What options do I have for a revision after trauma to my upper lip? (Photos)

Question

I fell 12 weeks ago resulting in a 7cm tear through my upper lip (no tissue loss). I still have pain, swelling, issues with diction and pursing functions. I am looking for additional advice regarding revision approach, complexity, and realistic feedback on how close to normal I can achieve. My main concern is the drooping section (upside down U shaped flap) followed by Vermillion Border symmetry and scar over Cupid’s Bow/Philtrum Column. Prefer no lip implants or temporary fillers. Thank you!

Eric M. Joseph, MD · Answer

I'm sorry to hear your story. The most distracting part of your upper lip may be the pink portion (vermilion) that is hanging too low. The scar on your philtrum may be best to let mature since 3 months post injury is relatively early, and that may improve spontaneously. Depending on your examination, direct excision of the hanging vermilion lip may be considered with minimal downtime and inconvenience. Hope this helps you. Dr Joseph

Jason Emer, MD · Answer

I recommend getting a formal evaluation with a cosmetic dermatologist for after care. I recommend Silagen + Bioshield to promote healing. Any scarring can be improved with lasers and microneedling/prp or revision. See an expert. Best, Dr. Emer

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs and I am sorry to hear of your lip injury.  I do hope you are feeling better.  Based on your pictures alone, you still have significant tissue swelling that is masking your long-term appearance and results.  Assuming a plastic surgeon was available to fix your lip, you should see steady improvement over the next several months until your tissue quality returns to normal.  I know waiting is difficult, but for now pursue gentle scar massage, sunblock/moisturizer application, and scar creams to help your current healing.  Best wishes.

John A. Standefer Jr., MD, FACS · Answer

Hello, and I am so sorry to hear about your accident!  Hopefully you are otherwise feeling better.  The swelling in the upper lip mucosa that has persisted for three months may require excision of the damaged tissue with re-approximation of the underlying muscle to get you the look you desire. The vermillion border appears to be in good alignment and may improve with a little more time. If it needs to be adjusted, it can be done at the same time as the removal of the lower swelling. Time often helps these types of injuries more than you can imagine, but judicious modifications may be indicated since the swelling in your lip persists to this degree. Steroid injections may be indicated to help soften the scars in your philtral ridge and vermillion border. Your plastic surgeon or facial plastic surgeon will help you get the look you desire.My Best!John Standefer MD

Leonard Grossman, MD · Answer

I'm sorry to hear about your injury. I think it would be best in your interest to speak to the plastic surgeon who treated you since they know exactly what it was that they had done. It's possible that the little overhang area is simply swelling and that should go away in a matter of a month or so. At the same time if this is not swelling, this area should be simply excised and your lip will look near normal or normal again. Good luck from New York City

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