Lip Lift. Washington, DC

I have a 22mm upper lip which is not only aging,...

I have a 22mm upper lip which is not only aging, but is not attractive.
I have had 4 consults. 1) Dr Haworth 2) Dr Rodriguez 3) Dr Stephen Baker and a 4th who would not do it.
I felt the most comfortable with Dr Baker. The fact that he does a lot of reconstructive surgery around the mouth, is Ivy League graduate, and was first trained as a dentist (then later as reconstructive and cosmetic surgeon) made me feel comfortable. He told me he would take out 8mm and I could always come back later to get more taken out. I saw some of this photos of other patients who had this procedure who were African American. They had stunning results and no visible scars.

Today was surgery

After reading everyone's reviews, I feared the shots that would numb me for the surgery. But Dr Stephen Baker assured me that in his previous work as a dentist he developed the ability to administer these numbing shots with little pain. He was right. I only felt a little pinch. That's it. And I didn't need any numbing cream to numb me for the injections.

He said he drew the markings to indicate he was going to remove 8mm.
The surgery went off without a hitch.
No pain. Just a little tugging.
I told him that I had read on other reviews that people's lip lifts had descended such that if the doctor removed 8mm, the end result would ultimately only be a 4mm shortening. He said he had never experienced that before with his patients. He thought this might be because of his suturing technique.

He game me some tylenol/codeine to take for the pain that I would experience for the next few days and said to come back to see him again in 2 weeks. (The stitches are dissolvable.)

If I feel he was too conservative, I can always do this procedure again.
He said that he felt that he had given me a modest amount of tooth show, which would be stunning if that is the outcome.

Right now, my lip is swollen and I understand from others that it will get worse over the next few days. He told me I should take a week off from exercising.

He did tell me something about scarring that was news to me.
I assumed that scarring would be worse on older folks than younger folks. He said it was the opposite. Apparently, when you are young, your body can scar more strongly, meaning with heavier scars. But when you are older, the body can't scar as well, which means that the scar left is thinner, which ultimately (from an aesthetic standpoint) means it is less visible. So FINALLY an advantage to being older.

22mm Upper Lip "Before" photos

Here are photos taken of my lips before the surgery.

Pain

It's 4am. The pain is terrible and I am more swollen. (The latter of which, I am not helping by not icing.) So ladies, make sure you have the option of big gun prescription for pain.

Btw, for anyone who is curious, I am in my mid 50s.

17 Hours after surgery

The swelling gets worse. Now looking downright comical. I keep telling myself to not worry and that this is normal at this stage and in a few weeks, I will look dramatically better.

9-16-15 (Day after surgery) 13mm

Increased swelling. I measured the upper lip today and it is 13mm, or 8-9mm shorter than before surgery. In other words, the amount he said he removed. Given the amount of swelling, I don't know how it is possible for this shorter length to be maintained. If I were a betting woman, I would guess that as the swelling resolves, the distance will lengthen and I will be left with about 17mm. Let's see what happens.

Pain Subsides

At 11pm at night, 32 hours after the surgery, the pain noticeably decreases.
I have also taken some bromelain and massaged the upper lip area with a cube of ice. Not sure if the pain subsiding is a direct result of bromelain/ice or just time's passage. Lips still as big.

3 day post op. Upper lip measures 14mm

There is still swelling, bruising under the upper lip. Upper lip is feeling softer. Not like frozen rubber as it did the first couple of days. I'm curious to see if there will be any lift to the side areas as time goes by. Before the lip lift, I was concerned about the fact that I had a good distance on both sides of my mouth where my lip curled under, and giving me a line instead of a mouth. This is why I asked Dr Baker about a corner lip lift, which he refused to do saying the scar would not be worth it. I remember Real Self commentator Sarahyellow mentioning that her mouth was rather slopey (as is mine now) for several weeks and then became less so between weeks 2-4. So we shall see if I have the same outcome.

Also, am curious to see if my 14m upper lip measurement will stay or will descend as happened to RealSelf reviewer Loska who also had 8mm removed but ended up with a 4mm difference.

