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Lip Lift - Very Long Recovery Time - Atlanta, GA

ORIGINAL POST

I've never had big pouty lips nor was I looking to...

koje67
$900
I've never had big pouty lips nor was I looking to achieve that. But as I get older, I've noticed a slightly longer philtrum (mine was 1.9mm), my lips have become thinner and have less tooth show than I did in my 20's and 30's. Additionally, my lips were also slightly asymmetrical (.2 mm). In the past, I've had small amounts of filler before but the bruising, swelling and cost seemed ridiculous for such a slight temporary fix. Plus, I don't like the duck-like look, which is exactly what happens with too much filler in thinner lips.

I decided on the lip lift with Dr Morgan after doing extensive research and reading a great review on realself.

Dr Morgan cant her staff could not be nicer, and the procedure itself seemed relatively simple (removing 5mm). But unfortunately, I was one that experienced problems with healing. I've had many surgeries (mostly medically necessary, but also a few cosmetic procedures) and I've never had any trouble with sutures, or healing (I'm healthy and not diabetic).

Dr. Morgan used absorbable sutures subcutaneously (deep and mid layer) and on external sutures. Initially, I was excited that I didn't need to have any sutures removed, but in hindsight, I wish I had asked for non-dissolvable sutures (ones that are removed after a week). Because in my case, I had an adverse reaction to the Monocryl dissolvable sutures. I've also found from previous surgeries that I tend to heal faster with a cleaner scar when non-dissolvable sutures are used.

Immediately after the procedure I was swollen, as I expected (fish-like, as others have put it). The swelling was the worst on day 3, but then subsided dramatically. The pain however, was a different story. I was not prescribed any pain meds, and normally I wouldn't take them, as I feel I have a high tolerance for pain (giving birth, other surgeries, injuries). But I experienced a tremendous amount of pain with this procedure, not just the first few days, but for weeks. I had ocycodone left over from a breast lift, so I took those initially, but I ran out after a few days. One of the causes of my pain was from an infection I developed in the suture site, just beneath my right nostril. I called the doctor on Thursday (surgery was Monday morning). She was very responsive, called in a prescription for antibiotics, and told me to call if I needed anything, or if I had any concerns over the weekend. The antibiotics helped, but I had very painful, hard bumps/small knots near suture line - something that can happen (from what I now understand).

A week after surgery I went for a follow-up appointment. Dr Morgan said that I was having an adverse reaction to each layer of the sutures, and was very detailed in her explanation and very empathetic to my situation. She asked if I wanted her to try and extract some of them, I agreed to it – was numbed up, and she began pulling out sutures that had not yet dissolved. I was hoping by extracting these, the painful bumps would dissipate, and the healing would begin. But sadly, it did not happen in the time frame I wanted it to.

I tried to be patient the second week, but did not feel that any progress was being made - I still had open sutures, oozing, and redness. Maybe my expectations were too high or my optimism got the best of me, but I had seen numerous reviews of lip lifts, and after one week (2 week tops) they were out and about looking like they never had anything done.

Because of my slow healing I scheduled another appt with Dr. Morgan over the weekend (third week after surgery). I explained that I had never had any issues with sutures, glue, staples on my face or any other part of my body. Since I had experienced such an adverse reaction, I asked what type of suture was used, and was informed that it was Monocryl. I honestly don't know if this material has ever been used on me before, simply because I never had a problem, so I never asked. She explained that sometimes this happens, and that at 6 weeks post surgery the bumps, indents, spitting sutures should be gone, and the scar should heal nicely. Ugh. 6 weeks? That seemed like an eternity.

It's now been 4 weeks since my procedure, and while I see bits of improvement, it's not at all where I hoped to be. I still have spots that have not healed completely, pain, tightness, redness, and indentations where sutures 'spit' (body rejects sutures and they start to pop out from skin).

