Dentistry/Scarring after mucocele surgery
I had my mucocele in my lower inner lip removed about a month ago by an oral surgeon. The first week after surgery the area seemed to healing normally, no scar tissue. But after two weeks post surgery, there is 'scar tissue' forming in the area where the incision was made and it is slowly growing. I have gone back to the oral surgeon and he said it was scar tissue. Now is five weeks since surgery, I can still feel the scar tissue slowly growing each day. Is that normal? Could the scar tissue cover the whole surgery site or can it expand beyond that? I am worry that it could be something else because it shouldn't take long for scar tissue to form?
ANSWER: Jack - You are correct that five weeks the area should have completely healed without discomfort or excess scarring. If you touch the area from the inside and outside of the lip at the same time, does the area feel hard? Is the area sore? If no soreness exists, a simple massage of the area between two fingers, one outside he mouth and the other inside your mouth will help to promote the healing
My suggestion for you is to see your surgeon again to evaluate the areas. Healing can occur in different ways and that can happen for a number of reasons. So contact the surgeon. If you have additional questions, feel free to contact me again.
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QUESTION: First of all, thank you Dr. Teig for taking your time to reply to my question on July 4, hope you are having a wonderful 4th.
Yes ten days after the surgery (surgery date was 5/27), I regained sensation in the surgery area including my lip, the scar knot area was already getting hard, the area seemed to be healing just fine. However a little bit past the 14th day that was when I started to feel something growing where the 'scar knot' is located. It is hard to explain but with my tongue it felt like some kind of web-like tissue. It grow slowly to this day and it is making that whole area sore again and kind of puffy. I can definitely say this, I was feeling much better on the 10th day post surgery than I do today. I have gone back to my surgeon on 6/20, all he told me was that it was scar tissue and set an appointment 2 months later to check up again. He didn't even let me explain what I felt. I know I am not a medical expert for sure but I can feel the changes in my mouth.
What could be causing this? Is it really scar tissue growing that I am feeling in my mouth or could it be something else?
Thank you again for your time and your insight.
ANSWER: Jack - from your description of the sensations you are experiencing where the scar knot is located, the knots are often an attraction for bacteria and I wonder if there is an infection brewing in the lip or is there some residual cells from the mucocele and they are growing again into a new mucocele. Mucocele lesions often reform after their removal. I, of course, cannot be sure, but the surgeon should know of the common reformation of mucoceles after its removal.
My recommendation, besides having the surgeon evaluate the area again, is for you to do warm salt water rinses, with focusing the solution against the inside of your lower lip. You will need to do it for 2-3 minutes, 4-5 times a day. This repeated exposing the area to the warm salt water will help reduce the inflammation if there is an infection or inflammation in the area. If there is a new mucocele developing, the warm salt water will help to draw excess fluids from it.
So see the surgeon again and ask him to evaluate if a new mucocele lesion is developing. I wish you well. If you have any further questions, feel free to contact me again.
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QUESTION: Dr. Teig,
It has been another two weeks (a bit over 7 weeks post-surgery), yet the scar tissue is still growing. It is creating discomfort in the nearby mouth area, some swelling and sensitivity. I have gone back to the oral surgeon and he doesn't see another mucocele there but yet he doesn't know what is going on. He has refer me to another doctor for a second opinion. I have been reading up on scar formation online. There is such thing as hypertrophic scar and keloid (my surgeon told me it is most likely not that). In your years of practice, have you seen such over-scarring occur after a mucocele surgery?
jack - I am lucky to not have experienced an excessive scarring, however, I have witnessed patients who did develop it from other surgeries. I treated other patients with one of the medications that reduces the scar tissue. I also did an excision of an overgrown scar. I then used a cortisone medication to help reduce the reformation. The scar on this lesion was slightly larger, but not excessive, as I had previously seen. Those scars were on skin. Yours are intraoral from the mucocele. I am not aware of any medication that can be used in the mouth.
I have seen excessive tissue growth after mucocele removal. In one situation, the doctor left other close by small salivary glands that had blocked ducts. The block did not allow saliva produced to be released. So this was basically a new mucocele under the tissue.
In another situation, the patient developed an infection in the tissue. This infection was treated with medication.
If you have additional questions please contact me again.