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Mucocele excision - surgical removal of a soft tissue lesion

A mucocele is a benign, raised, saliva-filled lesion, usually located on the lower lips. They usually form after a traumatic injury to the lips. (sudden lip biting)

A year ago, patient came to me for endodontic treatment. Upon consultation, i also saw a raised lesion on her lower lip. After a more thorough interview, i speculated that it might be a mucocele. I told her to observe it for a while and hope it disappears by itself.

Six months later, the lesion persisted. Alternately growing and shrinking every few week/months.

Long story short, patient decided to finally get rid of it. Although it was painless, it was a also a source of annoyance to her, as it also becomes easier to accidentally bite it the bigger it grows.

For this procedure, i literally 'called a friend' to do the surgical procedure. My colleague, Doc Gee, did the deed while i assisted and documented the procedure.

Here are the pre-operative pictures. First picture was taken in Jan 2018, during our endodontic meetings. Second and third picture taken June 2018, right before removal.

mucocele preop 1-2018
mucocele preop 6-2018
mucocele preop 6-2018

Next pictures, show the wound after removing the lesion, and the excised lesion itself.

mucocele excision site after removal 6-2018

And because the lesion was both deep and wide, the skin was perforated.

excised mucocele specimen

Here the excised lesion is immersed and fixated in formalin. It was sent to a laboratory for histopathological examination. After a week, the results came back and it confirmed our diagnosis.

excised mucocele specimen after fixation with formalin

The wound was closed using 4-0 silk sutures.

mucocele excision site wound closure 6-2018
mucocele excision site wound closure on skin 6-2018

We decided to recall the patient 4 days after surgery, to remove the sutures, if wound closure was sufficient.

mucocele excision site 4 days post-op 6-2018

mucocele excision site 4 days post-op sutures removed 6-2018

Luckily, the wound healing was fast, and the suture was removed both internally and externally.

The patient was recalled at least once per month to check the healing. And the results were astonishing!

mucocele excision internal wound healing 3 months follow up
mucocele excision external wound healing 3 months follow up

Patient was advised to use Dermatix to prevent scar formation, but opted not to. She used Lucas Papaw Ointment instead. Fusidin antibacterial ointment was also used during the initial healing period.

Thanks to my colleague Doc Gee, the princess of mucocele excisions, for doing this procedure for my patient.

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