While I do like the subtle lift in my lip, I would not do it again knowing what I know –nor would I ever want to go through this long recovery process. I haven't wanted to go out and public (not even to pick up kids from school) and am feeling a bit like a recluse. I'm depressed, and embarrassed that I made this choice, and that these are the consequences of my actions. I would have never thought that what seemed to be such a small procedure, could take such a huge toll on me emotionally.

koje67's provider

Elizabeth Morgan, MD, PhD (closed)

Elizabeth Morgan, MD, PhD (closed)

Board Certified Plastic Surgeon

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Replies (10)

February 3, 2015
Oh, you poor thing...I'm also allergic to those non-dissolvible sutures and they hurt like the dickens...sooner or later, they will all pop out, but it takes months sometimes...hang in there
February 3, 2015
Thanks for your kind words and encouragement!
February 3, 2015
I am very concerned and surprised to learn of this patient's distressing experience with her lip lift. I take this very seriously. I follow my patients very closely and spoke with her several times during her first week after surgery and saw her one week and two weeks after surgery. She has a six week post operative appointment coming up. I have asked my staff to contact her at once so I can see her earlier and discuss her experience to see how I could have made things better for her. Three days after surgery, she did report a slight infection with swelling and drainage, but this responded immediately to antibiotics. This infection occurred despite my giving her appropriate preventive antibiotics before surgery. The infection probably led to her reaction to the sutures. Infections irritate healing tissues, and thus increases reactions to sutures. Although the skin sutures selected were intended to be absorbing for her convenience, I removed them at her first visit, because of her reaction. I saw her a week later, two weeks after surgery. Her result was excellent, although the infection had left the skin under one nostril slightly pink and I saw a small indentation from a suture reaction. This will smooth out in time. If there have been problems since then, she has not told me or my staff. Lip lifts do cause swelling that can make the lip feel very stiff and unnatural. Swelling subsides faster in some people than others. Infections always makes things worse. Having had a lip lift myself, I know it can catch some people off-guard to find surgical swelling is a frustrating process that takes time to subside. I am very sorry that she had so much pain. Like many other patients, she declined pain medicine at surgery so as to drive herself home. For most patients, Tylenol, Advil and ice packs are enough. When I spoke with her about the apparent infection on day 3 after surgery, she did tell me she had pain from the infection. I prescribed a new course of antibiotics and the infection subsided promptly. At the same time, I offered her a pain prescription, but she said she did not need one, because she had been taking oxycodone that she had at home from a previous surgery. The sutures I used in her were fine monocryl sutures, one of the best sutures available. They were used in the deep layer to provide support to the healing tissues, and near the skin to close it without leaving suture marks. Monocryl is widely used by plastic surgeons, because it is well tolerated by most people and absorbs around 6 weeks after surgery, when the wound has reached 90% of its final strength. Although she wishes in her review that I had used permanent sutures, this would have ended up being a poor choice. Permanent sutures are placed through the skin, not under it. The swelling from an infection around permanent sutures can leave permanent marks in the skin. Unfortunately, there is no perfect suture – I can only choose what appears to be the best one for each patient and in this case, given the infection, it proved to be a good choice. This patient does have some issues that her review does not mention that would be expected to make her surgery and recovery more difficult than average. And unfortunately, infections and suture reactions can occur, despite our taking every possible step to prevent them. All that aside, our patients come first with me always and I will follow her closely to be sure I help her through a difficult time so she has the best possible final result. I hope despite her initial distress, she ends up happy to have had her lip lift. - Elizabeth Morgan MD
February 4, 2015
To clarify - by no means was I blaming Dr. Morgan or questioning her judgment or choice of sutures. I gave her a 5-star review based on how kind, empathetic, knowledgable and available she made herself to me. I just wanted to share my experience with others who might be considering any kind of cosmetic surgery - no matter how small or simple it may seem. The point I was making was that despite going to a great doctor, following aftercare instructions, and being healthy - things don't always go as smoothly as you'd like them to go, and it can take an emotional toll. I realize that I will eventually heal - just not as quickly as I anticipated. My apologies if my post came across differently, or in a negative manner towards my doctor.
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February 3, 2015

Thank you for sharing your experience on RealSelf!

