UPPER LIP SCAR REVISION: WHAT CAN BE DONE? My upper lip scarred after a burn. Cortisone shots did not improve the scar. (photos)

Question

I went to a plastic surgeon for a consultation. The biggest part of the ( burn) scar is approximately in the middle of my upper lip. The rest of the scar is along the vermillion. The surgeon's plan of action is to excise all the area #1 marked in light blue and all area #2 marked in dark blue. Area 1 will close horizontally. Area 2 will close vertically. I am afraid of uneven healing, and worsening it! My question: What can be done to improve the look of my upper lip, and not destroy it?

Stephen Weber MD, FACS · Answer

It's hard to second guess the plan of someone who has had the opportunity to see your lips and evaluate them in person. There are alot of options for lip scars such as yours. These can range from permanent makeup (tattoo), fillers, lasers or surgical scar revision. I don't think that scar revision is a bad idea but the goal needs to be raising the lip line on your right (left side of photo) without further elevating the lip line on the left (right side of photo). This would approximate the lip line that you create with lipstick. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

Im not the biggest fan of lip surgery that cut the vermillion boarder, it often leaves a more noticeable scar if there is any complication at all.  I think filler and laser treatments of your lip would be successful.  I'd try those first before considering a lift/augmentation, although the surgical option is not a bad plan.  There are other non-surgical options you just need to see a cosmetic dermatologist or plastic surgeon with experience in treating scars and lips.  I wish you the best of luck, Dr. Emer.

Nima Shemirani, MD · Answer

Dear Lipservice,Thank you for the illustrations, they are helpfulIn my honest opionion (without an examination), I would not place an incision along the entire upper lipI would perform microneedling treatments to even out the skin tone and coloring so the scar look less obviousAs for the asymmetry, there are 2 options: 1) we can inject a little filler in the right upper lip to raise it to the same level as the left side (my preference), or 2) excise a sliver of red lip from the left side to bring it down to the right side (less predictable and less reversible)Overall, I think the microneedling works very well (like a laser without all the heat damage) and a little filler to get as symmetric as possibleBest,Nima Shemirani

UPPER LIP SCAR REVISION: WHAT CAN BE DONE? My upper lip scarred after a burn. Cortisone shots did not improve the scar. (photos)

Answers (4)

Answer: Upper lip scar

Answer: Upper lip scar

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UPPER LIP SCAR REVISION: WHAT CAN BE DONE? My upper lip scarred after a burn. Cortisone shots did not improve the scar. (photos)

Answers (4)

Answer: Upper lip scar

Answer: Upper lip scar

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Recommended reading

Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.