Q: Dr. Eppley, I emailed you previously about a lip lift I received from another doctor at the end of last year. I was very unhappy with the length of my upper lip which has not changed since. I have another new issue now, my scar. It has come to my attention that it has recently widened and thickened. So now I have a terribly high lip, and also a terrible scar! It’s been a very terrible emotional roller-coaster for me, as you can imagine.
You were very nice and helpful when I reached out to you initially for your input. So i wanted to reach out to you again for your opinion on some research I’ve been doing to potentially help my situation.
I was wondering what you thought about performing a z-plasty scar revision on either side of my columella, the would essentially help thin out my scar, and ALSO potentially lengthen my upper lip, while partially camouflaging the scar within my philtrum creases (if this makes sense).
I’ve attached a few recent photos of my concerns, (sorry i don’t look overly enthusiastic in my pics!)…. I’m curious if you think this could work for me, of course in a few more months time (possibly a year), I do realize I’d have to wait before I do another surgery.
A: I remember your upper lip lift concerns from just a few weeks ago. While it may seem like an eternity to you, you are still very early in the healing process. I would not expect any changes in your upper lip length at this point. This is a process of 3 to 6 months, not 3 to 6 weeks after the procedure. The only thing you can and should do at this time is use your tongue to push out the upper lip under your nose as a form of upper lip stretching.
In regards to any form of a z-plasty scar revision, this is a procedure that lengthens scars by changing the scar line in z-shaped pattern. Besides the issue that this will not really be effective for upper lip lengthening, it will also creates more scars that would become even more visible than the scars yo already have. The philtral columns are not a crease but a raised skin ridge so this is not a good place to put any scars. Therefore, this is not a viable treatment approach for your concerns.
The most effective strategy for your lip lift at three months after surgery is to do either fat or PRP injections underneath the scar/nasal base followed a month or two later with a scar excision/re-closure. This will give your lip plenty of time to relax, drop a little and give the tissues more healing time to better respond to scar revision.
Dr. Barry Eppley