What Are My Options To Correct An Uneven Top Lip Due To Scarring?

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

If your scar crosses the vermillion border between the white and pink areas than filler could exacerbate the deformity. In this case, you may require a step plasty to correct the scar and recreate a proper vermilion border. If the scarring has caused one part of the lip to be thicker or narrower than the other, filler could improve the appearance. My patients report that kenalog injection is painful so you should understand this and clarify whether it is has a reasonable likelihood of success prior to undertaking it. I have used Restylane for lip enhancement successfully and filler in this area is inexpensive and lasts for about a year or longer.

Sculpting of an asymmetric upper lip due to scar can involve either filler injection or scar revision. The proper solution really depends upon the cause of the problem. Photos would be very helpful to differentiate the best approach. If there is a scar that's tethering or distorting the lip then scar revision will likely be very helpful. If the issue is a loss of volume due to scar contracture or missing tissue then fillers would be a reasonable option to provide symmetry.
Thank you for your question.Stephen Weber MD, FACS