After doing extensive research on lip lifts for...
After doing extensive research on lip lifts for over a year, and consulting with several doctors around the country who specialize in lip lifts, I selected Dr. Perenack in Baton Rouge and traveled from my home in Scottsdale, AZ to have it done.
My main goal was to reduce the length of my long upper lip (which was 20mm) and balance my features. Gaining some tooth show (I had absolutely nine) would be a plus, and I also hoped to roll the lip up to remedy how flat it was from the side view (ugh, very aging). I am 51 years old so my goal was not to get full, pouty Hollywood lips. At my age I just wanted wanted a natural, non-surgical look.
Dr. Perenack excised 6 mm of skin (he didn't cut or hem the muscle; this was a skin-only lip lift; be sure to research both methods carefully); he excised 7 mm in one small area of my upper lip where I had some assymetry. I opted for local anesthetic and experienced no pain. Dr. P is so good at this, I didn't even feel the numbing shots into my lips and gums, which others have described as painful. Before he gave me the numbing shots, he applied a thick numbing paste to the inside of my gums. So he numbed me for the numbing shots!
In the OR, I lay on the surgical table and listened to John Mayer and Maroon 5. I wasn't scared and I never felt pain the entire time. Dr. P excised the strip of skin, then did two layers of stitching, then zapped the seam with a laser and then did a third and final layer of stitches. He also put some Juvederm Ultra into my lower lip and some Juvederm Ultra Plus in the lip corner crevices (not everyone will need this; at 51, my lips are thinning and I'm getting some downward cracks at the corners). Then I was done and drove myself back to my hotel room where I spent the evening icing my lips.
I will post pics of my lips "Before" with markings Dr. P made prior to the surgery; of my lips immediately after surgery and of Day One post-procedure, which is where I'm at right now. Of course I'm a swollen mess right now but that will resolve with each passing day. I still have no tooth show but Dr. P says once the swelling is gone he thinks I will have 1.2 mm of tooth show. I will post more pics as I heal!
Day One Photos
The scar is neat and tidy - I can tell it's going to look great when I'm done healing.
Photos 3 Days Post-Procedure
No pain whatsoever. Somb numbness, tightness and the bruises darkened. I look like I have a bruise-mustache! Am hanging on the homefront, laying low and just patiently waiting it out...
Feeling discouraged on Day 10...
Trying to be patient - I'm sure everyone heals at a different pace but wouldn't you know I'd be on the slow side. I was supposed to be back at work today but I'm still bruised and the incision is still on the red-and-raw side so I called in sick. I have one stitch that's trying to poke its way out and looks like a pimple, even though it's not. Ideally I need the rest of this week to hide out but I won't be able to pull that off at work. Hopefully when I go back tomorrow I will just look like my nose is raw from a nasty head cold?
Also, I am starting to worry that I should have had more mm of skin excised - I still have zero tooth show. Again, am trying to be patient and not to draw premature conclusions. But what what a drag would it be to have to do it all over again several months from now...
So one thing I can advise those of you who are considering a lip lift is to ask your doctor during your consultation, "What happens if the result is too conservative and I need a revision?" I never thought to ask Dr. Perenack this question so I don't know how it would work in terms of cost...does he charge a reduced amount, etc. Right now I feel depressed because it seems like I paid a ton of money to go from having a really long upper lip to a on-the-longish side upper lip! Dr. Perenack did tell me he leans toward the conservative and of course that sure beats the alternative of having too much taken out...but right now I have to say the jury is still out for me. Keep you posted!
Photos Day 10
I am also going to research veneers and corner of the mouth lift as I believe both would help enhance my result. Argh, more time and money!
Check out how much prettier in profile post-lip lift!
I hadn't really mentioned before how much Dr. Perenack improved my profile with his lip lift technique, but I really love it. So natural-looking - subtle yet what a difference! Thank you, Dr. Perenack.
One month post-op
Hi everyone, I'm posting more pics - today is my one-month marker and the results from my lip lift keep getting better. Still zero tooth show - unless I tilt my head back a bit - but I'm still glad I did it; it's definitely been an improvement! I'm posting pics below. I have had some post-op inflamed cyst-like nodules along my incision line. Dr. Perenack called in a prescription for doxycycline and it went away, but yesterday I got another new one. So he is refilling the doxy. Dr. Perenack has called me a couple of times to check in. The downside to traveling a long distance to have a surgical procedure is that you can't just pop in to see your doc if you have any post-op issues. But at least Dr. P. responds right away which I appreciate. I still have some numbness and a little swelling along the incision line but that's to be expected at only one month out. The incision is a bit inflamed from the persisting nodules. Hopefully it will be gone soon - Monday is my birthday followed by Christmas with social activities. But makeup helps cover it up, thank goodness. Pics posted below. Merry Christmas RealSelf Sisters! Thank you all for your ongoing support!
