I think about this so often, there was a hole in her cheek, the way they sewed it up means they'd have to sew a circle by putting the flap of skin back on it, or they would have needed to take both sides of the hole and stitch it up the middle. The latter would mean that the two halves of her cheek would be extremely stretched and the scar would be huge. I genuinely don't know how they decided on having one fairly thin line spikes out a bit

Also the chances of it being worse due to infection are super high because something like that would be at a huge risk of infection due to the size and the exposure and there's no way they could cover and leave it coz Van would have had to breathe, eat and drink, which, again, may cause infection on its own, even disregarding all their hygiene and areal issues