Flat, Pancake-like Skin Tissue After Wisdom Tooth Extraction: Causes and Concerns

The flat, pancake-like epidermal tissue on the skin may or may not heal on its own over time?

Hello, Director Wu.
My question, although related to wisdom tooth extraction, seems to pertain more to dermatological issues, so I would like to consult you.
Three months ago, I underwent surgery to extract my lower right wisdom tooth.
After the extraction, my right cheek was significantly swollen.
One month post-surgery, I was referred to a medical center for intraoral drainage (a small incision was made, so there were no stitches or follow-up appointments for stitch removal).
After another month, the swelling noticeably decreased (though there was still a lump, which felt spherical and was not painful).
I then began to massage the area (perhaps with a bit too much pressure).
After nearly a month of massage, the lump has almost disappeared, but now I have a concern that feels strange.
Although the spherical lump has nearly resolved and is not visibly apparent upon close inspection, if I pinch the skin where the lump used to be, I can feel a flat, slightly hard, non-elastic area about 1 cm in diameter (no longer spherical).
This skin tissue is the same color as the surrounding skin (barely showing a very faint coffee color from the original bruise) and has a similar texture (smoothness).
However, upon closer examination, the tissue around this area appears to be slightly depressed.
I would like to ask you: 1) Based on this rough description, could you provide an idea of what this flat, pancake-like skin tissue might be? (Knowing what it is might alleviate my concerns.) 2) Is this flat, pancake-like skin tissue a result of improper massage? Will it gradually return to normal? 3) Will surgery be necessary? Is there a risk of scarring? Thank you, Director.

Hao, 20~29 year old female. Ask Date: 2024/07/08

Dr. Wu Yuxin reply Dermatology

I'm not quite sure what your description of the problem is.
Please seek medical attention as soon as possible for a physician to evaluate you.

Reply Date: 2024/07/08

More Info

After wisdom tooth extraction, it is not uncommon for patients to experience various changes in the surrounding tissues, including the skin. The flat, pancake-like skin tissue you are describing could be a result of several factors related to the surgical procedure and subsequent healing process.

1. Understanding the Flat, Pancake-like Skin Tissue: The flat, slightly hard tissue you are feeling may represent a few possibilities. It could be a form of scar tissue that has developed as a result of the healing process after your wisdom tooth extraction. Scar tissue can sometimes feel different from the surrounding skin, often being less elastic and more fibrous. This is particularly true if there was significant swelling or trauma to the area during or after the extraction. The fact that it is the same color as your normal skin and only slightly rough suggests that it may not be a serious issue, but rather a normal part of the healing process.
2. Impact of Massage: You mentioned that you have been massaging the area. While gentle massage can sometimes help with swelling and promote circulation, excessive pressure or aggressive manipulation can lead to further irritation or even damage to the healing tissue. This could potentially contribute to the formation of scar tissue or alter the normal healing process. It is essential to be cautious with any manipulation of the area, especially if you notice changes in texture or firmness. In many cases, the body will continue to heal and remodel the tissue over time, and the appearance may improve. However, the timeline for this can vary significantly from person to person.

3. Need for Surgical Intervention: In most cases, flat or hardened areas of skin following a dental procedure do not require surgical intervention unless they are causing significant discomfort, functional issues, or cosmetic concerns. If the tissue remains unchanged or continues to cause you worry, it would be advisable to consult with a healthcare professional, such as a dermatologist or an oral surgeon, who can assess the area more thoroughly. They may recommend options such as observation, physical therapy, or, in rare cases, surgical revision if deemed necessary.

4. Concerns About Appearance: Regarding your concern about whether this will affect your appearance, it is difficult to predict without a thorough examination. Many individuals experience changes in their skin texture after surgical procedures, but these often improve with time. If the area is not painful and does not show signs of infection (such as increased redness, warmth, or discharge), it is likely that it will continue to heal and may become less noticeable.

In summary, while the flat, pancake-like skin tissue you are experiencing is likely a normal part of the healing process, it is essential to monitor the area for any changes. If you have ongoing concerns about its appearance or feel that it is not improving, seeking a professional evaluation would be the best course of action. Remember, healing can take time, and patience is often required as your body works to restore normal function and appearance to the affected area.

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