5mm Permalip Implants with Vermilion Advancement - Indianapolis, IN

I always had decently full lips, but felt like...

I always had decently full lips, but felt like they didn't match the rest of my face. They were also only full in the middle- the outer thirds tapered off drastically. I decided to get permalip 5mm (go big or go home) in top and bottom for a poutier look (check out Irina Shayk for my dream lips) and vermilion advancement on the outer thirds top and bottom (avoiding the middle Bc vermilion advancement dulls the lip roll and I have a nice roll on my top lip).

Day 3 Post Op

Swelling in the bottom lip has decreased. Well, both have gone slightly down but the bottom right (your right) is the most decreased. Had my follow up. Doctor said swelling is as to be expected for 5mm lip implants. The tunneling technique to get them in is brutal to the lips. The stitches for the vermilion advancement held through the most extreme swelling- there are external and internal stitches. I have been slathering them with an ointment the surgeon gave me. Last night ALL the skin (top layer) shed my lips like a snakeskin. I can open my mouth wider and eat a little bit. I iced off and on the entire day yesterday. Doctor recommended arnica Montana gel and tablets to help decrease swelling faster (homeopathic- not a prescription) so I will be picking that up. I think I can feel the end of my bottom implant protruding a bit on the left side a little from the middle but the surgeon used the longest length implant so the ends are all the way in my corners so it isn't likely that it's actually protruding. I think of anything it's Bc that side of my lip is still very swollen and its pushing the implant out.

Day 4 post op

Swelling is continuing to go down. I am a little upset today. It looks like the bottom vermilion borders in the corner go further out than the corners of the top lip, which is the opposite of what I wanted. I know I have to wait several weeks to see the final result, but I am worried. I want more of a taper in the corners on the bottom lip and I think they were not advanced that way and I also think the implant is emphasizing that extra volume right in the corner. Honestly right now I feel like I made a mistake in touching the lower lip with advancement at all. I hope I won't feel that way with the final result. Love the top lip. The shape looks like pretty much what I wanted and the implant is placed perfectly.

Day 5 post op

Swelling continues to go down. Too slowly for my liking. The more the swelling goes down on my bottom lip the more obvious it is that the implant is poking out unevenly. I'm afraid to go back to work next week with this thing jutting out. The bottom implant just feels too long in general. I can feel it spring back straight after I purse my lips. Top implant seems fine. There are bumps or puckering at the stitch line on right lower. Right now, I absolutely regret doing anything to the bottom lip. I should have left the bottom alone. Pretty upset Bc even tho I have to wait another few weeks to see the result I have a feeling that I'm going to need to have the lower re-placed or removed and a revision of the lower advancements to minimize the bumpy scars that will probably form. Feeling really down- any input is appreciated.

Day 6 Post

Regret.

Day 7 post op

Still very swollen (I hope otherwise they're too big). But I think they'll still go down a lot since it seemed that most people took until 15 days to rly have it go down a lot. Bruising is lightening. Left lower implant still protruding. Doctor said she stitches should come out (dissolvable) at day 7-8. I have some sticking out but when I tug gently they are stuck so don't want to pull. Planning to call Monday morning to ask about cutting the knots on my top lip. Maybe that will loosen them all. Icing about twice a day. They do seem smaller right after icing but then go back up. No pain. Stitches inside my mouth for the implants are kind of annoying but not painful. I REALLY hope the swelling goes down significantly by Thursday as that's when I have to go back to work, and I'm not one of those people who wants to announce they've done something to the world. I was HOPING it wouldn't look too different than my overdrawing so it wouldn't be so obvious.

Day 8 post op

Don't notice that much more swelling has subsided. Doctor gave me the clear to cut my stitches so I may try that later (I was an out of town patient). One side of my top lip is much less swollen- I'm hoping that's pretty much the finished product- it looks good. Bumped the side of my lower lip with the protruding implant rly hard earlier while doing yard work so I'm sure that didn't help with the swelling on that side.

Day 9 post op

Much more confident about going back to work Thursday. I think with makeup on it will be hard to tell what exactly is different. Removed the majority of my stitches on the top vermilion. Looks great. The line created was a little disjointed to me- rather than a gradual curve the angle up more sharply. I'm not particularly upset about this since the vermilion was done after the implants and so I think the swelling made this line appear more curved initially to the surgeon. And even with this, the top lip is a major improvement over my natural top lip. Implant still feeling secure.

