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 :)

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

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!

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!

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'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!

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. :)

Dr. Scott E. Kasden in Southlake, Texas

1 out of 5 stars Overall rating
1 out of 5 stars Doctor's bedside manner
1 out of 5 stars Answered my questions
1 out of 5 stars After care follow-up
1 out of 5 stars Time spent with me
1 out of 5 stars Phone or email responsiveness
1 out of 5 stars Staff professionalism & courtesy
1 out of 5 stars Payment process
1 out of 5 stars Wait times
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