Hard lumpy facial scar? Yikes....
June 6, 2011 8:20 AM   Subscribe

After a hard landing on the edge of a metal basket, I had a large gash in my cheek and a broken nose. The gash was stitched up, internally and externally, and has closed nicely. However, the area under/around the wound is now hard and alternating between being tingly and being numb.

While on vacation, I passed out and hurt my face pretty badly. I went to the ER in India and had 'surgery' to close the wound on my cheek. The surgeon put in internal and external stitches because the cheek wound was so deep.

The injury happened just about ten/eleven days ago; I still have bruising around my eyes from the broken nose and along my cheek where I hit the basket's edge. As soon as I got back in the US, I had my doctor remove the stitches to prevent any scarring from them (5 days had passed - the recommended time for facial stitches).

This morning, I finally removed the steri-strips the US doctor had covered the wound with. The Indian plastic surgeon did a fair job and the scar is really thin. I imagine that in a year, or less, it won't be noticeable.

My concern and what I'm hoping to get anecdotal reassurance about is the hard lump under/around the wound. While the stitches and bandages were on, I left the wound alone and didn't press on it. This hard lump surrounds the scar and continues up my cheekbone. As I've poked at it this morning, I've noticed that it's numb. The skin on top is fine, but the lump itself is numb. Every once in a while, it'll tingle.

Is this normal for a bad wound that's only eleven days old? Is this something I should be running to the ER about?

I have an appointment with a plastic surgeon in a few days, but I'd greatly appreciate some input before then.
posted by LOLAttorney2009 to Health & Fitness (10 answers total)
Purely anecdotal, so please feel free to ignore and call your doctor with questions:

I had an operation to pin a badly set break in my arm when I was a kid, and for quite a while after the stitches came out, the area around the scar tingled, itched, and/or was numb. The area immediately adjacent to the visible, external scar also felt hard and scar-tissue-like (under the skin). When I had to have the pin removed a year later, the surgeon explained that the nerves there would feel weird for a while as they re-grew and made new connections.

So, I don't think this is a dash-to-the-ER situation, but do call your doc before you meet with the plastic surgeon if it's really freaking you out.
posted by rtha at 8:32 AM on June 6, 2011

IANAD. I have three c-sections and there was always a big lump for a while underneath. It always went away eventually. I don't remember it being tingly but it was definitely numb. There still isn't quite as much feeling along the scar now as in the surrounding areas and my youngest is almost three.
posted by artychoke at 8:35 AM on June 6, 2011

I wonder if it's some fluid build up. When I've had an incision (related to surgery) in the weeks afterward there would sometimes be a firmness around the incision that was serous fluid. Occasionally it would leak from the incision, and when I asked my doc, she said that it was normal, and what didn't drain would just be reabsorbed.
posted by kimdog at 8:35 AM on June 6, 2011

Also anecdotal not a doctor here but last time I had a bunch of stitches to close up an injury the area was numb for a few months after. Think the feeling is back now. But it's in a spot that it doesnt matter either way. When I mentioned the numbness to docs the just nodded and continued to do whatever they were doing (ie didn't seem concerned at all).
posted by WickedPissah at 8:38 AM on June 6, 2011

IANAD. Please talk to your doctor about your concerns.

I've had many, many stitches in my life. In my experience, the are around stitched wounds is often numb for a while until the wound heals completely and the scar tissue shrinks. I've never had a permanent loss of sensation in the area, and to date I only have a slightly "odd" feeling of light pressure when touching a scar that arose from a major abdominal surgery.

I've also found that stitched areas and scars often look awful and swollen for a while after surgery and then, before you know it, are just faint silverish areas under normal skin.
posted by Inspector.Gadget at 8:38 AM on June 6, 2011

Sounds like the nerves are reconnecting. I cut my thumb quite badly once and had similar symptoms and that's what my medic explained to me.
posted by Dagobert at 8:39 AM on June 6, 2011

Response by poster: Thank you all for the anecdotal information! The last time I had stitches, I was... maybe nine years old and just can't recall what the healing process was like. I tried googling for the information, but I just didn't hit on the correct string of search terms to find what y'all have provided.

Kimdog, thanks for the link to serous fluid. From it, I found this: "Seromas (a pocket of serous fluid) can also sometimes be caused by injury, such as when the initial swelling from a blow or fall does not fully subside. The remaining serous fluid causes a seroma that the body usually gradually absorbs over time (often taking many days or weeks); however, a knot of calcified tissue sometimes remains."
posted by LOLAttorney2009 at 8:52 AM on June 6, 2011

I got a somewhat similar injury on the inside of my arm about 3 months ago. It's still hard, numb, tingly and weird. Per my doctors, it's normal, and you can expect it to be like that for a while. Sorry...part of the healing process.
posted by kjs3 at 12:00 PM on June 6, 2011

I had a deep cut across my left wrist sewn up a couple of years ago (accidental! not suicidal!) and the internal scar was hard for a year or so but is now normal. Your surgeon will probably talk to you about massaging it so it breaks up.

The numbness is due to trauma to the facial nerves, and may be temporary or permanent depending on exactly what was cut and how well the repair reapproximated the ends of the severed nerves. The skin on my wrist just past my surface scar is still numb.
posted by nicwolff at 2:22 PM on June 6, 2011

I had periodontal surgery a couple of years ago, and ended up with numbness in my upper lip, similar to how novicaine feels. My dental surgeon warned me that it might happen, and it lasted for many months, but ultimately the feeling came back.
posted by crunchland at 10:33 PM on June 21, 2011

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