Bottom lip: swelling has continued to go down. Left side is still bigger than right side but I think this is because this is where the implant is protruding. At this point, I do not need the protrusion going away and I am sure this will need a revision as that pocket feels loose and the implant is tunneled obviously different as compared to the other side. Luckily, it is not as obvious as some permalip inconsistencies I've seen. Spoke to the plastic surgeon and the fix for the bottom going out too far with the vermilion is a reduction as I suspected. We would only take in the very ends and the stitches are on the inner lip so I could do it over a regular weekend. So that's relieving. It looks like the suture line on the top vermilion has healed very well. No bumps or raised areas. There even seems to be a bit of a "roll" to the edge which is nice to see as vermilion advancements general cause you to lose the white roll on the border (it becomes flat). If you do a vermilion advancement, I would advise that you know EXACTLY where you want your lip line to be placed and the EXACT shape. Then check your surgeons markings before he cuts. What happened to me is that I said for the bottom "do the same as the top". Which is exactly what he did. But actually, what I wanted was more specific than that. So I do not blame the surgeon for that at all as he DID do what I said. Even more so, he made sure to give me the ideal lip shape (bottom equal with the top in size or bottom larger) even when I didn't say to do that. So, he had the best intentions. Unfortunately, the look I want is with the bottom just as pouty but with the borders not as wide as the top and it was my error in not communicating that. If I could go back, I would draw out what I wanted myself and see the doctor the day prior to surgery to go over it, instead of going over this right before the surgery the first day I met the surgeon in person (I was an out of town patient) and heavily drugged for sedation.

Before and immediately after

Received these photos from my surgeon and thought they may be useful as they show my lips (without any makeup) before the procedure.

Day 11

Going back to Indianapolis Friday to have both implants removed. By this time enough swelling has gone down to show that the lower implant is protruding on both sides. I have attached a picture looking downwards to show how lopsided and lumpy my lip is. I decided to have the top removed as well Bc since most of the swelling subsided I can move it from side to side slightly and feel that that can only mean complications like the bottom in the future. Also, they do not feel natural at all. The top one is placed properly- at the wet dry border- but even if it softens in the future, I do not see this feeling natural. To me, it would be obvious that there is something in the lip, and who wants to have to worry about that when they're kissing someone? FYI- the protruding edges are painful- if I smile at all I get sharp pains where the ends are.

Implants are out! Thank god!

Implants were removed about an hour ago. I feel and look a million times better. The vermilion advancement on the bottom even looks more minimal Bc it isn't being all stretched out so maybe I won't need a revision of the bottom after all. The suture lines on the bottom also look less pronounced Bc they aren't being so stressed.

So, what happened is that the implants were too long for my lips (the surgeon should have measured my lips rather than just using the longest implant) and so the bulges on the sides were not the ends of the implants, but were actually places where the implant had buckled because it was too long and could not lay flat. So you can imagine how painful that was. The top one seemed to be fine. My surgeon was reluctant to remove it, but to me they just seem like a ticking time bomb and also did not feel natural to the touch so out they came.

For the removal in case anyone else wants to have permalip implants removed at some point: very easy. Took about twenty minutes including the time it took the numb me. Surgeon cut a very small incision on the inside of the middle of each lip (unlike in placement where I had four incisions in he corners of my mouth, top and bottom. I have one dissolvable stitch in each lip. They are not visible with my mouth closed. My lips are still swollen from the initial procedure but they are also stretched out from having the implant inside. As I heal, they will go down. The surgeon said it's possible I will have scar tissue inside my lips from the implants which would cause them to be larger than before. Well, that's just fine with me.

I will continue to update, but weekly I think and eventually do a six month check in. At this point, I would say, do not go to Dr. Eppley for lip implants. The procedure for the implants is that you measure the length of the patients mouth. This was never done. You cannot use the longest size implants for the very reason of what happened to me. Additionally, his "fixes" for the buckling implant were to go in and snip out a portion of the middle of the implant so it would bend more easily. He also said (after the implants were already in) that he always orders the longest size and then just cuts off the ends of they need to be shorter. This is not what you are supposed to do (and if you read some reviews on here about permalip there are a few where the doctors cut the implants shorter and it caused a bunch of issues).

I am upset because I basically threw away $3500 for the implants. Also more than that because I had my initial plane ticket and then my emergency removal ticket. Plus hotels and rental cars. The ordeal ended up costing me thousands of dollars. While I do think the vermilion advancement will turn out well and I think Dr. Eppley did a good job with that, I could have saved a lot of money just doing that alone. So that is really disappointing. All in all, I am so relieved to have the implants out and no longer look and feel like I'm disfigured.
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