Photos - one month post-op
Very natural-looking results, nothing fake that screams surgery, thank God (and thanks Dr. Perenack)! Still hoping for a smidge of tooth show...Dr. P says it's still possible as the swelling subsists and things continue to "settle." The centering under the columella is improving as the swelling goes down, too.
Two Months Post
21 Jan 2014
2 months post
Still have some numbness and stiffness around the incision area, but the results definitely look natural. Posting new pics!
10 Weeks Post-Op
29 Jan 2014
2 months post
Swelling and numbness continue to dissipate each week. Very natural-looking results. Still no tooth show in repose.
About to undergo second lip lift!
Hi RealSelf Sisters, it's been almost two years since my lip lift and I made the decision to have a few more mm of skin excised. My first lip lift was done well but my philtrum isn't still longer than I would like and I have zero tooth show. My second surgery is scheduled for August 28th and I'm calm and relaxed about it since I know what to expect, having gone through it before. The only thing I'm not looking forward to is the recovery - mine was longer than most to look "normal" again, and it took many months for the numbness to go away.
This time, I am having my procedure done by a different doctor, only because I don't want to travel all the way to Baton Rouge again. Instead I'm hopping a one hour flight to San Diego and having my lip lift with Dr. Hilinski. He dies beautiful lip lifts just like Dr. P. with natural-looking results. I trust him not to make me look "done" or "hiked up." At my consult he said he's thinking he will excise 5 mm. I will post my progress. Sure hope I don't experience those nasty, pimple-like "bumps" along the incision line again...that took a month to eradicate last time, ugh. Anyway, wish me luck! Here's a current photo of my lips.
Profile Photo "Before"
I forgot to mention that my upper lip "flattened out" again after my first lip lift. When I first had it done it rolled up in a very pretty, feminine way but almost two years later that is no longer the case. Hoping my second procedure will bring back my original result - it was so pretty!
Here are more "Before" photos, before second lip lift
I'm one week away from my second lip lift and am posting these photos in the hope that some of you may offer your opinion. My goals are to shorten the philtrum a little more so i don't look long-lipped in repose; to (hopefully) getting a little upper tooth show (right now I have none); to lift the lip in profile so my dude view doesn't look so flat; and to get my upper lip better centered when my surgeon stitches me up. It used to be perfectly centered pre-LL number one, but the way I was stitched back up, is slightly off-center. I also plan to put a little filler back in to enhance the fullness of my lips.
Full Face BEFORE 2nd Lip Lift
Okay girls, I'm being brave here and posting some full face photos from varying angles. Round 2 lip lift is day after tomorrow (Friday). Gulp!
Just before surgery...
Here I am on my way to Dr. Hikinski's
Here are my lip lift surgical markings...
Dr. Hilinski and I agreed to keep it natural - so you can see from the markings that it's about 4-5mm that he's taking. He did not want to take more from the sides/corners for whatever reason? I know some girls have blogged that they had 5 mm removed from center and 8-9 from sides, so I did ask about that but decided to trust his judgment.
Day One of 2nd Lip Lift
These photos were taken immediately after surgery. No, I did not do anything to my nose...the surgical tape is to help keep my nose from swelling. Dr. Hilinski used "vertical mattress" stitching and he said it's unlikely I will get those awful cysts along the incision line that I got from my original lip lift stitches (although it's still a possibility). Also, he put some Restylane filler in my lower lip as well as in the corners to help nudge them up a bit.
