Guess the obvious question is did the surgeon biopsy the lesion? Question number two is if the lesion was excised four times was it biopsied a second time and perhaps sent to a another pathology lab? Anything of significance in the medical history?

Personally, I think you’ve done your part, provided a good service and I would refer further treatment to an oral/maxillofacial surgeon.

Al

Andrew, very often there are residual structures that if they are not completely excised will cause a recurrence even if the patient is not biting her lip. If u feel something in there , there probably is something in there and at this point I would punt and send her yoa local oral surgeon to complete the task.