Lower Lip Scar Tissue Removal Decision

[SJDennis]

I am a 34 year old lady who almost bit through my lower lip (20 months ago).  I think my lower teeth and upper teeth actually bit mostly through the inside/wet part of my lower lip (to be more specific).    Initially the open wound to the lip looked like an uneven cross shape.  When the scar had healed initially I was left with a lump which is mostly on the wet part of my lower lip.  This lump however can be seen at all times when the lips are open or when I smile and this is giving me some distress.  The lump is only not visible when my lips are closed.  20 months on, the horizontal open line of the 'cross' wound has healed ok (slight flattish scar) but the vertical part of the 'cross' it seems is where the problem lies (resulting in the visible lump as described earlier).  The scar tissue lump has softened/flattened slightly over time but I fear that it will not go completely so long down the line (i.e. it's 2 years since the accident in March 09).  
Questions:
1. My options?  1. Surgical removal of lump? Or/And 2. I was also wondering if injections to plump the unscarred lip around the lump would be possible to conceal the lump?
2. If I seek a surgeon to remove the lump, who would be most practiced at this sort of procedure?, and what would their medical occupation be? (i.e. Maxillofacial?), and what qualifications should they have?  I want someone who has done this actual procedure before as part of their daily job and understands how to improve the aesthetics of the lips through surgery. If I seek surgery, what are the chances that the surgeon could make the lower lip completely 'flat' (back to how it was before) so that my smile is even? and what are the chances of success of this procedure (based on statistics, if there are any)? and what are the key complications?
3. Do you think it could still improve if I leave it? Is there anything else I could do or put on it to help it improve further?  
Thanks a million!!



  



      

[SJDennis]

Dear Howard Rosenberg, I just wanted to say thanks a million to you for your speedy response and expert advice.  It is much appreciated.  Thanks again, Sarah.

[Howard Rosenberg, MD]

Most plastic surgeons would have experience with residual scarring from through-and-through lacerations of the lip.  It is a common problem with these injuries due to build up of scar tissue.  I would not expect the scar to resolve on its own at this point in time.  Steroid injections would not likely work.  Surgical revision of the scar will reduce the fullness that you have.  There are no statistics regarding per cent success of this procedure because of the variability of the size, location and nature of the scar as well as differences in the genetic scar forming propensity for each individual.