seroma and scar tissue in chin

[BirdsEye]

I had a surgery on my chin in 2006, to reduce its prominence.  It was only the "pad," there was no reduction to the bone.  I got two seromas in the days following, both of which were drained.  The healing resulted in a very uneven appearance, with the look of an "empty" space under my skin on one side, which bunched up when I chewed, and with much dimpling.  I did a lot of massage, and then in August of 2010 asked the same surgeon to try to correct the problem, since it had certainly had plenty of time (more than 4 years) to resolve / heal.  This time, he did the incision at the mental crease, and took out some scar tissue and tried to achieve more symmetry between the two sides.  Unfortunately, once again I got a seroma, which was drained about 3 times, and the same lifting up, "empty" looking result with a lot of "redundant skin."  The surgeon did two steroid injections into the large, hard lump that formed under the seroma.  I saw no effect from these.  Now, 8 months later, I am scheduled for a scar revision.  By next August, my surgeon says it will have been a year since the actual surgery, so it may be time then to go in again and try to reduce both the dimpling and the "bunching up" of the skin, that is,  whatever the scar revision doesn't accomplish.  He also mentioned the possibility of putting some kind of bonding material between my chin and the underlying tissue, at that one year mark. From your point of view, what are the options and timing of new surgeries that will be most effective, and least risky?  What is your opinion of the material to be inserted (i think he said pig tissue)?  Are there other methods for firming up the skin, reducing the dimpling?  Would other fillers possibly help?

[joyid]

A related discussion, Scar tissue after seroma was started.

[Howard Rosenberg, MD]

Soft tissue reduction of the chin, while a recognized procedure, is an uncommon surgery.  Your complications are even rarer.  Your surgeon sounds like he is treating you appropriately, but the outcomes of any revision will remain unpredictable.  It would be impossible to second guess an appropriate further surgical approach without a direct examination.