Massive scar after lip lift procedure - can this be improved 2 years post op? (Photos)

Question

I had a so-called bullhorn lip lift 2 years ago and the scar got wider and bigger on the lateral parts, directly under the nose it looks ok. It’s very visible, even with concealer, the scar broght white and has obviously a different texture than the surrounding skin. People notice it and it’s starting to bother me more and more. I guess the only option would be to cut the scars out, hoping they will remain tiny this time around? 2 years back I wasn’t super careful after the surgery and travelled a day after I had the sutures removed. If I get it done again I‘d obviously be super extra careful. What are the prospects?

Kyle Kimura, MD · Answer

Thank you for your question and photos.
First off, I'm sorry that you are having to deal with this issue. Unfortunately, scarring is one of the most common complications of lip lift surgery and is often due to an excessive amount of tension on the incision lines. One option to consider if you haven't already is a series of microneedling of the scar to get things to soften a bit. Another option to consider would be laser resurfacing of the area. I think the last option, but also a reasonable one, would be to excise the scar and re-close the incision with less tension (as not trying to re-lift the lip). 
Hope this helps and best of luck! Kyle Kimura, MD

Anna Chacon, MD, FAAD · Answer

A scar that remains wide, bright white, and texturally different two years after a bullhorn lip lift can certainly be frustrating. The good news is that even at this stage, there are still treatment options that may improve its appearance.

At two years, the scar is considered mature, so it is unlikely to continue changing significantly on its own. Before considering another surgery, I would first evaluate the scar carefully to determine why it widened. Contributing factors can include wound tension, individual healing tendencies, skin thickness, genetics, infection, smoking, or early stress on the incision. Traveling shortly after suture removal alone is unlikely to be the sole reason the scar widened.

Scar revision surgery can be an excellent option if the scar is truly wide or irregular. During a revision, the old scar is excised and the wound is meticulously re-closed to minimize tension. However, it's important to understand that scar revision does not erase the scar—it aims to replace it with a finer, less noticeable one. While many patients achieve significant improvement, there is always a possibility that the revised scar may widen again, especially if your skin has a tendency to heal that way.

Depending on the characteristics of your scar, non-surgical treatments may also help, either instead of or after revision surgery. These may include:

Fractional laser resurfacing to improve texture and blend the scar with the surrounding skin.
Microneedling or radiofrequency microneedling to soften the scar and improve its appearance.
Laser treatments that target scar color, although mature white scars can be more challenging to treat than red scars.
Medical tattooing (micropigmentation) in carefully selected cases to reduce the color contrast between the scar and surrounding skin.

If you do undergo a revision, meticulous postoperative scar care can make a meaningful difference. This typically includes silicone gel or silicone sheeting, strict sun protection for several months, avoiding unnecessary tension on the incision during healing, and close follow-up with your surgeon.

From your description, it sounds as though the central portion healed well while the lateral portions widened, which often suggests that the issue may have been localized wound tension rather than a uniformly poor healing response. That pattern can be encouraging because it may indicate that a carefully planned revision has the potential to improve those specific areas.

While I can't predict the outcome from photos alone, I would say that a noticeable improvement is certainly possible, even two years after your original procedure. The key is choosing the treatment approach that best matches the scar's width, texture, and color rather than assuming another surgery is the only solution.

Gary M. Horndeski, MD · Answer

At 2 years, the wounds have soften and it would be a great time to do a revision. Your initial surgeon may have used skin sutures, which when removed results in widening of the scar. I recommend surgical excision with the scar more in the nostril than below the nostril. Self-dissolving sutures are used the dissolve in about 6 months to minimize scarring. This takes about 1 hour to perform under local anesthesia.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

My first suggestion would be a Dermabrasion of the scar and surrounding areas of lip and cheek. This will improve color discrepancy to a certain degree which may be sufficient? Good luck.

Massive scar after lip lift procedure - can this be improved 2 years post op? (Photos)

Answers (4)

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