I am 8 days post to a VY-plasty and fat transfer to my lips. I still cannot smile. Will I return to normal? (Photos)

Question

I do not have any range of motion in my upper lip. I am unable to laugh or smile. I look completely distorted. My stitches have not dissolved at 8 days post op and I can feel tissue under my upper lip coming between the stitches. I have a family event in 8 days and need to be picture ready. I feel as though I am healing disfigured.

Miguel Mascaro, MD · Answer

Thank you for your question! To be honest with you, its hard to say without having done your procedure (the number of V-Y's performed, particular V-Y modifications, etc), or knowing exactly how much was advanced/how much fat was placed into the lips.  Another variable is whether the fat was injected in or placed as a dermal fat graft.  I, personally, like doing 3 V-Ys in the upper lip, and 2 in the lower lip (although sometimes I'll switch over to 1).  I also prefer dermal fat graft over injection as I find its much more predictable.  That being said, restriction in movement and a sensation of a "tight smile" is something that I tell all my patients to expect for around 3 weeks or so.  by week 4 the smile looks normal, but it will still feel a little funny.  If we are doing dermal fat graft, then it usually takes a little longer to regain that natural sensation.  I also tend to be a little more aggressive too as I will usually do V-Ys in cases where a lip lift can't be performed such as excessive tooth show with a shortened prolabium.  Long story short, swelling at this time is not uncommon.  I would discuss your concerns with your doc as they know exactly how much was advanced and how much fat/what kind of fat was placed.  Knowing these variables can help guide you a little more as far as what to expect in the coming weeks.  I hope some of this helps.

Jason Emer, MD · Answer

Yes, this can be typical. Swelling is typical after fat transfer/surgery and can last 3-6 months. I recommend prp to help improve final results. Icing the area, predisone, ibuoprofen and venus legacy treatments can help reduce swelling. See an expert. Best, Dr. Emer

Robert M. Tornambe, MD · Answer

technobae.    It is very early in your postop recovery period and lip surgery in particular, involves an enormous amount of swelling! Allow at least 2 weeks to pass before becoming concerned because not all the fat transferred may take and more swelling will resolve!  Visit your surgeon and voice your concerns.  Good luck!

I am 8 days post to a VY-plasty and fat transfer to my lips. I still cannot smile. Will I return to normal? (Photos)

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