Can My Subnasal Lip Scar Be Improved?

Q: Dr. Eppley, I had a subnasal lip lift last month and I hate the scar that has resulted. The scar is around 2mm height, goes from one nostril to the other and is indented about 1mm in depth. Would a scar revision help and would it cause any change to the current lip shape? (I want no more changes only want the scar removed) Another surgeon told me fat grafting to the scar can help. Is it true? How would a scar revision differ from the original cutting technique and closure? If it is the same, would  it will lead to the same problem? Thank you again for taking time to answer my questions.

A:  In theory scar revision may eventually be helpful but it is too early to make a final judgment on what your scar will look like in its mature state. But to answer your specific questions, any scar revision would not change your lip shape long-term. There is always lengthening and relaxation of the lip even when 4 or 5mms of vertical height is removed. While I love fat grafting and it can be very useful for many facial volume problems, I fail to see its benefits in your subnasal lip scar concerns.I would not think that any type of scar revision would be radically different from the initial procedure…other than less tissue is being removed and that places less downward tension on the scar. That may may the difference in the outcome. 

The most useful comment that I can probably make is to not jump too soon into doing anything, particularly in the first months after surgery. The tissues are chronically inflamed and will not respond well to manipulation no matter how well done or cleverly designed the procedure will be.  Ideally, you should wait it out for six months before having scar revision (if eventually needed) and allow all tissues to heal completely and undergo scar relaxation.

Dr. Barry Eppley

Indianapolis, Indiana