February 4, 2015
I've read your doctor's response...she seems like a very compassionate and concerned PS...she detailed every visit you had with her. I don't think this outcome was due to any fault on Dr. Morgan's expertise. I believe you are just one of the patients that have real problems with the dissolvable sutures as I experience. Please be patient, and all will heal. I do not know Dr. Morgan, nor do I know of any person that knows her. My comments are simply from my own experience.
April 17, 2015
First, I am sorry that you have experienced the issues you are going through. I would hope no surgery client would go through that. At some point, I may get a procedure but I have not found the information I need to go forward with it. So on that last comment, thank you for sharing. But I have to ask, did you have skin excised directly under the nose or directly along the upper lip border?
April 20, 2015
Thanks Gwyneth, to answer your question, my surgery was directly beneath the nose along the crease. I would advise against doing a lift along the the vermillion border (lip line) since comparatively speaking - there are a lot more issues with that procedure. I did a lot of research, but had not heard of anyone having such a difficult time with absorbable sutures (I've never had problems in the past either). However, I've heard privately from other real self members who've experienced the same issues. I had the scar excised about 5 weeks ago, and was hopeful that all the underlying sutures would come out, but I am still not completely healed, and the scars are still very real and very visible (red and raised and bumpy). I found Manuka honey to be extremely helpful, however, I'm still having the tiny remnants of sutures surface, and they leave little pin holes along the incision line which will not close until all remaining underlying sutures are out. At almost 5 months post-op- they should be absorbed, but I guess I'm an anomaly! You are very wise to take your time and do all the research you need until you are comfortable. I foolishly saw this as a simple procedure and never anticipated it taking so long to heal. Good luck to you!
April 22, 2015
Thank you again for sharing. I'm typically a very curious person and in the interest of all persons who undergo this and when I have more time, I want to look this type of absorbable suture up. I have to wonder if you really are an anomaly or if more persons have difficulty with this suture, you know what I mean, since it's not always possible to know how many have experienced this out of all the persons who have used this product. Therefore, it looks like we, the client have to join in and start to add to this body of research. Basically, what we do here does that because what we report is what is known in scientific studies as meeting important standards of proof/fact. Some of those standards are that the phenomenon is observable (we see, experience it) and replicable (several experience it). I wish I had the administrative abilities to create a database that allows us to strongly (in which are search terms provides strong correlations/relevancy to our outcomes) cross-reference these experiences. For example, in this case we have "bull horn lip lift" with "reaction to Monocryl absorbable sutures" "subcutaneously" placed, " not resolved after 5 months" "5mm excision" "no previous reaction to Moncryl {specifically this one used before?)? Anyhow, you get my point. Sorry, I'm a nerd. I just believe that medicine already has the answer to so many health issues to include ours - yes the cosmetic side of it, but that it's 'hidden' not provided in one big database where EVERYONE could look these things up, share, provide photos, both layperson and professional input. I never discount a layperson's input - they can provide so much valuable information! Oh, one thing, make sure you update your records to indicate your response to Monocryl, and very importantly don't just say you had a reaction or have an allergy. As a matter-of-fact I would almost consider avoiding those particular words, since a less thorough health practitioner might chalk it up to something less meaningful and thus affecting your future care - their interpretation may cause this to be ignored, thus setting you up for another round of issues. Make sense? Write a succinct few statements to add to your health record with EACH practitioner you visit. Absorbable Monocryl (be specific as to thickness) suture, used on this date___ for sub dermal placement for lip lift procedure, first week developed symptoms ____, symptoms a b & c…. lasted ____weeks, at 5 months symptoms include_____, attempts to address were_____(scar excision at ____ weeks), result: continued _____ (list symptoms) at 5 months. Again, I hope you continue to heal and thank you again.
April 23, 2015
I agree, I would love to have access to such a database! I've scoured the internet for answers and it mystifies me that there isn't something like that out there for us. Yes, I specifically asked my previous plastic surgeons if Monocryl was used, and it was. At first I thought maybe the reaction was because in previous surgeries these sutures they were placed deeper in the skin, but I recently had MOHS surgery (skin cancer removal) on my face without any problems and healed completely in 2 weeks. I also had them when I had a breast lift and they were used around my nipples (also healed in 2 weeks) I also had no problems with scarring with either of those surgeries. So why would I react now after so many years and surgeries without a problem? I am at 5 months - still red, inflamed, and terrible scarring. It's been a nightmare. I wish I could go back and un-do this surgery. But how could you ever know something like this could happen? I think a lot of people suffer silently because they are embarrassed because they feel they brought upon themselves.
UPDATED FROM koje67
1 month post

