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Dimple caused by cheek injury

93 replies

armarni · 23/05/2009 19:09

Hi everyone, about 4 weeks ago my 17 month old DD had a nasty tumble and her cheek hit the corner of our coffee table creating a very large bruise. She seemed fine after a few minutes of crying so I didnt think anything of it. Yet as the bruising has subsided Ive noticed that a hard lump has appreared under the skin at the point of impact and this has caused her to have a one sided dimple when she smiles as the skin is now contorted around this lump. I hate to think that her face is disfigured for life now. Can anyone else whose been through this post up any advice please. I've googled the issue and I'm not the only person who this has happened to, but nobody seems to give a definitive answer as to wether the lump is permenant scar tissue under the skin or if it will go with time.

TIA

OP posts:
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19
knittingaddict · 18/01/2022 08:22

Zombie! Words fail me. Grin

alejandrog89 · 27/02/2022 13:50

Hi,

My son had a fall on his cheek when he was around 2. He is now 6. See pic. Wondering if anyone has any sort of procedure done and how complicated would that be? Here in the UK won't do anything about it.

Dimple caused by cheek injury
Commonrider · 27/02/2022 22:25

@alejandrog89

Hi,

My son had a fall on his cheek when he was around 2. He is now 6. See pic. Wondering if anyone has any sort of procedure done and how complicated would that be? Here in the UK won't do anything about it.

I’ve seen facial fat grafting be recommended. It’s not a very major or complicated procedure. You would find a cosmetic surgeon that would do it with temporary fillers first to make sure it looks good then do it later with his own fat which is permanent I wouldn’t make it an issue for your son though unless it really bothers him. It doesn’t look bad and you don’t want to make him self conscious. If he personally feels it is a problem when he is a teenager you can support him and look into the fat grafting. He’s only 6 his face is going to change a lot it will likely become far less noticeable and could not even be an issue if you just let it be.
Soso7719 · 21/12/2022 00:21

Hi there any update on this. My 19 month son did the same 8 weeks ago left an indented line on his cheek. Just curious if your little ones ever filled in and how long did it take ?

Soso7719 · 04/01/2023 13:30

After the injury was it immediately indented or over time did it gradually get more prominent? My son has the same mark when he smiles. It happened over two months ago seems like it’s getting more noticeable over time.

Kartchnerjessi23 · 04/01/2023 16:39

Hi,

when I was 2 I hit my cheek on a coffee table that created a dimple in my cheek. I am now 27 and it has never gone away. The nerve in that cheek is damaged and cannot be fixed aside from surgery. The best thing to do is find a way to appreciate it as a beauty mark.

Dimple caused by cheek injury
DumberthanDumb · 11/01/2023 11:30

To Soso7719 and all the other parents who are concerned about their little ones' facial indents caused by trauma:

I waited three years for my child's indent to improve (which is not in the cheek, but much higher up in between the temple and eye, so cannot readily be passed off as a cheek dimple). It did not - at all. It remained the same as the day we first noticed it, shortly after the haematoma settled. I did everything suggested by the health professionals (i.e massaging gently etc), but to no avail. One consultant even told me he thought it would improve with time, and probably disappear with age (but was clearly wrong). It is there permanently, for life. It is due to scar tissue forming beneath the skin, and tethering the muscle, so that when they make facial expressions, it is very noticeable (much like a dimple).

Short of the child getting surgery when they are of an age where they can decide for themselves if they want to try to improve it (whereby there are no guarantees of success), there is nothing you can do. In time, you will learn to accept the indent scar as part of them, but it can take time, because that's your baby's face that's changed. It's likely to be more about you than it is about them, and your feelings towards it. Unfortunately, there is not much information made public regarding this type of accident (referred to as 'traumatic facial dimples'), so it's a case of extracting what info you can, and trying to accept early on that it's unlikely your child's scar will improve if it's this type of scar (the type that shows with facial expressions).

I am happy to answer any further questions if anyone wishes to PM me, since I've investigated this to the nth degree.

DCMILLER · 01/04/2023 02:51

Hi all, Just thought I would get in the mix here, as a worried mama who also has a child with this injury. I've read through this message board countless times over the past 3 years hoping to find an answer or solution, so I thought I would throw in my 2 cents and experience in case it could help anyone else.

My son was 3 when he fell into a corner and got a traumatic cheek dimple. He is 6 now and it is still there when he smiles or talks, sometimes quite prominently. It is permanent.

