Sometimes it helps to think outside the box. A young patient was referred to me for a “lump” on her left upper lip. She had seen another plastic surgeon, who recommended a wedge resection (removing the entire lesion and surrounding tissue). This would have resulted in a potentially visible scar between her nose and lips, and possibly cause a significant amount of bleeding, as the lump was a vascular malformation (most likely a hemangioma).
Although this is a knee-jerk reaction for any lesion (let’s just cut it out), I decided to do further studies. A high resolution ultrasound was performed by the radiologist, which showed the lesion to have no major feeding vessels. This made the treatment much simpler, since I did not have to worry about any major blood vessels complicating the procedure.
I chose to inject the lesion with a sclerosing agent, similar to spider veins on the legs. This is not a new technique, but its use for treatment of hemangioma of the lip is not common either. After the injection and two months of waiting, the lesion had shrunk enough so the entire hemangioma could be removed under local anesthesia, and the incision was small and kept inside the lip, to prevent any visible scars.
This treatment, although somewhat unconventional, resulted in a nice cosmetic result and a happy patient.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience. His office is located in Orange County, California. To schedule a complimentary consultation, please call (714) 834-0101.
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