Note; I have tried to update my initial review to include the doctor's name plus the amended date of surgery, but this website doesn't seem to accept my changes after I press the option to "Save Changes." Not sure what is going on.

Incision (3 days post op)

Here is a close up of left nostril where glue used to be. I need to go to pharmacy now to see about getting replacement surgical glue (if they have something like that) before I compromise the result. I was a non-compliant patient because I picked at the glue. I was told NOT to do this and to leave it on until the office told me it could safely come off. But I have to say, the incision is pretty damn impressive give it is 3 days after surgery.

No More "Smoker's Lines"

I am not a smoker, but with age and a 22mm upper lip, I noticed that when I spoke, my hyper mobile and extra long upper lip was beginning to show outlines of what some kind of definition. A few of the muscles were a tad more visible. As I look at my new 14mm upper lip, I am wondering if those will reappear when all the swelling goes down. Or if they will have disappeared. I'll give you guys an update at the 1 month mark. Right now, I am just thrilled about the result. Really, over the moon. Wish I had done this years ago.

4 days post op

All the glue is off. I was a non-compliant patient. I picked it off when I was told explicitly not to do this. I couldn't find any surgical glue from Walgreens or CVS. Have been on Amazon and tried to find something that would work. Have left message for doctor's assistant to ask if there is a way to buy some. Hope she checks her message this weekend. The incision site was initially pale pink when I picked off the glue but now is dark red, as you see in this photo. Hope I have not permanently messed up my results. Still swollen in nostrils. But expecting to stay this way for a few more weeks. Upper lip continues to stay at 14mm. (I have a little lip coloring on my lips.) I noticed that in repose, my lips have that rabitty look. But when I smile, they do not.

1 week follow-up with Dr Baker

I had my appointment with Dr Baker. He gently admonished me for not being compliant with post op instructions to not pick off the surgical glue. As a result of my doing so, I have two small spots inside my nostrils where there MAY be some slightly wider scarring in the future. He told me that for the first 6 months, the body responds to any stress in the wound area by laying down scar tissue. After 6 months, the scar will start to get thinner. So, ladies, it is very important in the first 6 months to do nothing that would make the body think, "Oh, I need to lay down more scar tissue here." For anyone reading this, make sure you comply exactly with the surgeon's instructions. (Unlike me.)

The good news is that he said if those small spots did produce noticeably thicker scars and I didn't like it, it will be very easy to fix just these two spots without redoing the whole enchilada.

I asked him his thoughts about a second lip lift, if I wanted to remove more MM. He said we needed to wait until we really see the final result with the first to discuss the best course of action. I also discussed Dr Haworth's corner lip lift technique, showing him a page from Haworth's website. I also apologized if doing this was breaking some protocol -- like going to a restaurant and asking the chef to make the meat using the recipe from a different restaurant. Regarding the corner lip lift, he said that he often sees patients who come to him to revise the scars they incurred from a corner lip lift, so he's not a big fan. That said, he was willing to potentially do a corner lip lift on me, if I felt the impact of having more vermillion visible at the corner outweighed having potentially a scar there. When I asked whether there was something about Haworth's technique that made it different than what he would do...I wish I could tell all of you exactly if the answer was a clear yes or no. He generally seemed to say that the technique he himself would use would produce as good a result as one could get, which doesn't mean it is the same as Haworth's. I should add hastily that I cannot say whether or not Haworth's technique is the gold standard by which others should be measured. I just know we have some examples here of Haworth's lip lift work that are outstanding. (And we have examples of other's work that is also good. ) I am intrigued by Haworth's dividing up the type of corner lip lifts into several types. To my inexperienced eyes, that is either innovative surgery or innovative marketing. Or both.)
Overall, I am thrilled with my result, although I still have a ways to go until I have the ideal mouth that I would love to have. I think my scar is almost invisible already. The fact that he identified a small spot where I might have a thicker scar in the future didn't phase me. I will just do a tiny revision if it bothers me.

I will post photos in the future when there is a noticeable progress.

Photos 8 days post op

I thought I'd let you see where I am now, 8 days later.
As you can see, the corners of my lips naturally turn under by about 5mm on each side before they turn down. I want to revisit a corner lip lift in the future. I am showing you close up to let you see the small incisions, a view of what my lip looks like when my teeth are clenched together and also what my smile looks like with this lip lift.

