Dr. Gary Horndeski in Sugar Land, TX / Lip Lift / 25 Years Old

Hi everyone! I wanted to share my (ongoing)...

Hi everyone!

I wanted to share my (ongoing) experience with this procedure. I'm a little more than a month into it, but I can already say without a doubt that Dr. Horndeski is a surgeon I would 100% recommend.
Thank you to those of you who on this site who posted reviews, you helped me find and choose said surgeon!

This is a procedure I've wanted for years, but never knew the correct way to go about. I've been self-conscious over the length of my philtrum as well as the size of my upper lip, and used to research lip augmentation before I found out a lip lift would be more suitable to my personal desires.

I settled on Dr. Horndeski because 1) His technique for this procedure is very innovative and yields minimal downtime trauma (request 2 weeks off tops) with permanent results: he, with the help of his also amazing assistant of 20+ years, Elisa Gonzalez, removes only the skin under/around the base of the nose and nostrils, stitches you up internally, and leaves one external stitch to pull out 5 days after the procedure. This results in a much nicer, less visible scar. 2) The reviews on this site sold me, and 3) his office is a 20 minute drive away from my house.

I've asked Dr. Horndeski how many times per week he does this procedure, and I was told on average about 2-4 times per week. He doesn't have any pictures or details regarding this procedure on his site, which is why I'm thankful RealSelf did, and why I want to add more information about it from my point of view. This isn't what Dr. Horndeski mainly specializes in so it's not something he promotes front and center.

In my next posts I'll discuss the procedure itself, and various stages of healing.

What to expect

I had a consultation with Dr. Horndeski on a Monday where we discussed details of the procedure, and what he recommended removing for me personally considering I wanted a drastic change. He was adamant about not making too drastic of a change for the initial surgery since you can remove skin but not put it back - I really appreciate that about him. If I still want more skin removed, I can schedule a revision 6 months after the initial surgery (which costs an additional $1,000). I thought about everything for a day, then scheduled my surgery for the soonest available time. There was a cancellation and I ended up having my procedure bumped up to Thursday that same week.

The procedure itself was a breeze, and the entire thing took about 30 minutes; it was easier than seeing a dentist.

First, I was taken into the room we had our consultation in and Dr. Horndeski marked what exactly was to be removed: 6mm from the lower sides of my nostrils (a little more from one side to fix some asymmetry, I don't know the exact mm), and 3-4mm from my philtrum (I pushed for 4). Unfortunately I don't know the initial length of my philtrum, it was never information I cared to keep in mind as I simply knew I didn't enjoy the original length. I was then injected with local anesthesia, which was quite painful and made me shed a tear, but it's over quickly. He asked me to look at myself in the mirror after that and I could only laugh; I was already swollen with duck lips and numb to the touch -> see photos labeled day 2 to get an idea.

I was then taken into the next room where the actual surgery takes place. I lay down on a bed and let the masters do their work. I admit I was nervous with pre-surgery jitters (this is my first cosmetic procedure and the only surgery I've had prior to this was wisdom teeth removal), and already anxious due to a loved one suffering a heart attack the night before (he had surgery the same day as me and is healing fine). I had trouble clearing my head, and when Elisa commented that my longtime partner looked very concerned in the waiting room, I almost started bawling thinking about my father-in-law's state in the hospital. Elisa instantly reminded me to breathe deeply and try to relax, grounding me. But, I truly could have fallen asleep during the procedure had I not been riddled with anxiety. I cannot emphasize enough how easy the surgery was from my perspective. During one point early on I felt slight discomfort around my left nostril, which I mentioned and I was quickly administered more of the local anesthesia, no pain this time since I was already 99% numb from the initial shot. Slice here, stitch there, and voila, it's over. I was asked to look at myself in the mirror and once again I could only laugh at how comical I looked due to swelling. Gauze was put over my nose/upper lip and advised to be removed 24 hours later (in fact my day 2 photos were taken right after I removed the gauze). I was given a sheet with post-op care, prescriptions for an antibiotic and pain medication, scheduled my next consultation appointment, and I was out the door.

