Bullhorn and Corner Lip Lift 12th April, 2019

I used to have a full profile (to a minor degree) due to my slightly protruding front teeth. In 2013, at the age of 38, I decided to get braces with 4 premolar extractions to pull my teeth back. All I wanted were nice teeth and a more neutral profile. At that time I had no idea that extraction orthodontics do much more than that.
After two years my teeth were straight, but due to the teeth having been retracted backwards, my lips shrunk, my philtrum lengthened and I was left with excess “face flesh”, for want of a better word, on the sides of my mouth. The skin that had been held taut, supported by my teeth and jaw bones, was now deflated and sagging due to having lost the support of dental and bone tissue. These changes took place gradually over 3-4 years, during and after the orthodontic treatment, as the redundant alveolar bones got resorbed.
I looked like I had suddenly aged two decades, and decided that I needed to do something about it. I had two courses of action - 1) to reopen the extraction spaces and get implants to replace the extracted teeth, essentially undoing the orthodontic work, and putting my mouth back to where it used to be, or 2) to reduce the excess sagging skin around the mouth to match my now smaller alveolar mass. I chose to go with the latter option as I couldn’t bear the thought of undergoing dental and orthodontic treatment again, putting my teeth under more pressure on top of what they had already endured.
To get rid of the excess skin surrounding my lips, I decided to get a bullhorn-type lip lift to remove the excess skin above my lips, and a corner lip lift to remove the excess skin on the sides of my lips. This decision took much agonising, researching, enquiring and soul searching, as I have never had any plastic surgery on my face, and this kind of extensive facial surgery was a terrifying prospect.
I came across Golden View when I was researching plastic surgeries in Seoul. The clinic is famous for lip-related surgeries, and Dr Song seemed to have extensive experience in the area. The clinic also has an active online community where patients and prospective patients can connect with one another and with the surgeon himself, to ask questions, post reviews, and so forth. The level of openness and the apparent expertise of Dr Song inspired enough confidence in myself to choose Golden View for my surgery.
The surgery took place on 12th April 2019. When I saw post-surgery photos online, I noticed that there was very little swelling immediately post-surgery, and the swelling happened in the following days, peaking around day 3. Well, immediately after my surgery I could see that I was already starting to blow up. The following day was horrendous. And today (2 days post surgery) it’s about the same as yesterday. My lips and entire mouth area are so swollen and tight, I actually cannot move my mouth. I have to spoon water into my mouth one spoonful at a time with my head tilted back in order to be able to drink. I had not imagined this level of destruction!
I flew to Korea for this surgery and am staying at an Airbnb for two weeks. I deliberately decided to stay alone for the first two weeks post-surgery because I want to keep my mouth as still as possible, and don’t want to need to talk, or be compelled to smile or laugh during social interactions. Dr Song told me that it is very important not to overuse the mouth or open it too wide for the first 3 months after surgery, as that will put pressure on the incisions and have a negative effect on scar formation. I am so scared of being left with visible scars, that I am trying very hard to open my mouth as little as possible, so I am very glad that for the next two weeks all I need to do is eat (very slowly and painstakingly), sleep, take my meds, take care of my incisions, and visit the clinic for check ups.

The swelling seems to have reduced infinitesimally since yesterday. It is surgery +3 days today. It’s a tiny difference but encouraging, nonetheless. The surgeon has instructed me to wash the incision area with plain water and soap three times a day and cover the stitches with an antibiotic ointment (Fusidin 20mg). On top of that I am also applying DMSO and arnica gel around the incisions (not directly on the incisions), and taking arnica tablets.
I am worried that I am not drinking enough water. I usually drink around 3 litres a day (12 cups) but at the moment I can manage less than a litre because it is just so hard to get water inside me. Dripping it in spoonful by spoonful is like trying to feed an elephant with an eye dropper.

The swelling is continuing to go down very slowly. I noticed this morning while taking photos that the philtrum is lengthening as the swelling is going down. Of course, that is to be expected but I am surprised that the philtrum has lengthened so much while there is still a lot of swelling left to dissipate. I am worried that once all the swelling disappears, the philtrum will be left too long. I wouldn’t want to go through this surgery again. It seems that the downtime required is much longer than I anticipated.
Dr Song uses a method that cuts (or hems?) the muscle. He is not in favour of skin only lip lifts, because although it is a much simpler and quicker surgery, and the recovery is much easier and faster also, it is not always stable. Many cases end up with the philtrum stretching out again because the skin by itself is not strong enough to withstand the pressure of constant lip movement and gravity. I tend to agree with him and did not want a skin only lip lift for that reason. I am not 100% sure what exactly he does to the muscle, but he says he has developed his own method of anchoring the sutures to stronger structures under the subcutaneous layer so as to prevent stretching out, and also to minimise nose distortion. His aim is to stop the columella being pulled down or the nostrils flaring as much as possible.
Based on this, there shouldn’t be too much difference between the immediate post surgery philtrum length (once the swelling is eliminated) and the final result. That’s comforting. I just really hope that once the swelling goes down I will be left with the ideal philtrum length.
My pre-surgery philtrum length (centre of the Cupid’s bow) was 20mm. When I was simulating a lip lift at home by pulling up my philtrum, I thought 5mm in the middle and 8mm on the sides would look good. But simulating a lip lift with your fingers is not really an accurate representation of the surgical result, so I didn’t really spend too much time worrying about the exact millimetre measurements.