Lip lift needs correction - what kind of procedure would help? (Photo)

Thank you for sharing your experience—what you’re describing can be very distressing, especially when the outcome affects something as central to facial expression as the smile. You’re not alone in this, and your concerns are completely valid.

In a lip lift, the incision is typically placed just beneath the base of the nose. If the incision extends unevenly into the nasal sill or heals asymmetrically, it can sometimes affect nostril shape, columella position, and movement when smiling, as you’re noticing. This can lead to one nostril appearing wider or the columella being pulled off-center with facial animation.

Whether this can be corrected—and how—depends on several factors, including how much scar tissue is present, the depth of the original incision, and how the soft tissue healed. In many cases, correction is possible, but it often requires a targeted revision procedure rather than a simple touch-up.

Potential options may include surgical scar revision, nasal sill reconstruction, or a minor structural adjustment to the columella or surrounding soft tissue to rebalance tension. In some situations, carefully placed filler or fat grafting can help improve symmetry, but when the issue involves altered anatomy or muscle pull, a surgical approach is usually more effective.

It’s important to know that revisions in this area are delicate and should be approached conservatively. The goal is not perfection, but restoring symmetry and natural movement, especially when you smile. With the right approach, many patients do see meaningful improvement.

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars.

Best,
Dr. Karamanoukian
Realself100 Surgeon

You would benefit from a wedge resection of the skin in the nostril to pull it more medially.

Best Wishes,

Gary Horndeski, M.D.