I will add, I took a leftover Hydrocodone I had from my wisdom tooth removal before I went in on surgery day, anticipating pain from the local anesthesia shot. I do not recommend this as that needle is going to hurt no matter what, and, about 30 minutes after the surgery was over I started to feel pain - but it was 3 hours too soon to take more pain pills. I also took a small dose of Klonopin, which perhaps added to the feeling that I could have easily fallen asleep during the procedure. I had called prior to the surgery to verify that it was okay for me to take these pills before coming in. I also want to add how friendly and informative Dr. Horndeski's staff is, any time I called I was given prompt answers to any questions or concerns I had. His staff was also very friendly any time I came in to his office.

Preparing for the surgery & healing / aftercare

I wanted to eat a low sodium/high protein diet to aid in swelling reduction and a speedier recovery. Do your shopping prior to the surgery, unless you don't mind walking around with a good portion of your face swollen (although some people don't swell as much as others).

Here are some items I bought/already had:
1) Saline nasal spray. Do not forget to buy this prior to your surgery, you'll definitely need help cleaning your nose for a bit. I always used my spray after a warm shower.
2) Low-sodium lentil soup from Whole Foods to eat for the first few days, as well as protein shakes (either made in a blender with various ingredients or made with whatever protein powder and bottle you have).
3) Adult multivitamin gummies.
4) A donut pillow + lots of normal pillows.
5) Arnica montana 30C tablets to help with swelling (which I had planned to take a week prior to surgery + following it, but my surgery was bumped up a week so I just took these every day with my antibiotic). Although, Dr. Horndeski said I didn't need to take any sort of vitamin etc. to help with the swelling and I could just ride it all out.

I had originally planned to sleep upright for a full week after my procedure. I told Elisa this and she said that was great to shoot for. ***It is extremely important you remain upright throughout these first crucial days post-op, as to help minimize swelling.*** I was only able to sleep 4 days upright because my tailbone was kiiilling me. In fact, the most painful part of this whole thing was the pain my tailbone suffered while sleeping! I slept with a donut pillow around my neck; 2 staggered pillows for my back; a small pillow at the base of my back; 2 pillows to my right and left, boxing me in to ensure I didn't slide over while sleeping; and 2 pillows under my knees. I found out if I rotate my hips and shift my weight to whichever butt cheek, I relocated the majority of pressure off my tailbone. The first night I woke up several times since I didn't know the rotated hip/butt cheek tip. One of the times I woke up that first night was because I drooled on my chest and I immediately thought I had somehow torn the incision area and was bleeding. Whenever I woke up I made sure to rotate to the other butt cheek and I was always able to quickly fall back asleep.

I want to reiterate how painless this was. The actual day of the surgery was the most painful, and the only day where I felt the pain medication was needed. After that, the only pain I had was in my tailbone, as well as the pain caused by laughing, smiling, yawning, sneezing, etc. Don't watch any comedies during this first week or so, and hopefully you don't have a goofy klutz partner (or whoever is around) like I do who is constantly making me laugh!

On day 5, I was scheduled to come in and remove the suture. I actually didn't even touch around my nose for those first 5 days, didn't submerge it under water or remove any blood crusties. I did wash my face of course, but I steered clear of the incision area. Dr. Horndeski said I probably could have removed some crusties (which he went on to do himself), and could go ahead and wash the incision area. He said I was looking great, but I should wait to remove the stitch due to the crusties.
On day 6, I was pretty damn itchy at the incision area (due to healing). I fully submerged the area by cupping water in my hands at the sink, and immediately that helped reduce the itchy feeling.
The next day, one full week after the surgery, is when it no longer hurt to laugh, etc. I felt great!
Days 8-11 were smooth sailing and I was just waiting for the swelling to go down even more. I don't remember which day it was, possibly sooner, but my upper lip was peeling a lot one day (from the new previously unexposed part of my lip being brought up/out).
Day 12 is when I came in to Dr. Horndeski's office to finally remove the suture. It would have been sooner, but he was booked. Look again at my photos to see how fast I'm healing at this point :) This was the first day that I felt comfortable enough making a public appearance. We also discussed the possibility of a revision, not that I'm unhappy with my results so far, in fact I'm absolutely thrilled, I just went into this envisioning drastic results. If I recall correctly, he said he could see an additional 2-3mm being removed. He once again commented on how great the healing was going, and I made my next consultation appointment.

