Volume loss on right side of my lip, it's very flat - can I fix it with lip filler, something else? (Photos)

Question

I had a small/medium cyst. The surgeon removed a large amount of lip tissue in his words "to prevent it from coming back again" but it left a giant hole in my lip. I didn't show a picture of that but I did a scar revision (zplasty) around 6 months ago to fix the hole. You can see pictures on my previous post. Wondering if lip filler can help with this flat area if there is a bunch of scarring inside the lip there from the zplasty.

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

The short answer to your question is yes, lip filler can work well for reflating depressions and indentations from trauma, infection, or surgery, as in this case. However, if there is a whole lot of scar tissue binding the area down, subcision may be needed to break the scar tethers, so that the filler can then do a better job. You would be wise to consult with a board certified cosmetic dermatologist who may use a a test dose of saline or diluted anesthetic to determine just how distensible the area actually is BEFORE initiating a definitive treatment. Hope this helps and best of luck.

Camille Cash, MD · Answer

Lip fillers can be used to improve asymmetry.  The treatment is done in the office and final results can be seen within two weeks.  The longevity of the product will vary depending on the filler selected.  See an expert injector near you to learn more.

Mats Hagstrom, MD (license on probation) · Answer

Go only way to find out if fillers are going to give an improvement is to try it. Based on your pictures, the contour doesn’t look all that distorted. Ask yourself if having fillers every six months for the rest of your life makes sense?
What works for one person may not work for somebody else. Talk to some plastic surgeons in your community. I’ll see what they have to say.
Best,
Mats Hagstrom, MD

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