Here are a few tips if you're about to undergo Lip Lift
It's important to ice the area for the first 48 hours post-surgery, to help reduce swelling. Put its difficult to get the ice pack or even crushed ice to "fit" just under the nose. Dr. Hilinski offered this great tip that I'd never heard of before: get some Caro syrup and pour some into a snack-sized Baggie, then put the Baggie in the freezer. He said it will me malleable and will mold right onto the incision under the nose! Also, I had to endure the painful numbing shots for this second lip lift when for my first lip lift procedure, the doctor used a numbing paste along the inside of my upper gums. He let it sit for 5 minutes to take effect and then gave me the shots. I never felt a thing! So I asked Dr. Hilinski about this. He was interested and said that probably because my first doctor (Perenack) is a craniofacial doctor, he would be familiar with such a paste. Girls, its worth asking your dentist where you can get some numbing paste! I mean, the pain from the shots is brief before the anesthetic kicks in, and I am very stoic so I endured it without flinching. But why suffer at all when it could be so easily remedied?
Much more swollen today, but that's to be expected on Days 2 & 3. So I'm hiding out in my hotel room with my two chihuahuas on my lap, keeping me company!
Day 3, Swollen Mess!
Definitely more swelling from my second lip lift than from my first, likely because of scar tissue. But no bruising, which I had the first time, so I've got that going for me LOL
Day 5 - Allergic Reaction to the Adhesive in the Surgical Tape
Ugh, my skin has erupted in a hideous rash where the surgical tape was. So I stopped taping my nose to prevent swelling - I'd rather have a swollen nose than hives. One of my best features is my complexion and my usual porcelain is now a mottled, bumpy mess. Tomorrow I get my stitches out and I will ask Dr. H for a cortisone cream to clear it up. Lips still swollen but I expected that. Just not a hideous rash. So I'm still holed up in my hotel room, in hiding.
Day 6 - Stitches Out
This morning Dr. Hilinski took my stitches out. He always insists on removing the stitches himself - never one of his staff members - because he said its critical not to inadvertently damage the scar. Then he put plenty of goop on the incision line and reminded me not to do a lot of smiling and animating just yet, while the wound is still in the early healing stages.
He prescribed an oral steroid to clear up my awful hives. He said while it's not common, he has seen other patients over the years get allergic reactions to surgical tape. It's a chemical in the adhesive, apparently.
Day 6 - a few more "After" shots
Here are some more photos - including full smile and profile. My skin still looks mottled from the allergic reaction to the surgical tape, but gives you an idea of my results...
One Week Post
I wish my lips would stay this full but they are still really swollen so it's doubtful. As long as I retain tooth show I will be ecstatic. Fingers crossed...
Day 12 - Vicryl Reaction to the stitches
When I woke up today I discovered a few hard little cyst-like nodules formed along my incision line. This happened to me during my first ip lift as well. I believe it's called "vicryl reaction" - sigh, I must just have very sensitive skin. I'm calling Dr. Hilinski's office to ask him to phone in an RX for Doxycycline, which should clear it up fairly quickly (I hope).
More info on "vicryl reaction" (cysts caused by stitches)
"Vicryl reaction" is simply bacterial contamination of the braided suture material, likely from "normal" skin bacteria present in the sweat glands and hair follicles the suture goes directly through during your surgeon's closure. These skin bacteria are actually protected from your body's defenses--your tissues' antibodies (and antibiotic, if given)--by the tiny interstices within the braided suture. These tiny microscopic hiding places are warm, wet, and a place that bacteria can multiply, causing the tiny pus pockets in some locations. That's also why removing the stitch, opening the pus pocket, and topical antibiotics (or just time as the suture dissolves and your body can "get to" the bacteria and eliminate them) solve this problem. That's also why Ethicon has added an antimicrobial coating to their Vicryl Plus brand of suture. That's also why many surgeons soak their Vicryl sutures in antibiotic irrigation fluid before use; this reduces the "Vicryl reactions." And now, many surgeons have switched to a non-braided monofilament suture like monocryl, which has no interstices for bacteria to "hide" in, and rarely see any kind of stitch abscess, for that is what is REALLY happening - bacterial infection around the stitch, not allergic reaction to the stitch.
Patients who have chronic problems with suture abscesses may harbor more or worse bacteria in their pores, sweat glands, and hair follicles. Showering the night before and the morning of surgery with Hibiclens (chlorhexidine) may help to reduce suture problems. And avoid braided sutures.
Found an interesting article to share r.e. lip lift technique
To those considering the lip lift procedure, you may want to read this article on the "wavy elliptical" cut. I found it on Researchgate.net. The article is titled "The Endonasal Lip Lift: Personal Technique" and it was authored by Drs. Peter Raphael, Ryan Harris and Scott Harris (Plano, TX) and published in 2014 in academic journals. Just so much to take into consideration when researching lip lifts!
