Bullhorn Lip Lift; detailed and ongoing review of entire experience

I had a bullhorn lip lift 4 days ago and wish more...

I had a bullhorn lip lift 4 days ago and wish more than anything I could undo it. I think that too much skin was taken in then center, not enough on the sides, leaving me with a strange triangle shaped mouth, a long and distorted columella, and no upper lip at all. I just hope that there is some way I can have this fixed. I cry every time I look in a mirror...

It's now day 8 and things are looking a bit...

It's now day 8 and things are looking a bit better. My doctor gave me steroids (Millipred DP) to help with the swelling and it is making a difference. My columella is still huge but there is now more space between my lips and nose (it was only 4 mm when the first photos were taken and now it's up to 6 mm). My doctor said that since the columella is the lowest point on the nose, it's the place where much of the fluid accumulates and also the last place for the swelling/edema to subside. I'm trying to remain hopeful (I know that its way too early to see the final result) and staying far far away from mirrors right now... they are NOT my friends! I'll post more pictures as things progress.

11 days post-op though it feels more like a month....

11 days post-op though it feels more like a month... people rarely talk about the emotional toll that the recovery process can take; up, down, hopeful, depressed, regretfull, excited, anxious, all within the space of one day; it's a roller-coaster ride and a long one at that. My face still looks far from normal, I'm still extremely swollen, my lips are a still a funky shape, and the columella is still distorted. I just keep reminding myself that it's way too early to see the final result. I've had two previous rhinoplasties as well as lower eyelid surgery and I do know that it really does take time for things to settle in and for all of the swelling to go away. I find it really misleading when you read up on procedures and they tell you you'll be back at work in one week... um, yeah if you don't mind going back to work looking terrible (and like you've obviously just had plastic surgery). That is the beauty of real reviews from real people and I hope that this one helps out! I just measured the vertical space between lips and nose and it's now up to 9 mm... YAY! I was really afraid I'd lost my upper lip altogether. I'll post more pictures next week :)

Hi May, Your lips in the Day 11 pictures look beautiful. This review is great, because you updated us so many times. It sounds like in your last update that you were satisfied with your experience. Thanks for the pictures and please keep us updated. Thanks so much for the review, -Britt
Britt, This is, Sandy! I have some pictures for the site of my lip lift and what a mess it is. If I fax them to you can you convert them to the Real Self web site? E-mail and let me know. Sandy from Texas

Hi sandy,

I sent you a PM about your pictures. Hope that helps!



Day 17 and so far from looking or feeling normal....

Day 17 and so far from looking or feeling normal. This is NOT a quick or easy recovery so please learn from my experience and don't expect it to be no matter what you read (or are told)! As the healing process progresses my whole lower face feels tight and numb and my nose feels like it's been shrink-wrapped as thick scar tissue forms around and inside of it. This is quite uncomfortable and I feel like I'm stretching the scar tissue when making certain facial expressions; I wonder what the best thing to do is here: try to keep everything still or try to keep everything mobile? Educated opinions much appreciated! I still cannot drink through a straw and the incisions are not well healed enough yet to be unnoticeable in person even when wearing makeup. This is difficult to see in photos but it is the case (my sister agrees). Lip to nose distance is still 9mm and columella is still very swollen. I'm resolved to the fact that I've got a ways to go still before I know how this whole thing is going to turn out. Fingers crossed

Your resultss are soo amazing! I've been researching this procedure for a awhile now and your photos are truly inspirational. I want to reduce the space between my nose and mouth too without using any fillers. Did use any special creams or medicine to reduce the scarring? Or do rely on makeup to hide it?

Your lips look amazing. I am sorry that you had to go though such tough recovery, but judging by the picture - it was worht it.

To Sandra 11 It is still too raw to start...