Before/After Direct Comparison 11 Days Post Op

I find it useful when people post side by side photos.
Before -- 22mm
After -- 15mm
8mm taken off.
Surgery Performed 11 days prior to this posting.
Still swollen at nose and upper lip.
Corners of lip are naturally turned under and I may address that later or live with it.
Incision is a thin red line directly under the nose. The incision on the outside of nostrils (lower side -- surgeon did not cut high) is completely not visible.

2 Week Post Of Photos taken with iPhone 6s

These photos are bit misleading in that the angle (for the non-profile photo) makes things look more distorted than they really are. That said, the nose and upper lip are still swollen, more so in the mornings or if I have a salty food item like I did today. Today, because of being a bit more swollen, the nostrils seem to differ. Upper lip feels stiff near the nose. I took photos using the iPhone 6s which is so good it shows pores. The photos are not flattering, but I used it to show the scar that a person can expect 2 weeks out. When I speak, I can feel the stiffness of the upper lip and it inhibits overly using the mouth. If you get this procedure, expect the recovery to sometimes stall or even go a little bit backwards and then go forwards again.

Another iPhone 6s photo 2 weeks post op

This is a photo with teeth clenched. I wanted to show that in repose, the lips have a tiny gap. This is probably a more realistic portrayal of how people would experience my scar at this stage and my swelling, which still distorts upper lip and nostrils.

19 Days Post Op: How Swelling Changes From AM to PM

I wanted to give folks an idea about the swelling changes that occur each day. In the mornings, I wake up to a nose and upper lip that is more much swollen than I had the night before.
In the photos, the first photo is the swollen photo and in the second, it's a photo of my lips and nose 8 hours later.

3 Weeks Post Op

I had a meeting with Dr Baker today to review my progress. I showed him that I have a red, raised bump with a stitch poking out right under one nostril. He clipped the stitch and then took a tiny, skinny needle and aspirated the bump, i.e. took the fluid out of it. The stitch had apparently created a small reaction that looked like a red pimple. Now it is on the road to healing. I also had another small stitch poking out under the other nostril (but no pimple) which he removed. Please note that I was a non- compliant patients who picked off the surgical glue before I should have. I suspect this is part of the reason this happened. He is now suggesting that I get a scar gel from the local CVS (not Medera or whatever it is called because he said there are no studies that prove it works) but one that has silicon gel in it. He said if I do that, I will get rid of the red incision line faster.

I will return to him in two weeks for him to review my progress and get a post op photo taken. When I asked him about deciding on a second lip lift, he told me to wait at least until 3 months post op.

I still have swelling in the middle area of the upper lip and under the nose. It is also firm. He said to try not to make big mouth movements and to NOT massage the area until I reach 8 week post op. When I reach that point, I can start to massage it. He said that if I were to massage it or move my mouth extensively prior to 8 weeks post op, I risk having my body react by laying down more scar tissue. Don't want to do that.

So folks, if you decide to do this, buckle up. The healing takes awhile and it is in the middle of your face. You have to be emotionally prepared. If I were a rich woman, I would have had the surgery and gone on Outward Bound trip for two months so I could hike and never be around a mirror.

PS I am not posting a photo of the pimple. You all know what a big red pimple looks like. lol

Scar status: 3 week post op

At the request of some folks, I am uploading 3 close up photos of my scar, using iPhone 6s. Alas, it will also include the dreaded pimple. (Sorry ahead of time for the yuk factor. On the positive side, I can already tell it is on the way to getting healed.) When I go out and want to hide the incision that is under the middle of the nose, I use the either Murad Invisiblur Shield or Anthelios brand, both of which are both sunscreen and reduce the appearance of pores. But in my case, I don't use it for pores, I use it for the indentation of my scar. These products act as spackle over which I can put a foundation without the foundation getting caked into the incision.

Scar fading dramatically

Dr. Baker suggested I apply Scarguard (or something like that) to the lip lift incision to help it fade. I've dabbed it on two nights in a row and, to my shock, the redness of my scar has dramatically diminished. Now, this could be a case of correlation and not causation. But on the chance that it's causation, I am going to continue to apply it at night.