Lip Lift - Long recovery time

koje67
I've never had big pouty lips nor was I looking to achieve that. But as I've grown older, I've noticed a slightly longer philtrum (mine was 1.9mm), my lips have become thinner and have less tooth show than I did in my 20's and 30's. Additionally, my lips were also slightly asymmetrical (.2 mm). In the past, I've had small amounts of filler before but the bruising, swelling and cost seemed ridiculous for such a slight temporary fix. Plus, I don't like the duck-like look, which is exactly what happens with too much filler in thinner lips.

I decided on the lip lift with Dr Morgan after doing extensive research and reading a great review on realself.

Dr Morgan and her staff could not be nicer, and the procedure itself seemed relatively simple (removing 5mm). But unfortunately, I was one that experienced problems with healing. I've had many surgeries (mostly medically necessary, but also a few cosmetic procedures) and I've never had any trouble with sutures, or healing (I'm healthy and not diabetic).

Dr. Morgan used absorbable sutures subcutaneously (deep and mid layer) and on external sutures. Initially, I was excited that I didn't need to have any sutures removed, but in hindsight, I wish I had asked for non-dissolvable sutures (ones that are removed after a week). Because in my case, I had an adverse reaction to the Monocryl dissolvable sutures. I've also found from previous surgeries that I tend to heal faster with a cleaner scar when non-dissolvable sutures are used.

Immediately after the procedure I was swollen, as I expected (fish-like, as others have put it). The swelling was the worst on day 3, but then subsided dramatically. The pain however, was a different story. I was not prescribed any pain meds, and normally I wouldn't take them, as I feel I have a high tolerance for pain (giving birth, other surgeries, injuries). But I experienced a tremendous amount of pain with this procedure, not just the first few days, but for weeks. I had ocycodone left over from a breast lift, so I took those initially, but I ran out after a few days. One of the causes of my pain was from an infection I developed in the suture site, just beneath my right nostril. I called the doctor on Thursday (surgery was Monday morning). She was very responsive, called in a prescription for antibiotics, and told me to call if I needed anything, or if I had any concerns over the weekend. The antibiotics helped, but I had very painful, hard bumps/small knots near suture line - something that can happen (from what I now understand).

A week after surgery I went for a follow-up appointment. Dr Morgan said that I was having an adverse reaction to each layer of the sutures, and was very detailed in her explanation and very empathetic to my situation. She asked if I wanted her to try and extract some of them, I agreed to it – was numbed up, and she began pulling out sutures that had not yet dissolved. I was hoping by extracting these, the painful bumps would dissipate, and the healing would begin. But sadly, it did not happen in the time frame I wanted it to.

I tried to be patient the second week, but did not feel that any progress was being made - I still had open sutures, oozing, and redness. Maybe my expectations were too high or my optimism got the best of me, but I had seen numerous reviews of lip lifts, and after one week (2 week tops) they were out and about looking like they never had anything done.

Because of my slow healing I scheduled another appt with Dr. Morgan over the weekend (third week after surgery). I explained that I had never had any issues with sutures, glue, staples on my face or any other part of my body. Since I had experienced such an adverse reaction, I asked what type of suture was used, and was informed that it was Monocryl. I honestly don't know if this material has ever been used on me before, simply because I never had a problem, so I never asked. She explained that sometimes this happens, and that at 6 weeks post surgery the bumps, indents, spitting sutures should be gone, and the scar should heal nicely. Ugh. 6 weeks? That seemed like an eternity.