To Sandra 11

It is still too raw to start using scar creams at this point; there are places where the incisions are still pretty raw. I've been keeping it constantly covered in a thick layer of Aquafor. This is a luxury that those that have to go back to work right away cannot afford and one of the reasons that knowing how long you REALLY need to recover is so important). It's so nice to have the time to recover in an ideal way. I once had a bike injury and ended up with really bad road rash, I never ever let it dry up or scab and kept it constantly covered in Aquafor until there was new skin under the goopy salve. Now the large patches of skin on my arms and leg that were scraped down to the fat layer are barely scarred at all, no scar creams even needed. I'd been worried that I was going to have huge ugly scars so I researched the best way to prevent scarring and that is what I read. I'm a true believer after my bike accident so I wanted to pass along that little tid-bit of knowledge to you. (This is not a good idea for burns and I'm not sure as far as lasers go. I've read pro's and con's about Neosporin after a certain point in the healing process so Aquafor is like the ointment without the antibiotic. The theory is that by keeping it constantly moist you never allow it to form a scab which will make a much more noticeable scar and people who pick scabs will have even deeper and worse scars. I think Band-Aid makes scar prevention blister bubbles for that very reason but it’s almost impossible to attach a band aid to many parts of the body like creases (which is where most plastic surgeons try to strategically hide incisions) and highly mobile areas like elbows and knees) A thick ointment will mold anywhere allowing it to do what the Band-Aid can’t do here. Hydrogen Peroxide is also not a good idea after a certain point as it can cause necrosis of the tissue, as can steroid creams and injections. I did take the oral steroids so I read up on them and they can slow down wound healing and thin the tissue. They did, however drastically help with the swelling. Not sure if it's worth the trade- off. I'd like some plastic surgeons' and dermatologists' opinions if you’re out there and of course discuss the best course of healing with your plastic surgeon, that is what you are paying them for. Be annoying; ask lots and lots of questions:) I will begin using scar creams and massaging them as soon as the incisions are completely healed and everything has calmed down a bit. It's hard to show this in photos because a lot of what is going on is inside of my nose and nostrils. With this procedure they end up having to sew a piece of skin that is longer horizontally than the width of your nostrils so puckering can occur (I have a little by my left nostril but its getting better.) This can happen with face-lifts & donut breast lifts as well. Any time you're sewing a larger piece to a smaller opening this can occur. It almost always resolves itself naturally as the swelling subsides, the skin starts to relax, and the scars begin to mature but it can take time. My doctor attached some of that long ribbon of skin to the inside of the nostrils and spread out the tension inside of the nose to keep the incisions free from shouldering all of the tension. He said that I should not have distortion of the columella because of this re-distribution of tension. That being said my columella looks horrific to me close up as it’s massively engorged and does look distended. I’m only 18 days post-op and swelling in the columella can take a year and a half or more to completely resolve. Swelling in the nose will also take longer to subside if you’ve had previous rhinoplasty (ies), and longer with each one. So I guess what I'm saying is that there is a lot going on that pictures don't show and I'm still not able to see the final results. Like I said before this is not an easy two-week recovery so if you’re considering it please give yourself more time off if you can! I absolutely plan on posting photos as things progress; I feel like if we all really detailed our experiences with photos and comments through each stage of the experience then there would be a wealth of knowledge based on real experiences from the patients' standpoint and we would be able to research the procedure more effectively so that we can make truly educated decisions and go into it feeling as if we knew what to expect. There is such a wealth of dis-information out there regarding healing times and the recovery process because the only one who can really write about this is the patients! We are the ones who go through it and it’s up to us to document it for each other. I was unprepared for this because I didn't know what to expect so this is my way of doing good and helping others, pass it along! That's what this site is for, lets share!

I just had a bullhorn lip lift myself. My smile is extremely restricted. I have an appointment with my surgeon tomorrow to discuss this issue. Did you notice any issue when you smiled for the first time? Also, are you able to close your mouth comfortably? Because I'm having issues closing my mouth. I think I'm regretting this procedure as well. Thanks!
In above response I forgot to address your question about closing your mouth. During the first week I was so swollen that it was difficult to close my mouth. The turning point was around day 11 (after taking the oral steroids), and now I can close my mouth but I can't drink out of a straw yet or press my lips together (I can't even imagine trying to kiss). Though it feels slow, progress is progress and at the end of the day progress = hope/a light at the end of the tunnel. Good luck with your appointment and do let me know what your PS says.
Hi May6385, thank you so much for taking the time to respond. I went to see my doctor last week. He didn't cut the muscle, just removed skin. He told me that the reason for my discomfort and restriction when smiling is because my scar is extra firm right now, which I guess is typical during this time (it's been 3 weeks since my lip lift). He told me to massage my scar to help the stiffness go away and that it would eventually soften so I can smile normally again. Although it was reassuring, I'm still very nervous. He cut into my nasal sills, which for the moment, due to the scar, they look uneven and it's stressing me out. I've also had rhinoplasties in the past and I feel that the lip lift scar is highlighting the unevenness in my nostrils. My nostrils were uneven before due to a bad rhinoplasty which I have been trying to fix since. Ugh! I guess, like you said, all I can do it wait it out and see how I heal. Thanks for sharing. It's a huge help! You are looking great by the way.

In response to the question from Kenya123, My...