Swelling Update 26 Days Post Op

By the end of today, I realized that the swelling along the philtrum, which had caused my upper lip to protrude unnaturally (something the photos did not capture) was dissipating. I am now hopeful that I may attain an almost completely normal appearance in a few days. Dr. Baker's staff had told me that by week 4, the majority of swelling would be gone. Frankly, as of 4 days ago, I didn't see that happening at all; my swelling was stubborn and I was starting to worry. I am glad to be proven wrong and the doctor right. With the swelling diminished, my lips are less sloped, i.e. rabbit-like, which is good.

The corners of my upper lip remain, obviously, turned under, giving my at-rest mouth a sad look. When I tug up on the corners to show vermillion, the improvement in my lips is so dramatic, I think I really must get a corner lip lift. The only remaining question is which doctor to use.

I will post a photo on Tuesday, which is exactly 4 weeks post op.

Pimple is Back. (Sigh)

Remember that pimple that Dr. Baker addressed, which appeared around a stitch? I thought it was on its way out permanently after Dr. Baker had snipped the exposed stitch and drained the fluid from the aforementioned pimple. Alas, as of tonight, it looks like the pimple is back with a little yellow fluid. No sign of stitch at this point. I believe this is a spitting stitch situation. I will call Baker's office tomorrow to see if I need to do anything special or just wait it out.

I decided to post about this so that anyone going through the healing process will know that healing isn't a linear process. It moves forward and sometimes backward.

One Month Post Op Photos

The swelling by the philtrum is down but it is still noticeable. The same suture that the doctor clipped last time, which had caused a little cyst (pimple) is back at it. That is, the part of the suture that was still left inside of me is trying to find its way out so another little pimple has been created. Grrr. I don't dare pull it out. Must just wait.
My mouth moves more easily now.

Emotionally, I am wishing that I was one of those miracle healers who at one month out looks totally normal. But I suspect it will take a few months longer.

The incision line is pink and can be covered with make up to make it look not quite as pink.

The distance holds steady at 14.5mm, down from its original 22mm

What Boyfriend Noticed That I Did Not

My boyfriend came back into town after being away for a month, so this was his first time seeing me since the surgery. He observed that when I speak, my upper teeth are now very visible. Before the surgery, this was not the case at all; I had to laugh or smile very broadly for my teeth to be visible. According to him, it is a huge improvement and very youthful. (Given that he is many years younger than I am, this is an unexpected bonus.)

Swelling coming down, now wearing Scarguard under nose

Swelling of the philtrum is coming down. I have ScarGuard on my incision. My corners are still in need of a corner lip lift.

4 weeks, 2 days post op photo

I hope you folks can see how the swelling of the philtrum has come down a bit.

Tooth show photo

Here is me mimicking talking so you can see the toothshow.

2 month post op

I went to Dr Baker for my 2 week follow-up.
Here is where I stand:
1) There is still a slight pink scar visible directly under the part of the nose that is between the nostrils. (Not sure what that is called.) Other than that, no scar is visible.
2) In the AM, I continue to wake up and am more swollen, but it pretty much resolves by late afternoon. I am told this may continue for several more months.
3) I am still right under the nose but am told this will go away in 4 month or more.
4) I was 22mm before the procedure and am 14.5 now, which is what I was the week after the operation. He told me it would stay this length, except for the normal aging over the coming decades. If I want to remove more, he said to wait until at least 6-8 months post op (preferably 12 months post op) to see the final result and then judge if more can be taken off and achieve a better result that does not distort nostrils or give a rabbitty pulled up in the middle look.
5) At rest, my lips are a tiny bit parted. The upper lip is still too long to have tooth show at rest. However, when I speak, I now have tooth show of my upper lip which is much more youthful appearing.

The doctor's assistant took photos with a camera designed to give proper close-ups. I asked to get those photos emailed to me. When I get them, I will post them.