It's now been 4 weeks since my procedure, and while I see bits of improvement, it's not at all where I hoped to be. I still have spots that have not healed completely, pain, tightness, redness, and indentations where sutures 'spit' (body rejects sutures and they start to pop out from skin).

While I do like the subtle lift in my lip, I would not do it again knowing what I know –nor would I ever want to go through this long recovery process. I haven't wanted to go out and public (not even to pick up kids from school) and am feeling a bit like a recluse. I'm depressed, and embarrassed that I made this choice, and that these are the consequences of my actions. I would have never thought that what seemed to be such a small procedure, could take such a huge toll on me emotionally.

Replies (0)

UPDATED FROM koje67
1 month post

Compassionate and Empathetic

koje67
Let me start again...I think my first review might have been misunderstood. By no means was I blaming Dr. Morgan or questioning her judgment on choice of sutures. I realize that some individuals have adverse reactions to sutures regardless of what type is used, and I also realize people heal differently. At the end of my review, I gave Dr Morgan 5-stars in every category based on how kind, empathetic, knowledgable, and available she made herself to me. I also mentioned that her staff could not be nicer. My intentions were to share my experience with others who might be considering any kind of cosmetic surgery - no matter how small or simple it may seem. In hindsight, I shouldn't have mentioned who performed my surgery - because the problems I experienced had nothing to do my doctor's performance. In fact, I might have posted this is the wrong place - as I said, I wanted to share my recovery process.

The point I was trying to make was that despite going to a great doctor, following aftercare instructions, and being healthy - things don't always go as smoothly as you'd like them to go, and it can take a toll on your emotions. I realize that I will eventually heal - just not as quickly as I anticipated. My apologies if my post came across differently – Dr Morgan is once of the compassionate doctors I have ever met, and I would highly recommend her to others.

Replies (8)

