AboutAlan M. Engler, MD, FACS Expertise Dr. Engler has answered over 2700 plastic surgery questions for Allexperts. His expertise is in cosmetic plastic surgery including breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts etc.
Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction."
Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), and the Dr. Keith Ablow Show. Videos of his appearances are available on YouTube (SEARCH FOR "DR. ENGLER"). His website is www.bodysculpture.com.
Experience Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on amazon.com, barnesandnoble.com, etc.
Education/Credentials Dr. Engler graduated from Yale University (undergraduate) and the College of Physicians and Surgeons of Columbia University (medical school). He did his residency training in General Surgery and, after that, Plastic Surgery, at the Montefiore Medical Center in New York. He is on the faculty of the Albert Einstein College of Medicine in New York.
Question My 26-month old daughter was bit by a relative's dog one month ago.
Overall, thankfully, very mild damage. His top teeth caused some mild
abrasion resulting in hematoma.... the more severe damage was done by his
canines. One was a superficial slash on her cheek. The drs felt that this was
not very deep, equal to a scrape at the playground, and did not need stitches.
The wound of more concern was a small, moderately deep puncture in the
crease where her nose meets her cheek. No gushing blood, no stitches. She
was given an antibiotic for infection, was told my ER drs and her own MD to
keep it clean, slather with polysporin, and I have done that.
The follow-up 1 month later: it has healed very nicely, most of the hematoma
is gone, and the cut on her cheek is about 95% gone. Everything is cleaner,
clearer, and lighter. But my biggest concern is a small hypertrophic scar hat
has developed on the puncture spot (this was confirmed by a plastic
surgeon.) It is located in the valley between her nose and her cheek, almost
on the cheek itself. The wound has sealed and it looks clean but the edges
are slightly jagged and the whole thing is raised and red.
I am writing bc I unfortunately did not care for the plastic surgeon that
examined her recently and after taking wads of my money and trying to sell
me many products, I walked out feeling like I was given the runaround.
So my questions at this point are: I have read that hypertrophic scars usually
go down on their own...is this true, and how long does that usually take?
Given her young age, what are the chances of this looking like the bite never
happened? What will happen to her skin in that area as she grows older (ie.
will it stretch or whiten or completely disappear)? And is there anything that I
can put on it to help soften it or reduce it? And will the hematoma go away?
Any advice you can give is very appreciated. As you can imagine this is a
parent's worst nightmare. I am grateful that it wasn't worse, but of course
every time I look at her face it is upsetting.
Thank you!
Answer from Dr. Alan Engler
www.bodysculpture.com
Hi Kerrie,
I'm obviously very sorry for what happened - as both a plastic surgeon and a parent! - but, as you suggest, it could have been so much worse, and I think you have to keep reminding yourself of that every day. I know; easy for me to say...
First of all, you should find a plastic surgeon near you whom you like. There are lots of them (try plasticsurgery.org and surgery.org) and you should be able to find someone you feel you can work with. I'm also sorry for the experience you had with this one.
It can take a long time for scars to mature completely - up to two years or more - so it's premature to get overly concerned about this one in terms of its final appearance (everything I say has to, of course, be taken in the context of an online opinion and consult without being able to examine that patient). And kids sometimes have nasty looking scars early on. Most of the time, they settle down very well on their own, and the location of this one suggests that it will become less and less visible over time, anyway. Scars also tend to lighten with time (depending on the skin type and color, tension, and other factors). The hematoma should absorb on its own.
I would think that the best things to do are to massage the scar gently several times a day (this seems to help it soften and go down) and be careful to avoid sun exposure (though you should do that anyway - right?). I am not familiar enough with any of the available scar treatments to recommend any of them specifically, though many people have used them.
I suspect that it will be fine eventually...I just hope you will!