Doctor Photos Pre Op + 2 Month Post Op

I received small versions of the photos that the doctor's office took of me pre surgery and at 2 month post. I still have swelling and tightness under the nose. At this stage of the recovery you can see that there is some nostril distortion. My nostrils (which were not symmetrical before the surgery) are slightly enlarged and the assymetry is now more exaggerated. From the profile shot, you can see that the lip lift has pulled down my nostrils. Because I am still healing and I can feel hardness and tightness right under the nostrils, I am going to reserve judgement and hope that when it all resolves and the scarring internally has softened, that the nostril distortion will be diminished.

At 14.5mm (from the original 22mm) I believe it is an improvement, but I still believe my upper lip is too long and I still believe the corners need to be addressed. I suspect I will have a second lip lift (assuming the nostril distortion will go away) in about 9 months (as the 1 year mark) and will look into a corner lip lift.

I have also included a photo of the scar that remains. It is light pink but under the nostril that is more distorted, the scar inside my nostril is much thicker, with an almost pimple like feel, which I believe is why that nostril is more distorted than before the surgery. I remain hopeful that in time and with massage (and other methods) that one scar in that nostril will thin itself out and that one nostril will not be as distorted. I will post again at the 6 month mark or 7 month mark, hopefully to show that the distortion is going away.

I should remind folks that when I had the operation, I had a cold (don't do that!) and the sniffling and runny nose ended up making me pull off the surgical glue prematurely. I also had a little stitch that poked out under that one nostril that is enlarged. So I think my failure to be compliant vis a vie the surgical glue helped create more scarring than would have normally been there

Makeup Coverup Tip

I just discovered a great way to cover the incision. All the makeup I had been trying before was just not working well for me. Here is what has finally worked for me:
Step 1) I first put on a pore minimizer. I use this Murad Invisible Perfecting Shield which has SPF. There are a lot of brands out there so you can choose what feels best.
Step 2) I bought a Bobby Brown concealer set that had the concealer and the color matched setting powder. The latter is crucial. I used both and blended up into my nostrils a little. (Sounds weird, I know.)

Step 3) Go out in public with confidence. The make up stays in place for a long time, much longer than the other concealers or foundation I had been using.

Before After Photo of Profile, 3 month post op

I think that the lip on profile looks better. But you can see that my nostrils are pulled down a little. Hopefully, at 6 months to a year, this won't be the case. I retain hope it will look better because there is still tightness and hardness under my nose.

4 Months Post Op Update

Swelling:
The swelling has diminished from month 3 to now, month 4. The only time I feel any bit of swelling is in the AM. The area under my nose is still a little tight.

Scar: The scar has also gotten better. I have not been doing anything special to make the scar improve, with the exception of a week of using scar gel, which I did a few months ago. Frankly, I have to pull down the skin to really see the scar, which is now minor. A small part of the scar is still raised. (This is where I had the stitch come out.) I do feel like there is a slight line visible in the area of the skin that divides the nostrils.

Nostrils: It looks as if my nostrils are back to normal. The assymetry you see in the nostrils was there before the lip lift. (Although the pics confuse me. It looks as if a different nostril is now larger post surgery than before.)

Fraxel: I will look into fraxel for the remaining bit of scar, but I won't do that until after 6 months and I have the "ok" from Dr. Baker.

Corners: I am going to pursue a corner lip lift in April, 2016.

MM: I originally had a 22mm upper lip. Had about 8mm removed. My upper lip is holding steady at around 14.5mm. (I know. The math doesn't quite add up.)

Verdict: I think overall it has been a success, although I am still healing. No, I don't suddenly have perfect lips from this one procedure; I simply have a better version of the imperfect ones I had before. I have achieved a modest reduction of the overly long space between my nose and lips and I have a little more vermillion show. When I am 8 months post op, I will go back to see Dr Baker to discuss whether taking off an additional 4mm would be an aesthetic improvement.

Upper lip is now 16mm

My swelling has continued to go down and I am looking more and more natural, although I still have some pinkness at the scar. I measured the upper lip and it looks like it is now 16mm. So it has dropped about 1mm. Hopefully, it won't drop any more. I continue to think this is a dramatic improvement on my face and will consider a second lip lift later.

I plan on getting a medialized corner lip lift on March 10, 2016, which I am crossing my fingers will leave me with acceptable scars, although there are no guarantees -- it is surgery, after all.