February 7, 2015
How do you feel now? Still have pain? How do you feel about the aesthetic result? Does it look good? We would love it if you would post pics!
February 7, 2015
Ps I don't see any lip lifts on her page! How did you know she had experience doing them?
February 9, 2015
I'm at 5 weeks now, and while I'm seeing improvement , it's still taking longer than I would have liked. I go in for my 6 week follow-up appt. next week. The office called to see if I'd like to come in sooner, but I'm still healing and nothing can speed that process up except for time, but I did appreciate them reaching out to me. Like I said before, I clearly have an adverse reaction to dissolvable sutures (probably all brands), some are still coming out, and the suture line is still very tender and pink, so I don't want to put makeup on it for fear that it might impede healing. I found the silicone strips (dr recommended) helps to flatten bumps and healing. I think the end result will be good, and that the scar will heal nicely, but for me personally , the time it took to heal doesn't make it worth it. Once I forget about how long it took, I might think differently, but honestly recovery time is a big factor for me in choosing to do any elective/cosmetic procedure. I want zero time down time or as close to that as I can get - as you can probably guess, I'm very impatient! If I were one of those people who recovered in a week or two, I'd say it would definitely be worth it. Actually, there was a woman back in October who posted her lip lift pics, and had amazing results with the same doctor. She healed in a week with no visible scar. I know that lots of people will not release their photos to their doctors to be posted, simply because they don't want to be recognized. That's why so many doctors don't have before and afters on their websites, even if they've done the procedure dozens of times. I know pics would help - but I'm really still not comfortable doing so. When I'm completely healed, I'll reconsider posting.
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February 16, 2015
How are you doing now? I completely understand your feelings in terms of the down time and discomfort vs the trade off. I'm slowly coming to terms with a recent TT and my expectation for shall I say an easier recovery. I'm scheduled to have this procedure soon. What if any advice would you share? I'd greatly appreciate your feedback. I hope that in the end this phase will be a distant memory with a stellar outcome. Best wishes!
February 17, 2015
Today, I am 6 weeks post-op, and go in tomorrow for my follow-up visit. Just yesterday, the little holes from my sutures finally closed up, however in a couple of spots under my nostrils there are small divots from the infection I had. I am hoping those will fill in as the collagen starts to rebuild. I also have a few raised bumps along incision line, but I think all the sutures have either come out or dissolved at this point, and the bumps will soon dissipate. There's not really an incision line that is visible, but the skin is crepey - very thin, wrinkled and red. I don't like putting makeup on top of it because it looks like I am trying to cover something up - which I think looks worse than the redness (like when you try to cover up a bruise). I've read that time is the best healer, but like I mentioned before, I never anticipated it taking this long. Even at 6 weeks, I am still not comfortable being around people I know, since it's obvious I had something done. While my lip looks natural subtle, the redness/scar is a giveaway, and it still feels, and looks a bit raw. Last spring, I had MOHS surgery on my face, and while that was not pleasant and I had stitches and swelling, it was at least something I could explain, i.e., 'I had skin cancer removed'. As far as the aesthetic appearance of the lip - it looks very natural and subtle, but the redness/scar is a giveaway. I feel like there's really no way to explain this without seeming like the most vain person in the world - if that makes any sense! Like you, I had a skin only TT (14 mos. ago to tighten the skin from multiple pregnancies), and while the swelling was bad for a long time, the scar was not a problem. In fact, it was barely noticeable at 6 weeks. And because it was covered by clothing, I was not as self-conscious about it. As far as your upcoming lip lift, I hope you will be one of the 81% who has no problems with recovery. The odds are in your favor! You will look freaky for the first 3 days from swelling and distortion, but that's expected, and not a concern. Icing helps a lot. I would keep your incision covered for as long as possible following surgery. I would recommend NOT getting it wet for at least 3 days (I think that's when mine became infected). And do not start using any scar cream or silicone strips until all wounds are closed, and there is no longer any crusting. After bandages come off, you can use vaseline to keep it moist. As healing progresses, a few things I noted that I'll share with you in case you have similar issues… With dissolvable sutures, even when I thought my wound was completely healed, all of a sudden a spot on my incision line skin would open up/spread apart to release another stitch. Kinda gross, but 'spitting sutures' look similar to a tiny pimple, and if squeezed, a tiny piece of material will come out. (I had these up until yesterday, and might still have more). For deeper dissolvable sutures, sometimes a small hard bump will appear on the surface of your skin near incision line. Apparently, this is your body trying to break down the foreign object. And over time, these become smaller and flatter. Each week I see small improvements. So I'm sure in time, I will eventually get to a good (or at least better) place. Luckily, I work from home, or this could've been a lot worse. With that said, I would still really like to go out soon without being so self-conscious! I truly hope you have a successful surgery and very speedy recovery - I hope this info helps!
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February 17, 2015
I can't tell you how grateful I am for your generous feedback! I'm considering dissolvable sutures because I don't live in GA but now I'm not sure if I should risk the possible irritation and spitting sutures. I've had a BL and TT where dissolvable stitches were used and I did great with no irritation. I did have 1-2 stitches poke through with the breast. I'm not sure that this is a guarantee that irritation will not occur this time. Food for thought. Again, thanks for sharing and I'm happy to hear that things are improving for you! It's winter anyways....you'll be great by spring. Perfect by summer!
February 17, 2015
Glad I could help! Yes, I've had dissolvable sutures before, but maybe because the sutures were not as deep with the lip lift, the out layer of skin is affected differently - maybe more sensitive? Or maybe because it's on your face, you pay closer attention to it!
February 17, 2015
Dear Koje...will you post some photos so all of us at realself can view your progress. I had a disasterous lip lift with a vermillion type procedure. That is where the cutting is at the lip instead of under the nose. My PS did refund my $; however, nothing will ever compensate for the fact that I have no cupid's bow or philtrum (the little indents from the nose to the lips). We all need to be more careful when doing any type of cosmetic procedure. I also had a problem with the dissolvable sutures...kept spitting them out):)