dancinblond's Blog

Well, I finally had the surgery 5 weeks ago. I thought I should discuss my results at this point. I had mentioned that I was not comfortable with the only oral surgeon on my medical plan (I don't have dental insurance). I am sure he was surgically competent, but because I was obviously upset about the mucocele and what the surgery entailed, he seemed more concerned with trying to convince me to have conscious sedation than address my actual concerns. I really could not easily have someone drive me to this appointment.....I live alone, no family in town. I also wanted to be fully aware of what occurred during the surgery. This doctor totally misread my nervousness. I was not especially afraid of the actual surgery. ( which by the way took 15 minutes under local sedation) I was concerned with the aftermath. Especially with everything I had read on this forum and elsewhere. I then learned that other types of doctors performed this surgery, i.e. ENT's, and Plastic surgeons. I found an ENT/Facial plastics surgeon who is the section head of that department at the Cleveland Clinic. I assumed he would know what he was doing. By the time I had the surgery I had been dealing with the mucocele for at least 2 months. It had gotten much larger, but had never broken. This doctor had given me the option of total excision or marsupialization, where they make an incision in the mucocele and stitch it to remain open, greating a flap. This procedure allows the mucocele to continuously drain while new epethial tissue forms. It is tissue sparing and leaves very little scar tissue if it works. The problem is that it has a 30 percent recurrence rate. I struggled with the decsion but chose total excision. If I had any idea how miserable the scar tissue could be, I would have given the marsupializion a try.
I am having a difficult recovery. The mucocele was removed in its entirety according to the doctor, and he did/does not expect a recurrence. The mucocele was quite large. I saw it. It looked like the puffed up water balloon version of an almond! The first week I was incredibly swollen. The mucocele was quite inside my lower lip and nothing was visible when it was there. I had a fairly long incision and 4 stitches. My lower lip was unbelievably swollen. I was even swollen below my chin on that side. A week and a half after the surgery something that looked like a blood blister popped out of the incsion line. Later it looked more clear and almost like another mucocele. Of course it was the Friday after Thanksgiving and no doctors were around! I finally called the emergency line and talked to one of the staff ENTS of the Clinic that was on call in the emergency room. He said it might be a piece of the old mucocele or something else.....I don't remember what. He said to come into the emergency room if it continued to worry me before I could see my doctor. I went to a dance that night......sounds crazy, but I used to teach ballroom dancing 25 years ago and it has remained my joy and hobby ever since. Everything feels better when I dance....even though at this point smiling was almost impossible. I was already developing hard scar tissue at this point, but now it also really felt like a mucocele as this thing kept enlarging. On the way home, I was talking to a friend about driving me to the downtown CCF emergency the next morning if I felt I needed to go, and suddenly the thing burst...exploded. Tons of....I am not sure what, as I was driving and could not look poured out. It felt sticky, but not like blood at all. This really seemed like what happens with mucoceles per other peoples description. As I said, mine never did break so I had no personal source of comparison. By the time I got home, all that was left was a red spot. (I rinsed with salt water) I still had a few stitches at this point. Strangely, after it burst I had no feeling of hard scar tissue for a few hours. The next day there was a white spot, and the scar tissue feeling was back. By the time I saw the doctors assistant the following Tuesday, there was no evidence of anything. He did say I was forming a lot of scar tissue. He thought is MIGHT have been a piece of the old mucocele, but that it might have just self resolved. The nurse thought it was my body trying to expel one one of the stitches. Whatever it was, it never returned. (so far) I saw the doctor a little over a week ago. At this point my biggest concern was how massive the scar tissue was feeling. Its like I have a ropey, bumpy marble in my mouth. It feels as big as the mucocele except hard and ropey. I am always feeling pulling and tugging on my lip with almost any movement of my mouth. It also is still quite uncomfortable to laugh. I still have a small area of swelling on my actual lip which feels slighty tingly, numb, and sore all the time. If that was my only issue, however, I could deal with that. Visually, nothing is noticble unless I smile, and mostly to me, but I am SO uncomfortable. Eating is still tough, I keep thinking I will bite the area. The doctor said that all of this is pretty normal at this junture. I had a large mucocele and scar tissue is currently filling the area. He had already told me previously that the swollen area on my lip could last a couple of months. He now told me that the scar tissue would start to soften, but could take 4 or 5 months. UGH! He said after 2 more months a bit of injected steroid could help the scar tissue and the lip swelling if it was still really bothersome. I have to be really careful about steroids, however. So, I am back to doing everything I ever did....even kissing.....I actually asked the doctor if it was safe to do that. He just laughed and said that was fine. I was hoping it would be indirect massage....no luck so far.....but it does take my mind off everything. At least until it gets uncomfortable.
However, I am NOT a happy camper and cannot believe how uncomfortable, distrating, annoying, and by the end of the day really irritated this feels! It also just seems to wear me out, and I cannot keep my tongue off the area!
The doctor, by the way, said the pathology report confirmed the entire mucocele was removed. The doctor does NOT think the thing that popped out of the incision line was a mucocele, just some kind of fluid that built up from pressure of the incision. I hope that is true, because if this thing comes back I may throw my entire head off a tall building! If mucoceles are small, and they get everything, I don't this surgery is a big deal. But, when they are large.....this can really be an ordeal. Plus, you never know how much scar tissue you personally may form until you have something like this done.
I am praying that is NOT going to be the condition of my mouth indefinately! I will post again if the scar tissue and other issues begins to resolve.

I have had a mucocele inside my lower lip for over 3 weeks now. I had figured out that is what this seemed to be, prior to making an appointment with an oral surgeon 3 weeks ago. In the mean time ,(a week ago), a dentist friend of mine looked at it just to make sure that is what I was dealing with, because I could not get an appointment until the 20th (today), and it was getting bigger. I could only find one oral surgeon in my area that was on my medical insurance plan. I thought he would do the procedure today, but he just looked at it. I am a massage therapist, who has been out of work since June. I am finally getting interviews, and now I am dealing with this. I now have an appointment with this doctor next Monday. He has scared me to death. He wants to give me twilight sleep along with local anesthetic. I thought this was always just a local. He said he would do it that way, but made it sound like it would be horrible. I really don't have anyone to drive me, and I live alone. I would have to really inconvenience a friend, to get a ride to the appointment. I also don't actually want to be drugged up, I really hate that. I also did not like this doctor, feel comfortable with him, or trust him. My dentist friend said he is a good surgeon, but he is not the one that my dentist or he would have recomended. However, I am very penniless and cannot see anyone outside my plan. Are there any other types of surgeons who could remove a mucocele? I have read on the Internet that there are less invasive ways to treat mucoceles now, such as laser surgery, but of course, this doctor does not have that kind of equipment. With my demanding type of work, I am very concerned about recovery time. After reading here that the surgery could cause lip numbness, I think I would rather have this thing in my mouth than have that happen. I am really not sure what to do.