Updated Photos - approaching Week 3
Scar is healing nicely - I have no makeup on it in these photos. I still have a couple of tiny cysts but they shrink each day and should soon be gone. Upper lip is still stiff but that's to be expected. No one at work seems to have noticed so far. One of my sisters loves it and my mom and other sister don't, but they are happy I do. As I recall from my first ip lift, it takes a full four months for things to settle and all swelling to subside.
BEFORE & AFTER BOTH LIP LIFTS - for side by side comparison
The first photo is me before any lip lifting. The second is me after the first lip lift (fully healed). The third is me after my second lip lift (taken today, which is Day 21). Keep in mind that I'm still puffy and swollen (swelling still in my cheeks even), and I've aged a few years from the first shot - I am now 53 and the first photo was taken on my 50th birthday.
Lost most tooth show in repose, by Day 21
BecomingStronger asked if I'm happy with my second lip lift. In most aspects yes. I'm so pleased that Dr. H was able to center my lips under my columella. They were centered pre-lip lifting but after lift #1, they were slightly off center (likely noticeable only to me). I also think Dr. H did a great job keeping it natural, plus the incision line is so thin and precise I can't get over it! Which means in time you won't be able to see it.
I am sad, however, that I lost most of the tooth show I had during Week One after second lip lift. I liked it better when more of my teeth showed in repose! (See what I mean in the close-up photos below). It was a real thrill for me since I had absolutely zero tooth show before my second lip lift. Again, I am referring to the repose stance. Hopefully by the time I'm all done healing, I won't have lost all tooth show. I know better than to judge anything this early in the healing process.
Two Months Post
Hi everyone! Today marks two months since my second lip lift. Here are some selfies I took over the past week, full face, which I will pull down in a couple of weeks. The scar is virtually undetectable. I'm very pleased with this second lift with the exception of I wish I had tooth show in repose the way I did the first couple of weeks. My philtrum measures 1.3mm.
2 Most Post 2nd Lip Lift
Now you can see more of my teeth when I smile instead of a "half mast" smile. Definitely was worth it!
"You changed heads!" - 2 months post 2nd lip lift
So here I've been thinking no one at work really noticed I did anything...well, one of my co-workers popped into my office the other day...he hadn't seen me in a few months because he was on an assignment in another territory. So here's how the convo went:
Co-Worker: "You didn't tell me you were going to change heads!"
Me (genuinely perplexed): "Huh??"
Co-Worker: "When you turned around in the board room I almost didn't recognize you! At first I thought it must be your sister because she looked so much like you yet not you. But then I realized it was you! You changed heads!"
Me (face flushing, trying to seem non-chalant): "Well we girls do little things here and there to stay fresh. But hopefully nothing so major that we no longer resemble ourselves."
Co-worker: "No, you changed heads. Your face is different right here (points to area below his nose and above lip)."
Me: "Wow, I can't believe you think I look that different."
Co-worker: "You look lovely."
Soooooooo embarrassing!! Of course right after he left my office I ran to a mirror to stare at myself and see if "ME" is still there! And then face burning with the realization that if he noticed, likely everyone else did too, but he's the only one blunt enough to say something to my face! Groan, why do we even give a bleep what others say/think anyway?! Aargh.
Anyway, I still have swelling and still feel "stiff" when I try to smile broadly, which I know will resolve over time. I still like my results except I think from straight on, when in repose, my lips still look a bit "Hello Kitty"! I think if I had a medialized corner lift that the "slope" would go away. But I know from prior experience that it's way too soon to fully judge my results.
Close-up's of scar, without & with makeup, at 3 mos. post
Per your request, here is my scar (no makeup) 3 months post 2nd lip lift. I also included a few with makeup as well - with just a smudge of coverup on the scar line, no foundation though. You can see that with even just a little concealer, the scar is easy to hide.
Hi everyone, you can read a more in-depth review...
Hi everyone, you can read a more in-depth review of my first lip lift, and everything I learned about lip lifts in general, under "Lip lift at long last" on this website. I also wanted to create a separate entry about how pleased I am with the results of my second lip lift performed by Dr. Hilinski in San Diego. Very natural-looking results, which is a hallmark with this doctor. Here's a Before/After photo, taken six months post procedure. I'm very happy and would do it again in a heartbeat.