Why is my scar so low, deep, unattractive and has a double bulge when I smile? (Photo)

From the picture at rest, it seems the incision line follows the base of the nose contour as it should. The overall length of the lip does indicate it was a more conservative approach, and perhaps more lift can be accomplished. Conservative is better than too aggressive. I cannot visualize the bumps on the photo at rest, but its possible your are feeling and/or seeing the deep sutures and deep anchor points if this was done within the last 6 months. The incision on the smiling photo seems to be relatively deep from the elevated ridge that occurs under it. Again, if this is a fresh lip lift, it may be the deep sutures and anchor points causing this. It can also be excess skin bunching up if the lift was too conservative in the middle. Warm compresses, massages, and time can help with firm ridges. However, if you want more of a result, it seems you have room from that.The keys to a successful lip lift in a proper candidate are proper design, undermining / freeing the skin, and good support with deep sutures.

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

It seems that you were expecting more from your lip lift and you are complaining of immobile bulges which appear on the sides of your nose when you smile. If your lip lift is relatively fresh, I would suggest that you ask your original surgeon to inject steroids into the bulges which should provide significant benefit. If your lip lift is older than 6 to 12 months, you may consider repeating the lip lift, insuring that it includes deep multi layer muscle support such as the OOS or 3D lip lift.
I hope this helps and good luck.