We have seen many doctors (we live in the NYC area) and done a couple of different treatments, which I am happy to share my experience with. The bad news is that none of the treatments have really worked thus far (this includes surgical fat grafting). But we aren't giving up-- and are in the process of other treatments that may help and I will update the thread accordingly.

First off, we have seen three or so pediatric plastic surgeons who all recommended subcision with fat grafting. In July of last year, we decided to try it. The procedure itself wasn't a terrible experience for my son, but the fat didnt really take, so the doctor recommended we repeat the process. We aren't quite ready to do that yet, so I decided to go back to the drawing board.

I took my son to see a dermatologist who specializes in subcision, and about a week ago he had his first subcision treatment. I figure that trying to really "release" the scar tissue might be a better first step (and much less intense/invasive experience for him) and then we could revisit the fat grafting thing later, when we are all ready.

Subcision is also usually needed in a series, and so far sadly we aren't seeing much of a change in the dimple/depression. I will update after our next subcision treatments (likely sometime over the summer).

Additionally, our surgeon who performed the initial fat grafting also gave us the option of just putting filler into the scar until my son gets older and can more easily handle another surgery. We are seriously considering going this route.
It seems pretty low risk and like it could potentially correct the issue, albeit short term. I'm wondering the degree of correction we could get from filler.... Not sure.

I know there are much more serious problems that parents have to deal with, but it still pains me daily to see his beautiful little face scarred like this, and I hope that I can help him correct it.

One thing I will say, and I hope this message reaches someone-- but if your child hits their face hard (anywhere on the face), get ice on it IMMEDIATELY and ice religiously over the next 24-48 hours. We did ice it, but only for a short period bc my son was upset by the cold. I truly believe that if we had done this more consistently in that first 24 hours, we could have avoided the scar or perhaps at least minimized it. I didnt know how serious it was at the time, and I majorly regret not taking better precautionary steps since my son seemed mostly fine. I am now a bit of a psychopath when it comes to putting ice on my children's facial boo boos but I'm not taking anymore chances.

Anyhow, I hope this information is helpful to someone. I will update periodically as we go through treatments. Praying for good news on my next update.

DCMILLER · 09/05/2023 13:51

Hi everyone,

Just thought I would share a new development:

Theres a new medical paper out on a new technique to fix these types of soft tissue injuries. The good news is that it looks really promising-- more so than fat grafting. The bad news is that the study is from China and it appears that the doctors who use this method are the only ones in the world who do so, which makes it very inaccessible (unless you are willing to travel).

Here's a link to the research study:

https://journals.lww.com/plasreconsurg/Abstract/9900/The_buried_guide_suture_method__a_novel_technique.1755.aspx#ContentAccessOptions

I also have the full length version of the study as well, that I would be happy to share as an attachment via direct email.

I have seen some of the pictures here posted by Moms, and the injury that was repaired in the study is almost identical to some of your children's injuries. The results are very impressive.

I'm happy to help so please contact me directly if you want to see the study.
Email is best since I'm not on here very often. My email is danielleclemenza at yahoo dot com.

The buried guide suture method: a novel technique to... : Plastic and Reconstructive Surgery

n these closed injury cases. It is challenging to reposition the subcutaneous tissue without incisions on unscarred skin. The authors propose a novel three-dimensional technique to suture and fix the subcutaneous tissue at a distance through a conceale...

https://journals.lww.com/plasreconsurg/Abstract/9900/The_buried_guide_suture_method__a_novel_technique.1755.aspx#ContentAccessOptions

Worriedparent12345 · 04/06/2023 22:19

Hi
we are in simple situation and curious how your child scar is now ? I am very worried and unable to find much data

DumberthanDumb · 11/07/2023 15:09

Worriedparent12345 See my post above from 11/1/23

anonymous432 · 23/08/2023 07:16

Are you able to provide before pics for context? I'm hoping for the same outcome as you!

Leo7541 · 23/08/2023 18:04

Hi there,
I will try to forward pictures. My daughter’s cheek injury happened when she was 2. She is now almost 7. It is still there. It is only very obvious when she smiles a certain way. Otherwise you can’t see it when her face is static. And other times, it looks like a small simple. Sometimes when it is cold, that area turns a light pink.
In short, it got better-but it is permanent.

the first picture is prior to injury. The second is when her face is still.(You can’t see the injury).The rest of the photos are with various expressions.
depending on her smile, it looks like a dimple or a sideways letter ‘v’.
I hope that helps.

Dimple caused by cheek injury
Dimple caused by cheek injury
Dimple caused by cheek injury
Dimple caused by cheek injury
Dimple caused by cheek injury
anonymous432 · 24/08/2023 02:26

Thanks for sharing! Did you massage at all after the injury?