In response to the question from Kenya123,

My upper lip feels numb and my facial expressions are not back to normal at all yet. Smiling wide hurts as does opening my mouth wide, as does anything that feels like it's stretching my face. You have to remember that a scar takes a full 3 months before it's considered mature and then continues to flatten for the next year or so. If you look at the photos immediately following the surgery you can see that a large amount of skin was cut and there is a large incision (therefore there will be a large amount of scar tissue). This scar tissue forming combined with swelling is what causes those issues with facial movement, the tightness at this stage of the game. Like I mentioned before I've had two previous rhinoplasties and the recovery for this procedure if FAR longer and more intense. There's just a lot of tissue that needs to heal and flatten and a lot of swelling that needs to resolve. I'm thinking its going to be a good 8-12 weeks before that thick scar tissue starts to flatten and things start to loosen up again. How long has it been since your procedure? Did your surgeon cut the muscle? Mine did not. The muscle surrounding the mouth is circular, sort of like a doughnut with your mouth in the doughnut hole, and I have read that when they cut that muscle it can interfere with the natural movements of the mouth. If your muscle wasn't cut and it's still early in the scar formation process, try to be patient and see how the healing process progresses. If your muscle was cut I would go back to your Plastic Surgeon and discuss it with him/her AND seek a second opinion from a qualified doctor. Do know though that most Plastic Surgeons don't like to review/comment on other surgeon's work until after the healing process is complete. It's hard to accurately see what's going on with all that swelling, scar formation etc going on. This is why my review still says "undecided" it's the same boat that I'm in. It cannot be un-done, and the healing process cannot be sped up (don't we all just wish). So hang in there, stay focused on positive things, and my fingers are crossed for you!
Your smile is so pretty! It reminds me of Katherine Heigl
Indeed, may6385, thank you very much for your constant progress and replies!!
You're so welcome, it's theraputic for me as well :) Thanks for your comments!

Update, four weeks post-op: In answer to...

Update, four weeks post-op:

In answer to Kathy’s questions, yes, you can see the scar right now, even with makeup (it’s like a newborn baby at this point, red and raised which is perfectly normal for its age, no scar will be flat and colorless in 4weeks!). I’ve added new photos without any makeup and in natural daylight to really try to give you a close up look; I picked the worst of the worst photos (no vanity) so that you can really get an idea of what my scar looks like at 4 weeks without any camouflage of any kind and in the harshest lighting. I’m not overly concerned with the scar at this point as it looks as though it will eventually resolve and become barely perceptible, hidden in the crease of the nose and further disguised by makeup (there are also scar creams, dermabrasion, and lasers if the scar doesn’t heal as well as expected). As you can see I had a scar at the base of my columella before and it really didn’t bother me. What I AM still very concerned with is the length/distortion of my columella which is still very different than it was pre-op. It’s still very stretched looking and I’m holding out hope that this will subside with the swelling. The nostrils do appear to be wider but my whole nose still feels very swollen right now and I do remember a similar look to the nostrils after my last revision rhinoplasty. In that instance I didn’t start to feel like I looked “back to normal” until my nose sort of “shrunk up” at about 3 months post-op. The volume of my upper lip has increased and more of the vermillion shows. Also notice that the overall shape of my mouth has changed. The tightness that I was feeling at week 3 has improved quite a bit and my face feels like it’s slowly becoming more mobile, though I still can’t drink out of a straw easily. I hope that I’ve answered your questions and I’ll post again and add more photos as things continue to change!

I have big teeth in front so raising the gum line probably wouldn't work. I also have an overbite that causes a big crease between my nose and lip when I smile. After orthodontics in my pre teens, this was better, but I failed to wear my retainer for 2 long stretches in my life and my teeth moved forward. I used to tell my kids, ALWAYS WEAR YOUR RETAINER. I have been wearing it for 13 years now.

There is 20mm between the bottom of my nose and the top of the upper lip. I read from one surgeon that 1.1 cm or 11 mm is the ideal. That seems kind of small. What is your distance now? My jowls are a little more droopy, so maybe a facelift would be an easier answer. We'll see. I plan on getting my tonsils out first, because they have been bothering me.
I think you lips look very nice both before and after, especially in the last photos. However, when one looks at the whole face, in most western cultures, the smaller space between the nose and upper lip give the best look, at least for a woman. I would like to have this, but would need orthognathic surgery first on my gummy smile. Just don't know how feasible that is for someone at age 57 with osteoporosis. Didn't want to risk elective surgery earlier since I have 3 children whose father died when they were small. Now they are all graduated, would like to focus on myself. I am otherwise in pretty good shape for my age.

