Lip Scar Revision

Q: Dr. Eppley, I am interested in a lip scar revision. I am a 26 year old female. My lips were very thin and I had gull wing lift operation on my upper lip in November 2013. The result was terrible with many scars on upper lift. I  have waited for recovery over 1 year and the situation did not change. I subsequently had two laser resurfacing treatments and a revision to reduce vermilion height with inner stitching. As you can see in my most recent photo,  my lips do not look natural and that disturbs me very much even with make up. I want to have better lips and return to my daily life. 

Now my doctor offers another operation this month to reshape the whole vermillion border of my upper lift. He will cut my skin in order to discard distorted surface and he will move down the top layer of the skin in order to elongate the skin layer until the pink line to shape the border.Could you please tell me whether it is possible to stretch the top layer of the skin to stretch down to the vermilion? Any kind of information will be very helpful, looking forward to hearing from you very soon.

A: Your upper lip scar revision poses a dilemma. While the scar can be cut out, it is not going to stretch downward. Rather the vermilion will move up to the top of the cut out. This is due to the tightness of the skin and the relative looseness or stretchability of the vermilion tissue. The operation will not work as you have shown or hoped. It will get rid of the scar but at the trade-off of a much fuller or bigger vermilion. For your lip scar revision I would think more about a subtotal scar excision and consider doing it in stages.

Dr. Barry Eppley

Indianapolis, Indiana