 20th.
Since the suturing was done in the emergency room, it seems that it was not performed by a plastic surgeon.
I am very concerned about the formation of scars, especially since it is located on the front of my chin.
I have consulted with plastic surgery clinics as well as the Mackay Memorial Hospital in Hsinchu.
The clinics advised that scar revision surgery could be performed, and since the scar is already two weeks old and has adhesions, they suggested reopening and re-suturing it to improve its appearance and facilitate better care afterward.
However, the hospital physician mentioned that the wound is still in the acute phase and that there is no rush to perform scar revision; it would be better to wait 3 to 6 months to assess the scar's condition before deciding whether to proceed with scar revision or laser treatment.
I would like to know your opinion on whether I should rush to have the scar revision or if I should observe the situation first.
Currently, I apply scar gel and wait for it to dry before placing silicone tape.
Is this sequence correct? Is silicone sheeting better than silicone tape? Thank you for taking the time to read and respond.

Mr. Zhang, 20~29 year old female. Ask Date: 2024/05/28

Dr. Lü Mingchuan reply Plastic Surgery

You can visit the outpatient clinic for evaluation.

Reply Date: 2024/05/28

More Info

After experiencing a traumatic injury such as a laceration to the chin, concerns about scar appearance are quite common, especially when the injury is located on a prominent area of the face. In your case, you sustained a laceration that required suturing in the emergency room, and you are now in the process of managing the scar that has formed.

First, it’s important to understand that the healing process for a wound, particularly one that has been sutured, typically goes through several stages. Initially, the wound is in the inflammatory phase, which can last for several days. During this time, the area may appear red, swollen, and tender. As healing progresses, the wound enters the proliferative phase, where new tissue forms, and eventually, it will transition into the remodeling phase, which can last for months to years. Scarring is a natural part of this process, and the appearance of the scar can change significantly over time.

Regarding your concerns about the timing of scar revision surgery, it is generally recommended to wait at least 3 to 6 months after the initial injury before considering any surgical intervention for scar revision. This waiting period allows the scar to mature, as many scars will naturally improve in appearance over time. The advice you received from the hospital physician to observe the scar for a few months before making a decision about revision is consistent with standard medical practice.
Scar management techniques can also play a significant role in the final appearance of the scar. The use of silicone gel sheets or silicone gel is a common recommendation for scar treatment. These products can help to hydrate the scar and may reduce its appearance. The sequence you mentioned—applying scar gel and allowing it to dry before applying a silicone tape—is a good approach. Silicone sheets are often considered more effective than regular adhesive bandages for scar management because they provide a consistent level of hydration and pressure to the scar tissue.

In terms of whether to proceed with scar revision surgery now or wait, it is advisable to follow the guidance of your healthcare providers. If the scar is causing significant cosmetic concern or if it becomes symptomatic (itchy, painful, or restrictive), then a consultation with a plastic surgeon specializing in scar revision may be warranted. They can assess the scar's characteristics and determine the best course of action, which may include surgical revision, laser therapy, or other modalities.

In summary, it is generally best to wait and observe the scar for a few months before deciding on surgical intervention. Continue with your current scar management regimen, and consider consulting with a specialist if you have ongoing concerns about the scar's appearance or if it affects your quality of life. Remember that patience is key in the healing process, and many scars will improve significantly over time with proper care.

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