Picture wise there's not much to post during this time in the process. Day 2 you can see how swollen I am, and that diminishes day by day so it's a pretty gradual change not worth documenting in my opinion. You'll be swollen and numb due to the local anesthesia shots, and I've found that as the numbness dissipates from the area, so does the swelling. It takes time, so don't be anxious over this! I certainly wasn't despite being extremely swollen because I know this is just part of the healing process.

The first picture I've included in this post showcases Dr. Horndeski's amazing skill with stitching, which makes for a nicer scar. With this surgeon and this specific procedure he provides, you don't have all of those external sutures- just some internal ones you'll never see, and the one suture that starts from one side of your nostril and exits at the other nostril. That one primary suture is extremely thin and clear, in fact I had to remind Dr. Horndeski on day 12 that I was there to have it removed; I pointed at it and he couldn't see it until I put my fingernail behind it. Removing it tickled, but I immediately felt better and felt I could move much more freely, though at this point I still didn't want to pull much at the incision.

Around one month later

My surgery was on February 19th and today is March 25th. The pictures along with this post were taken yesterday; the swelling is looking amazing at around one month, especially when considering this is a procedure that you can expect to be fully healed at around 6 months (or possibly sooner!). My columella is still swollen/numb (but not the tip of my nose), which I'm not at all concerned about. Once again, whenever the numbness wears off the swelling wears off.

As far as scarring, it is looking amazing as well. I've included some photos. Some days it looks a bit pink, but it's still so soon in all of this and I think I'll heal just fine. In most lighting I hardly see the scar at all. I was told I didn't need to put any ointments or anything on the incision, and so far I'm not. I fully trust Dr. Horndeski's post-op recommendations. But, Elisa did tell me at my last post-op consultation on the 16th that if I'm going to spend time in the sun I need to put sunscreen on the incision or else the scar could be more visible. She also reminded me once again to not pull down at the area, as this would also cause scarring to be more visible.

When I relax my mouth there's definitely some tooth show, which to me is cute but I'm honestly a little self-conscious about that since one of my front incisors is crooked and both are a tad longer than I'd like. Depending on my enamel situation, having my dentist file those down a mm or two would be ideal. This is actually something I've thought about in the past, but is something I'm seriously considering now that I have tooth show. If I do end up getting a revision it would only be more noticeable, but we'll see how everything looks 5 months from now.

My next consultation is scheduled a little less than a month away, and I'll post updated pictures then.

Please don't hesitate to ask me any questions! This site has helped me so much, I would love to help others with any questions and concerns if possible.

Updated photos

I'm sorry for the confusion, my old photos were actually 3-4 individual photos combined as one image. They were large files but I didn't realize RealSelf would resize them so much, so I've removed them and I'm now uploading them all individually. This is my first review here so it's a learning experience :)

5 months I believe

Hi everyone! I'm updating first here instead of emailing my surgeon updated photos oops. I'm very pleased with my results so far :)

The scarring is minimal but it is noticeable if you look, though nowhere near as red. I'm thinking about purchasing some Kelo-Cote Kelo-Cote Advanced Formula Scar Gel over at Amazon to use for the remainder of the healing process and perhaps longer (can anyone give me their personal recommendations to help with scarring?). The base of my nose is still a bit numb, and so my nose is still slightly swollen. My nostrils aren't fully back to normal either, but I don't think they look terribly disfigured & I'm the only one who seems to notice them- however, looking at my earlier healing photos I can tell they have improved. I've always been slow to heal all of the piercings I've had over the years, so I guess I'm slow with cosmetic procedures as well! Because of this, I don't know if I should do my revision around 6 months, or wait closer to a year.

Here are a few more photos in different lighting

Texas Plastic Surgeon

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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