Scar tension and post lip lift pain. Is revision needed? (Photo)

Question

I am now 6 month post combined rhinoplasty (with columella strut) and bullhorn lip lift. Primary surgery for both. Cosmetically I am happy with results.However the ongoing pain in lip scar is getting me down. To me tension seems to be the problem, with downward tension still coming from lateral aspects of my upper lip and upward tension from incision centrally. If I tape my lip to relieve tension this improves the pain greatly, but not practical. What can be done for pain?

Jacob Tower, MD · Answer

Hello, hope you are well. At 6 months, your scar is still not completely mature. With time, it will likely gradually feel better. Since you are happy with the cosmetic result, I would advise against any type of surgical scar revision or otherwise at this point--that will just reset the clock on the wound healing process and invite opportunity for imperfections. Conservative options to consider are scar massage, silicone gel, botulinum toxin to reduce muscle strain on the scar and intralesional steroids if there is evidence of hypertrophic scar formation (not obvious on the photos you submitted). 
Best,Dr. Tower

Raffy Karamanoukian, MD, FACS · Answer

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

Randal Haworth, MD, FACS · Answer

I would try Kenalog injections, deep to the area. Should be safe at this time but of course, consult with your original surgeon. Good luck.

Zoran Potparic, MD · Answer

One of the reasons many plastic surgeons suggest avoiding both procedures in the same time is exactly what you are going through. Based on photos,  you do not have any visible deformity due to scar retraction; it is very likely that once scars mature and relax, you symptoms will disappear. Tapes, massage and patience. Good luck.

Jeffrey H. Spiegel, MD · Answer

So far what I can see looks quite good.  You can try massaging the area as this may relieve the tension somewhat and improve the pain.

Scar tension and post lip lift pain. Is revision needed? (Photo)

Answers (5)

Answer: Wait for scars to mature and relax

Answer: Wait for scars to mature and relax

Answer: So far looks good

Answer: So far looks good

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Everything you need to know about Lip Lift

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Scar tension and post lip lift pain. Is revision needed? (Photo)

Answers (5)

Answer: Wait for scars to mature and relax

Answer: Wait for scars to mature and relax

Answer: So far looks good

Answer: So far looks good

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Recommended reading

Everything you need to know about Lip Lift

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