Concerns About Flat, Firm Skin After Wisdom Tooth Extraction: What to Do?

Q: Concerns About Flat, Firm Skin After Wisdom Tooth Extraction: What to Do?

Hello Mr. <br>Zhong： 1. <br>& 2. <br>It is possible that the extraction site is healing, and there may be some soft tissue resembling scar tissue. <br>Generally, it will gradually return to normal, but if there is tenderness, it is advisable to return for an examination immediate

After the surgery to extract wisdom teeth, the flat, pancake-like surface tissue is a bit concerning?

Hello, Director Tseng.
I had my lower right wisdom tooth extracted about 4.5 months ago.
After the extraction, my right cheek was significantly swollen.
A month later, I was referred to a medical center for drainage, and the swelling noticeably decreased (though there was still a prominent lump that felt spherical when pinched).
After another 1.5 months (the lump had further reduced in size), I returned for a follow-up, but the doctor said it was fine and that I didn’t need to come back.
However, I have a concern that worries me: although the spherical lump has almost completely disappeared and my cheek is no longer swollen, there is still a flat, slightly hard, non-elastic area about 1.2 cm in diameter at the original lump's location (it is no longer spherical).
This flat area feels different from normal skin, as normal skin would have a slight elastic bulge when pressed, but this area is flat and non-elastic.
The skin color of this area is similar to the surrounding skin (with only a faint light brown hue from the initial bruise) and has the same roughness (smoothness).
However, the tissue around this area appears to be slightly depressed.
I would like to ask you: 1) Should I just wait for this flat, pancake-like skin area to disappear like the previous spherical lump, or should I return for a follow-up (if needed, which department should I see?) for more active treatment? 2) Based on the description above, could you give me an idea of what this flat, pancake-like skin area might be? (Knowing what it is might help alleviate my concerns.) Thank you, Director Tseng.

Zhong, 20~29 year old female. Ask Date: 2024/07/05

Dr. Zeng Guanghui reply Dentistry

Hello Mr.
Zhong: 1.
& 2.
It is possible that the extraction site is healing, and there may be some soft tissue resembling scar tissue.
Generally, it will gradually return to normal, but if there is tenderness, it is advisable to return for an examination immediately.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2024/07/05

More Info

After wisdom tooth extraction, it is not uncommon to experience various changes in the skin and tissue around the extraction site. The concerns you have regarding the flat, firm skin that has developed in the area where the swelling once was are valid and merit further discussion.

1. Understanding the Flat, Firm Skin: The flat, firm area you describe could be a result of several factors. After surgery, the body goes through a healing process that can involve inflammation, tissue remodeling, and the formation of scar tissue. The initial swelling you experienced was likely due to inflammation and fluid accumulation, which is a normal response to surgery. As the swelling subsided, the remaining tissue may have formed a fibrous scar, which can feel firm and lack elasticity compared to the surrounding skin. This is often referred to as "scar tissue" and can sometimes present as a flat, firm area that feels different from the surrounding skin.

2. Healing Process: In many cases, scar tissue will continue to remodel over time. This process can take several months to years, and while the appearance and texture of the scar may improve, it may not return to the original state of the surrounding skin. It is essential to be patient during this healing process. However, if the area remains unchanged or if you notice any new symptoms, such as increased hardness, pain, or changes in color, it is advisable to seek further evaluation.

3. When to Seek Medical Attention: If you are concerned about the appearance of the flat, firm area, or if it is causing discomfort, it would be prudent to return to your healthcare provider for an evaluation. You may want to see a dermatologist or an oral surgeon, as they can assess the area and determine if any further treatment is necessary. They may recommend options such as silicone gel sheets, pressure therapy, or other treatments to help improve the appearance and texture of the scar.

4. Potential Treatments: Depending on the assessment, treatment options may include:
- Silicone Gel Sheets: These can help flatten and soften scars over time.

- Massage Therapy: Gentle massage of the scar tissue can sometimes help improve elasticity and reduce firmness.

- Topical Treatments: Products containing ingredients like vitamin E, onion extract (found in products like Mederma), or other scar-reducing agents may be recommended.

- Laser Therapy: In some cases, dermatologists may suggest laser treatments to improve the appearance of scars.

5. Conclusion: It is essential to monitor the area and maintain open communication with your healthcare provider. If the flat, firm area does not improve or if you have any concerns about its appearance or any associated symptoms, do not hesitate to seek medical advice. Understanding that scar tissue can take time to heal and may not return to its original state can help manage expectations. Your healthcare provider will be able to guide you on the best course of action based on your specific situation.

In summary, while it is likely that the flat, firm area will continue to improve over time, it is always best to consult with a medical professional if you have concerns or if the area changes in any way. Your health and peace of mind are paramount, and seeking advice from a qualified professional can provide reassurance and appropriate management options.

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