March 10th Corner Lip Lift Count Down

For folks that are interested, my surgery for a medialized corner lip lift like the one anon101010 received, will be performed on March 10th. Stay tuned.

External Medialized Corner Lip Lift

I just had the surgery at 10am PST March 10th 2016. I decided to write a seperate review since it was with a new doctor. Look for it once RealSelf clears it for posting. But bottom line, so far so good. I will post picture here but for the whole experience, check the other review.

See my "Lip Surgery" review for details on Corner Lift

RealSelf doesn't have a category for External Medialized Corner Lip lift, so I labeled my review "Lip Surgery." This is where I will be posting the details of my surgery and recovery. I decided to do this because it was 1) a different doctor and 2) some folks may just want to know about corner lip lifts.

Corner Lip Lift Review

Go here for my review of my lip lift. I am 10 days post op.
https://www.realself.com/review/beverly-hills-ca-lip-surgery-external-medialized-corner-lip-lift-journey

Corner Lip Lift Day 13 Post up

Getting better. Still a little swollen. Redness fading to pink. Notice the vermillion is now reaching to the corners and the corners are not as downturned.

7.5 months Post Op Upper Lip Lift and 2 Months Post Corner Lip Lift

Scar under nose fading. Still feels tight under nose. Still poofy upper lip area. The corner lip lift is coming out well but it is still tight and hard on the incisions from the undissolved internal sutures. The area at the very corner is still a work in progress. It is red and raised and will probably take another 5 months to heal with the help of a few more lasers. I have mixed feelings about this whole process. I wanted a natural look. While I think the overall impact of the lifts is more harmonious, I definitely look like I have had work done. I sure hope that by the time a year has passed, it will look less "done."

Hope

Two days ago, I went to a dermatologist who used laser on the redness under my nose and around my upper lip border. She also used microneedling on the edges of my lips where I had a corner lip lip and on the scar under my nose. Both helped.

Today, I noticed that the puffiness I've been seeing on my upper lip area (the area that I felt looked teeppee -ish and made things look "done" ) has begun to actually look normal. The vermillon of my upper lip is starting to move a bit more naturally. I am now confident that I am on the home stretch to a normal looking upper lip that looks better than it did before both surgeries. I will post photos in about a week or so when the bruising from the laser for redness goes away.

8 Months update

Here's a photo of my profile. As you can see, the nose is not as pulled down as it was before. Also, my upper lip area has more of a convex curve which is more natural. The scar under my nose has diminished but I've been working on it. The measurement is holding at 16mm. It was 22mm. Ideal is closer to 12mm on me, but I think I will wait to go through another So things are getting better. Again, Dr. Baker said it would take up to a year for all the changes to take place and he was right. It is not finished healing but I am in the home stretch.

Almost a Year Post Op

It's been almost a year post surgery. My scar is now undetectable, unless I pull down my upper lip. Then, the slight white scar under my nostrils becomes visible. Given that I never do that in my day to day life, I can basically say I have no scar. However, to get to this point, I spent a few thousand dollars by going to a fancy dermatologist here in DC ( 4 times) and used several types of lasers as well as microneedling to tackle redness, the raised areas and texture.

Overall, between the upper lip lift and the corner lip lift, my appearance has improved, although the difference is subtle. Frankly, at 16mm, my upper lip is still too long and I've decided I need to do this procedure one more time to get the optimal result. But I know now that for me, the healing really does take almost a full year. When I do this procedure again, I will post about it again. I will post photos of my lips again exactly at the one year mark. (And will do so with a Laika camera.)

Latest photos

This really is the final result of my lip lift. There is a very light scar. Not very noticeable. I think the scar widened a tiny bit recently. Glad I did the corner lip lift as well, although wish I did it at the same time at LL so I didn't have two recoveries. I am very happy I did this procedure but feel I would look better with an even shorter distance. My current 16mm upper lip distance -- though a huge improvement to what I had before -- is still longer than ideal.

Close Up Photos 1 Year

I used an iphone 7 to take these photos to try to get a realistic look at the scars. No makeup
Washington DC Plastic Surgeon

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