The good thing is that I do not take biphosphonates for osteoporosis. That would preclude a lot of dental surgery. I am taking strontium instead. Need to talk to an oral maxillo surgeon first, but really appreciate those who share here.
Good for you! You deserve some time to focus on your own dreams and goals. I'd imagine you didn't have much time for that raising three children on your own! Sounds like you'd have a long road ahead if you chose to go ahead with braces and jaw surgery. My sister has a gummy smile as well and is considering laser to bring the gum line up and veneers to give her a bigger smile rather than orthodontics and jaw surgery. I don't know what your exact situation is but you might want to see a few different people who specialize in cosmetic dentistry and see if they have different opinions or alternative options. As far as the lip lift goes there are different approaches as well (bullhorn, gullwing (or vermillion advancement), corner lift) each with it's own set of pros and cons. How many mm of space do you have between your lips and nose? Do the corners of your mouth droop? Are you considering other facial rejuvenation procedures like a facelift at some point (this would effect the position of the corners of the mouth to some degree and should be taken into account when considering your options) How wide is your mouth in relation to the width of your nose? It's good to start taking note of these things and considering all of the options (or combinations of options) that are out there so you can find the solution that best works for you. Happy researching!

I'm adding new photos, up the nose close ups...

I'm adding new photos, up the nose close ups of the scar at 6 weeks with and without makeup (as requested by Kathy, yikes! Busy week and I'm running late so I'll respond to questions next week, Sorry! Hope you all had a happy 4th!
Hi Sandy from Texas,

I had a lip lift around the same time that May did. Don't worry, your lip will drop. The first couple of weeks I looked like a rabbit. I was freaking out because my lip looked so high up in the middle. I talked to my doctor about it and he told me that he had to place it that high in anticipation of the healing process since, as the swelling goes down, the lip begins to drop. By week 5 my lip had dropped down and the rabbit look was gone. Hang in there. It will look better.
Kenya, how long were you swollen? How far across or under you nose did you dr, pull up? I knew my job was wrong when I came out of surgery or the operating chair I might say. My job at ths time is only one quarter inch from my nose. I know it is still early but when Dr. Lam in Plano Texas suburb of Dallas saw me on the fifth day He did not assure me it was going to be alright. He said, Le.ts hope it settles down a bit and send me pictures in three months, and see me i five. The receptionist said, I am sorry that happened to you. But Dr.Lam doesn't like the procedure anyway, so his girls don't see many lip lifts if any. I know I sound so discouraging to the girls that haven't had the procedure as I believe it might be the best procedure's out there..Nothing can make you look uglier than when your top lip drops and when you talk just your botetom teeth are showing, s I am believer that this procedure should be done earlier than I had mine done. This is probably part of my problem now. You noticed I said, PART of my problem. Even some drop isn't going to fix this but would help. In inches how far was your lip from your nose? and how many inches did it drop( in inches, as I don't think many of us understand cinnemeter's'. Looking forward to hearing from you. SANDY
On fading of the redness of the scar - My friend is a skin esthetician in Washington, Tri Rivers area. She says use of a certain kind of red light promotes healing and fading of scars. I will ask her to comment on that.

So sorry I've been M.I.A., I've been...

So sorry I've been M.I.A., I've been dealing with some family/personal issues... I'm now 9 weeks post-op and much of the swelling has subsided. I'm still not happy with the columella but it has improved a bit and I'm just hoping that it will continue to do so. I've read that this procedure is often overcorrected initially as the skin relaxes quite a bit in the first 6 months. I just hope that mine will relax enough to improve the stretched down appearance of my columella. The distance between my lips and nose has held steady at 10mm which is only 1 mm shy of the "ideal" although at this point I'm not even concerned with the ideal, just a normal looking columella. I'm trying my best to stay patient and hopeful but sometimes it's so hard and I'm really struggling right now. I just want to feel happy with the result after all of this! The scar has improved and I'm massaging the area with a silicone based cream twice daily. I've posted a few new pictures and will go through the posts and answer any questions that I can. :)

May6385, are you still using this site? Just wondering. Came across your wonderful vivid description of the healing process but can't see any photos.
I just had an upper lip lift 4 weeks ago and my columella is stretched down and my nose is so long looking and pulled down. When is smile my nose looks terrible and points downward. This was NOT the case before. I have great tooth show and my shape of my mouth is pretty. But my face looks so disportoned now because of my stretched downward nose. I think too much skin was cut. Do you the this will resolve over time? What is the healing time. Omg I think I made a terrible mistake. I may have to get tip Arty to reduce the Size of my nose. :((
I'm scheduled to have a lip lift soon to correct the spreading out and lengthening of the area between nose and lip from a gortex implant I had removed thank god! The gortex implant caused damage cause I couldn't smile much and over the years, my lip (area above my lip and under nose )stretched out and lengthened from repeated smiling over the years because there was so much tension in my actual lip. My question is, will the scar from the subnasal lip lift cause tightening in the smile or nose to spread alot during smiling? After that nightmare wit h the gortex I'm hesitant to do something that will cause a problem with my smile. Also unnatural spreading of my nose and nostrils from smiling. Does this procedure cause this to happen? Thanks so much, any advice is appreciated! :)
Dr. Scott E. Kasden in Southlake, Texas

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