Hi,
I just finished your long PM to me and obviously feel your pain. I am sorry that life has been unkind to you in many ways. However, I am glad to hear that at least you have a good support network (son and husband). There are few things that I want to say to you. First, let's begin with the "physical" problem then we will go to perhaps something more important, which is your perception of it.
I clearly see the problem. However, a realizable solution may not be that easy in anyone's hands. I just took care of a lady pro bono who had a lower lip scarring from a burn injury in which there was just a massive amount of scar tissue. I just saw her last week and she looks much better. In your situation it is not too much scar, it is that the area has been contracted inward and is a bit tethered. I don't know if any of the solutions would be worth it for you. The two that come to mind are a red lip advancement into the white lip but I can't tell you for a fact that would work in light of the scarring. When it is truly tethered, restylane would probably be hard to create much vertical show to the red lip that is red lip height. Two more options would be to cut out the contraction in a vertical wedge fashion but that would only further contract the lip horizontally. The third option which is a big one is to do a cross lip flap to take tissue from the upper lip and transpose it to the bottom lip. Since I do not do cancer operations anymore it is been a long time since I have done one. I don't know if that is the best solution either. The white scar on your upper lip does not make me feel comfortable to cut across there. Your blood supply may lead to flap loss which could be devastating.
I know that i have given you a lot of options but none of which is necessarily safe or ideal. I know you are from Australia so it would be difficult to come to see me here also given that this would probably require multiple smaller things to get the job done. It is always a wrong thing to do to give medical advice in this forum which, as you know, is not the intent. I really wish you could find someone who specializes in facial cancer reconstruction, whether that is a facial plastic surgeon or a plastic surgeon. I just probably should not try to outline too much of a course of action for you given the limitations of what this forum is all about.
I will say this much. There are certain things in life that we simply can't fix. There are certain things in life that we simply can't improve. My father was born with a debilitating bone disease that ultimately took his life at 76. I can't remember a day after the age of 40 for my dad that he was not in pain. He sometimes got down about it but he always showed me the courage and bravery that I think most of us would not have had to deal with it.
I wrote a blog last week called "the Freedom of attitude". Instead of rewriting the whole thing here, I would ask you to read it. Here is the link:
http://www.lamfacialplastics.com/lfp-blog/archives/314
In short, Victor Frankl who was a concentration camp survivor could tell when the prisoner would soon die because he gave up hope. He gave away his food for cigarettes. Frankl instead focused on his getting back to Austria to teach again one day. And guess what he did. What he said was that when all freedoms are taken away from you, you have only one freedom left, your freedom of attitude. It is only your choice of how you deal with this situation and no one else's. My mentor, Ed Williams, told me that "happiness comes from inside", meaning that no matter what anyone should do for your condition (and I don't make light of it), only you will ultimately find happiness from your own perceptions. No surgeon no matter how good he is will give you that freedom. Only you will. I have learned that the hard way with some patients who are chronically miserable. They won't admit it but they ultimately wallow in their own misery and seek to sustain that misery because that is part of their own identity now.
Only you have the freedom to turn a terrible stigma of your past into something that you can wear with pride and say, "I survived this." I am now a stronger person. Only you can look at your own imperfections and say, "Boy, I am a survivor and am taking this journey day by day. I am thankful to the Almighty that I am alive and I will never forget this scar on my face that is physical proof that I am a stronger person because of it." Or you can take the other road and seek correction. I am not saying not to have it corrected. However, seek what you can to do it but don't let it become an obsession. Don't let it consume you. Use it as a way to make yourself a better and stronger person. Perhaps, you can use your strengths to teach others. If you can get out there and speak to others who may be in your same plight, you might find the freedom from it. If you seek consultations until you drive yourself crazy, you will ultimately fall victim to your own desires. Remember the law of attraction. the more you seek out correction, the more your mind enters into a deep abyss.
Open your mind to the fact that you are alive and well. Read Lance Armstrong's book, "It's Not about the Bike" (just finished it). Read the late Randy Pausch's book "The Last Lecture" (just finished it). Put perspective on your situation. I wish you the best in whatever you choose. But remember it is not a surgeon's choice.
It is entirely yours to make.best wishes,
sml
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