My 50th high school reunion is coming up; I'd recently had skin cancer surgery, with a MOHS Surgeon removing diseased tissue, and Facial Recon (Plastics) Surgeon performed the closure. Since I had to see HIM many times, for debridement of wound, I thought his precision was xlnt, and decided to have him take care of my lip lines. He utilized TWO syringes @ $ 550. each. He did a beautiful job! Updated on 16 May 2014: I continue to be very pleased with my outcome; yes, it hurt a bit, but no worse than a dental visit! I'm trying to find a 'before' photo that represents. The surgery, just to remove the aggressive cancer, was quite extensive, on both sides of face; worst, being the left side, where I was told I might lose skin! They popped up overnight, it seemed! With complications where you see the bandage; slowly but surely, it's healing!! When all is done and healed, it will be like a mini-facelift : I can already see the difference when I look at this photo - face looks puffier, before! Updated on 18 May 2014: I am starting to receive compliments from folks who don't know I had the Restylane; they simply say I look 'great'. Dr Delsaso is highy skilled and the nicest person!! Yesterday, my Pilates Instructor, out of the blue, said: "I love your lips!" She did know I'd had the procedure done. Updated on 18 May 2014: Photos: "After" is on the left; "Before" is on the right. Updated on 18 May 2014: The "Before" photo is also before the substantial skin cancer surgery, on both sides of face. Dr. Delsaso had the job of closing, with symmetry, when the largest defect was on left side of face, and HUGE! So, you are also able to see his skill in that area! Updated on 11 Jun 2014: Recent outcome of lips Updated on 7 Jul 2014: These photos show the Journey and Outcome as of June 14th; surgery performed by MOHS Surgeon and Facial Reconstruction Specialist (for closure) - last photo is approx 3 months post-op. I thought it would NEVER heal!!
At 6 days post-surgery I can already tell the fat pad is gone and I will be happy with the results in a couple months. The surgery was fast and painfree even with twilight sedation. There is minimal bruising, the swelling is starting to go down as of today (though my face still looks like a chipmunk), and the pain when re-wrapping the area is not as excruciating as it was the first day. As I have slightly laxer neck/facial skin than is best for this procedure, I've been wearing the compression strap 24/7 as directed. That has been the hardest part! The constant pressure pinning my ears against my head is torture, it's very difficult to swallow and of course, you can't sleep in any position but propped up on your back. I've needed to take the pain med not for pain but just to be able to sleep at night with all the discomfort. It's been like wearing an over-tight hot annoying football helmet constantly for a week. It's impossible to talk on the phone with it and interferes with my concentration for getting work done. Also I have opted to not leave the house while wearing the dressing, so I'm going stir crazy too. Plan accordingly when you decide to have this procedure. Make sure you have someone to bring groceries and take out the trash for the whole first week.
I am not a big fan of alar reduction, particularly in noses with fine features such as yours. The scars never look great and I doubt you could achieve what you are looking for with internal reduction only.
Not typical, but certainly possible. Hard to determine without seeing preop photos or knowing extent of surgery. I recommend vigorous massage to the submentum and lower cheeks/jowls as there is tethering of skin/subdermal surfaces to deeper muscular layers. This will improve with time , but serial corticosteroid injections may be helpful in time. Talk to your surgeon.