ROJ ADVISORY: Consult Early Enough for Lesions on the FACE and LIPS

Last July 22, 2011, I had a challenge in a patient with a lip disorder. Challenge, because the lesion was big and there was a need for a sophisticated lip reconstruction .  MA was a 19-year-old male from Quezon who presented with a mass on his upper lip (see preoperative pictures).  The mass dated back two years ago.  He associated it with a trauma on his upper lip during a basketball game. Several months after the trauma, he noticed a mass growing on his upper lip.  He consulted a plastic and reconstructive surgeon who injected steroids into and around the lesion. When the mass grew bigger, the plastic and reconstructive surgeon recommended an operation. For one reason or another, the operation supposed to be done by the plastic surgeon did not push through.  The mass grew bigger.  The patient had to stop schooling because of the appearance of his lip and face. He had to wear mask for almost two years to hide his mouth.  Last month, he decided to go to UPMC-FMAB for treatment.  After I evaluated the patient, my working diagnosis was a “granuloma pyogenicum” based on the appearance of the mass and the background history.  I decided to operate on the patient under local anesthesia because of limited funds. After the mass was removed, I had a 2-cm raw area to repair. I had to do some sophisticated plastic and reconstructive maneuvers to repair the raw area to effect a cosmetically acceptable scar.  It seems I was successful as there was no complication of flap necrosis and infection and the patient and his relatives were satisfied with the resulting appearance of the upper lip (see postoperative pictures).  The patient is now seeking a temporary job in his home province and plans to resume his college education soon.

An advice to the public: Consult EARLY ENOUGH in case you have masses or lesions on the FACE and LIPS.  If there is a need for an operation, smaller lesions are easier to manage, particularly, in terms of reconstructing the defects that will result from the removal of the lesions.  The cosmetic results after an operative treatment of smaller lesions are usually better.

Preoperative

Preoperative

Postoperative – 2 weeks after

Postoperative – 2 weeks after

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