Is there a way to loosen the tethering beside my nose from a lip lift? (Photos)

Question

I have submitted this question and doctors are responding, but RealSelf doesn't let you respond back. 1-I have a lip lift over a year and a half ago 2-I have NOT had a facelift 3-I have NOT had cheek filler 4-I have ONLY had a lip lift I had a bullhorn lip lift but the doctor came way up the sides of my very small nose. He took 6mm off of 18mm and I was 59 years old. Now, my cheeks look very weird. Is this because he cut the skin out and pulled it tightly? What can I do. Please note that ALL I have had done is a lip lift. Doctors have been asking about my facelift (haven't had one) or fillers in cheeks (haven't had any). Is there a way to loosed the tethering beside my nose so that my cheeks don't look so incredibly awful. I am devastated. I won't even take pictures with my kids. It really has made me almost a hermit. Can anything be done?

Anna Chacon, MD, FAAD · Answer

First, I want to acknowledge how much this has affected you. When a cosmetic procedure changes the way you feel about your appearance to the point that you're avoiding photos with your children or becoming socially withdrawn, that's incredibly difficult. Your concerns deserve to be taken seriously.

Based on your description, it is certainly possible that the changes you're seeing are related to the lip lift itself. During a bullhorn lip lift, skin is removed beneath the nose, and if the excision extends higher along the sides of the nostrils or is closed under significant tension, scar tissue can create a tethering effect. That tethering can pull on the surrounding tissues and subtly alter the contour where the nose meets the cheeks, even if you have never had a facelift or fillers.

At a year and a half after surgery, the scar is mature, but that does not necessarily mean nothing can be done.

The best treatment depends on what is causing the tethering:

If the problem is primarily scar adhesion, treatments such as subcision (releasing the scar beneath the skin), sometimes combined with fat grafting, can help restore a smoother contour.
If there is excessive tension from the original closure, a surgical scar revision with careful release of the tethered tissue may improve mobility and soften the appearance.
If there has been volume loss or contour distortion, structural fat grafting can sometimes help restore a more natural transition between the nose and cheeks after the scar has been released.
Less invasive treatments such as microneedling or fractional laser therapy may improve the scar's texture, but they are unlikely to correct significant tethering by themselves.

One thing I would emphasize is that simply excising the scar without addressing the underlying tension or adhesion may not produce the improvement you're hoping for. A successful revision usually involves releasing the tethered tissue, not just replacing the scar.

Your age at the time of surgery and the amount of lift (6 mm from an 18 mm philtrum) are not, by themselves, signs that something was done incorrectly. However, individual anatomy, skin elasticity, healing characteristics, and surgical technique all influence the final result.

From your description, I do think it is reasonable to believe that the appearance you're noticing could be related to the lip lift rather than another procedure. While I can't determine the exact cause without an examination, there are reconstructive options that may improve the tethering and contour. It may not be possible to return everything to exactly how it looked before surgery, but many patients do achieve meaningful improvement with the appropriate revision approach.

Most importantly, don't assume that you're out of options simply because it's been more than a year. Scar remodeling procedures are commonly performed well after the initial healing period when the tissues have stabilized.

Is there a way to loosen the tethering beside my nose from a lip lift? (Photos)

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