DCMILLER · 24/08/2023 02:41

Sadly I don’t think that massaging is any sort of real solution. My son had an ultrasound done and you can see the torn subcutaneous tissue beneath his skin. Nothing can fix that aside from surgery and I feel like doctors who suggest this are a little clueless (could be wrong, that’s just my personal opinion)

DCMILLER · 24/08/2023 02:41

My sons cheek injury looks almost exactly like this

anonymous432 · 24/08/2023 06:04

Thanks for your response. Can you please share pics before and after the procedures?

16claire16 · 24/08/2023 09:45

This is my injury from 15 years ago. Top picture is how it should look. So you can see the damage from where I fell from a balcony and my face hit the concrete slabs, doctors won't help me and say I'm vain. Every time I look in the mirror it reminds me if that day I fell, it was my exs fault I fell. I don't feel pretty anymore, I'm so lucky I'm still alive but for 15 years I have hated that side of my face, I can feel it pulling when I smile, it's gets me down alot, I was thinking of having botox injected into that area to relax the muscle, has anyone else tried this? Every day doesn't get easier tho. I hate having pics taken as I hide that side of my face. Seeing all your pics helps as I know I'm not alone. It's great we can all talk about it together ❤️

Dimple caused by cheek injury
DCMILLER · 24/08/2023 13:13

I ironically have a traumatic cheek dimple (as well as my 6 year old son, which is the reason I’m on this thread) and I had mine filled with injectable filler. It improved the dimple/dent by about 75%. You can still see it but it’s much less obvious. Def speak to a cosmetic surgeon about this (someone highly qualified, as there are major arteries that run through the cheek). Sadly I don’t think filler is a good solution for young children or else I would have already done this for my son. Also, not sure if you saw my comment above but there’s a new surgical procedure they are performing in Beijing to correct this exact type of injury and they are getting great results. Feel free to email me if you would like a copy of the study.

DCMILLER · 08/09/2023 13:47

I just had my 2nd round of hyaluronic acid filler into my own traumatic cheek dimple and it is now barely detectable. I have before and after pics I would be happy to share — feel free to email me if you would like to see : [email protected] Filler is definitely a great way to go! Unfortunately I don’t think it can be used on kids.

elonnia · 15/10/2023 13:01

Hi Katia,

do you remember roughly how long it took the hematoma to go away?

Katia17 · 15/10/2023 19:35

It has been already so many years since the injury. I can’t recall exactly how long it took for hematoma to disappear. I believe it was around 2-3 months if not more.

Posting more recent picture of my son’s smile. As you can see the deep dimple is there to stay. The smile shape is not more stretched and equal, but crease lines never got fully symmetrical, although they did improve overall. Now that he is into teen years, he started to notice and question for the first time. I hope it’s not going to affect to much over the next years of puberty.

Dimple caused by cheek injury
elonnia · 16/10/2023 09:16

thanks for the response :)

I’m 21 and 3 months post injury. I have a traumatic cheek dimple, uneven smile lines & what I believe is a hematoma.

I’m seeing a maxillofacial specialist tomorrow. I’m not sure if there’s anything they can do for kids but I’ll let you know what he says. Hopefully it will bring you relief if you know that there are options he can take one day if it bothers him.

Farzaneh · 10/02/2024 21:09

Hi everyone, so sorry to hear all these stories … my 20 month old son got a big traumatic dimple on his cheek after a fall ..been 6 weeks now and I feel its getting worse I am massaging daily with warm compress ! Anyone has tried that? Ot anyone has seen any similar case that actually the dimple has actually improved over a time?!! Is your dimple where dark like this at beginning too? Any scar cream suggestion! I feel helpless and it breaks my heart seeing his face like this!’

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Dimple caused by cheek injury
Leo7541 · 11/02/2024 00:47

HI DCMiller,
Would you kindly email me the complete article you mentioned. I live in Toronto, Canada and no pediatric plastic surgeon or other is willing to even entertain doing anything about the injury.

Also, If you don't mind sending me pics of what the injury looked like post fat grafting or other procedures you have tried on your child.

You live in NYC, that is not too far from me. Which pediatric surgeon did you see and would recommend? I would fly to NYC to see if they can help my kiddo.

Like you, I did not ice. I was so grateful, she had not broke skin because I was concerned with scarring. Little did I know that this would be much worse. I always feel guilty about that.

It still breaks my heart. And now she is starting to notice, that her face and smile is a little lop-sided.

Anyway, my direct email is: [email protected]

Thanks!

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