Dog bites account for over 44,000 facial injuries annually, and about three out of five victims are children. Preventing permanent, disfiguring scars may be possible, but prompt treatment by a board-certified plastic surgeon can improve the chances of a successful result.
I see many dog bites in my practice, and these can be particularly damaging injuries. Conventional knife cuts, for example, typically happen along a comparatively regular cut line, even with serrated knives. But dogs are instinctive creatures who tend to whip their heads around after biting down, sometimes with remarkable force.
Generally, there’s no single type of dog bite laceration. There can be puncture wounds from the teeth, combined with tearing from the dog’s movement. When a dog bite occurs on the face, prominent features, such as the nose, lips, and ears can provide points of connection for the dog’s teeth. The length of the attacking dog’s teeth may also create deep tissue damage to your tendons, ligaments, and nerves.
Because of the particularly violent nature of dog bite injuries, every case is different. However, if you or your child experiences a dog bite, there are three general stages to repairing the damage.
The first stage is the first aid and cleaning stage, making sure that bleeding stops, that the wounds are disinfected, and that you have a tetanus shot. This gives the best chance to avoid infection and other complications that may delay your healing.
The second stage addresses rebuilding if the dog bite has damaged your muscle tissue or support structures of your face. Successful cosmetic results at the end of surgery usually depend on the reconstruction of deeper tissue to a condition that’s close to your pre-injury condition.
The reconstructive surgery may involve grafting bone or muscle from other parts of your body. This surgery can be particularly demanding work since it involves reconnecting tiny blood vessels and nerves. While the body has some amazing systems for regenerating itself after an injury, these systems are based on survival, rather than on your cosmetic appearance. In other words, the body doesn’t care about scars; it wants only to survive. So it’s up to me, the plastic surgeon, to guide regeneration in such a way that your post-surgery appearance resembles your pre-injury look as closely as possible.
The last stage in repairing the damage created by the dog bite focuses on the cosmetics. Ideally, your injuries have healed, and any lost function has been restored. The signs of this healing process remain. You may have scars and discolored tissue to remind you of the original bite and follow up surgeries to treat the wound.
At this point, I have one challenge remaining, and that’s restoring your appearance. This may include some minor reshaping or refining, but largely the focus is now on minimizing your scars. One of the newest tools in scar reduction treatment is non-invasive laser treatment.
Lasers activate some of the body’s own healing mechanisms in a controlled manner. Laser energy passes through outer skin layers for absorption in the dermis, particularly targeting the collagen layer. As the laser light is absorbed, the collagen warms gently to a point where the body sees this tissue as damaged.
Two things then happen over several weeks after treatment. Existing, damaged tissue starts leaving the body through the lymphatic system, and new tissue takes its place. This new tissue reduces the appearance of existing scars, as well as discoloration such as the redness that often accompanies major healing.
Laser treatment smooths scars to evenly blend with surrounding skin while minimizing differences in color. Though the number of treatments needed depends on the severity of the original damage, dog bite victims can reasonably expect freedom from disfiguring changes to their appearance.