Lip Lift: Stories
Write a ReviewBullhorn Lip Lift; detailed and ongoing review of entire experience
- May6385
- posted 2 years ago
- updated 1 year ago
- Not Worth It
- Cost: $1,700
- Dr. Scott E. Kasden in Southlake, Texas (Dallas, TX)
I had a bullhorn lip lift 4 days ago and wish more...
- 28 May 2011
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...
- 1 Jun 2011
11 days post-op though it feels more like a month....
- 4 Jun 2011
Day 17 and so far from looking or feeling normal....
- 10 Jun 2011
To Sandra 11 It is still too raw to start...
- 11 Jun 2011
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!
In response to the question from Kenya123, My...
- 13 Jun 2011
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!
Update, four weeks post-op: In answer to...
- 22 Jun 2011
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'm adding new photos, up the nose close ups...
- 4 Jul 2011
So sorry I've been M.I.A., I've been...
- 28 Jul 2011
My Doctor: Join to view doctor's name
My rating:
http://www.ncbi.nlm.nih.gov/pubmed/20679836
Plast Reconstr Surg. 2010 Aug;126(2):543-53.
Long-term evaluation of elongating columella using conchal composite graft in bilateral secondary cleft lip and nose deformity.
http://www.ncbi.nlm.nih.gov/pubmed/20574219
Ann Plast Surg. 2010 Jul;65(1):56-9.
Anatomic study of the nostril sill: classification and histologic findings.
It takes up to 12 months before you can see the final result of this kind of operations. So try and be (a) patient and don't blame your surgeon the day after the operation.
If anyone is interested, there is a surgeon in Tucson - Dr Menick - who does outstanding reconstructions and is used to working around scar. His revisions look excellent.
So sorry for all who have had a bad result from this surgery, it is just too bad.
All your info has been incredibly helpful.
Sandy, in one of your comments you mention that you think a cleft lip surgeon from a med school would be a good idea. I thought I should mention that my lip lift doctor specializes in cleft lip surgery and is a director at UCSF, one of the top med schools in California, and he cut into my nasal sills. Like everyone else, his cutting into my nasal sills was very upsetting. Unlike Paris, Sandy, and May, my nasal sills were flat to begin with so my issue is not that the nasal sills need to be built up but that the scar has definitely warped the shape of my nostrils. I've come to the conclusion that plastic surgery is not a perfect art. I have yet to have a surgery that I'm completely satisfied with and I have had quite a few procedures done. Each time I've done my research, thought I picked the right doctor and yet ended up with issues. I honestly feel like I've spent the last couple of years fixing problems. If I had the opportunity to go back in time I would have never started!!! For those contemplating surgery, really weigh out the potential consequences b/c I get the feeling that the outcomes tend to be more negative then positive. I miss my old face!!! :(
Do you have photos you can post on here? You could do your own review and post them there if you cannot insert in this thread.
Hi, this is Sandy from. My first input is to stay from Dr. Scott Kasden and possibly Dr. Haworth. What Dr. Kasen did to me and May is something unheard of, this is not even how a lip lift is done. You don't go ripping the nose backwards cutting off the nasil sills and shortening the columella and moving it forward onto the top lip. Let me know what doctor you are going to, and let;s make sure you don't get off in a ditch like we did. May, asked this doctor that we went to if this would effect the nose, as she had just gotten her nose where she wanted it. He told her it would not effect her nose, then he cut her nasil sills completely off, worse than mine actually and pulled her columella down on her top lip. So you tell me! Yes you need to discuss with them about the surgery, but who knows if this is what you get. These are the facts. Lip should be 1/2 inch(1) centimeter or 12 millemeters. All the same from columella to top of lip. I would discuss if he believed in shortening or hemming the muscle as Haworth calls it(look up his web site) he talks a good game. Now! do you have a small nasil base? I do I should have been approaches in two ways . Bullhorn with a gullwing onthe sides of the lip. Look up Dr Steven Svehlak for sure I like him. I think Go to Youtube and type in lip lift and watch one preformed. I like phillip young in washington. Tell me where you live and we will go from there. bye for now Sandy
I was going to be getting a corner lift too, but I understand that scarring can be quite a risk here?
Am I right in understanding for bullhorn lift it is better to:
*Just cut the skin, rather than muscle.
*The incision is best under the nose, the surgeon shouldn't put the scar inside the nostrils. This can lead to distortion of the nostrils otherwise.
*The surgeon should leave the columella alone!
Would you add anything else to this checklist, from all your experiences?
Thanks so much for your input
Sandy, I think it is a very positive move that you will be seeing that expert in Texas. Sometimes I think about the stuff the true reconstruction surgeons do and what they figure out and I wonder how well it translates to the elective cosmetic surgeons. However, even the spa docs should have had intense residencies fixing deformities and tumor wounds.
Glad you have put such a positive spin on your confinement. What a healthy and wise approach that it. Let us know how the new doc at the hospital goes.
Becky
Becky, look up this Dr. Joshua Demke and look at the babies he fixed and the nose job's of a couple of girls. I just don't know if he can lift the lip. Bye Sandy
Sandy,
Dr. Joshua Demke seems impressive. He does a wide variety of surgeries. If doing the cleft palates of babies doesn't teach you about nasal sill cartilage, then I don't know what it would take. He must certainly have some good experience.
I want to know why a lift lip would need so much structural anchoring that you would mess with the columna as opposed to just pulling up the skin. Pulling up the skin rolls out the lip and seems to make it fuller..maybe. There must be a book somewhere that that diagrams this for docs. But maybe not.
Anyway, Sandy, the university library should have those medical articles and the librarian there should be able to help you. The more you refine research, the more you can dialogue with your doc. And he doesn't have time to research everything. You do. I think patients who do the research and talk to their doc, have an opportunity to make their docs better, to help them grow as docs. Not always, but docs do not know everything.
http://www.ncbi.nlm.nih.gov/pubmed/12016489
Columellar lengthening using the interdigitation of triangular flaps
I went to pub med and searched "nasil sills". You can look at the linked articles and build from there.
Various applications of chondrocutaneous composite grafts in secondary cleft lip nose patients
http://www.ncbi.nlm.nih.gov/pubmed/17119406