LAM FACIAL PLASTICS

Hi doctor Lam

First off, let me start by saying that until I found your website, I was completely hopeless about the state of my lips. More than 10 years ago, my dermatologist suggested that I "even" out my lips by injecting fillers. He started with collagen-which had no real effect. The next time he suggested a 'cocktail' of fillers assuring me that it was completely safe and would have a subtle effect. I guess I should have been suspicious when he asked that I pay cash for the 'cocktail' treatment...I was young and figured that the worse thing that could happen was that my lips would look silly for a couple months and then go back to normal.
Now, all these years later, my lips have looked more and more deformed. I have an especially large bump on the lower bottom left corner and I am petrified that my whole mouth will eventually look the same. I have had total strangers stop me on the street and ask what happened to my lip-if it was an accident or some sort of contagious condition like a cold sore. I even had one woman suggest that I get it biopsied because to her it definitely looked like skin cancer... I am completely humiliated and becoming more and more socially awkward. I used to feel confident and beautiful but now I am always convinced that people are wondering what I have wrong with me. My job requires me to meet and impress new people all day and I feel like my ability to do so is compromised.
Please, I would love to hear that there is hope for me. I have been to two dermatologists and one reconstructive plastic surgeon in Los Angeles where I live. If there is a light at the end of this long tunnel, I would travel to Dallas to have you treat me.
Do you have a private email so I could send you some pictures? I've included one here, but since I am all the way on the west coast I would like for you to have a clear idea of what's going on....
I await your expert opinion......thank you.

fortunately, i fix lips like yours (often 10x worse) almost every other day. your situation is not hopeless. it is something that i can help you with. you can send photos to my private account here. just click on my name and send it as a private message.
hope to help you.
best,
sml

Hi Dr Lam

I've been trying to send you other pictures to your private message, but it keeps giving me the file invalid message. Any other way to send them? Or is there a fix to this message board prob?

ok, send them to my personal email address: drlam@lamfacialplastics.com.
best,
sml

Dr. Lam, I am very happy to have found this forum. I am writing because, as the previous writer, I am desperate to find a solution to my lip problem. I live in NYC and do not seem to find any doctor who can give me an answer to my problem. I had a filler injected to my upper lip about 12 years ago when I was very young and unaware of the problems with these things. I was told it was duck collagen but I am not sure. It was in South America at a Spa. I was pleased with the results for the first seven years though surprised that it did not reabsorb. The last several years, my upper lip has looked increasingly horrible, it looks as though I have bubbles on the surface and they are just large and not attactive as the lip has the same size in the middle and at the edges..like an awful sausage. I even had lip reduction surgery last year. The surgery was succesful in that it reduced the size of my lip but I now have another bubble like thing on the surface and it has grown back. I am desperate to figure out what is wrong. can you help? please tell me what to do!

hi,
if your body is reacting to it, then you have some kind of unusual product in there that should be managed. i have heard 5FU can help unusual reactions but i have not used it to this end before. if it is just an enlarged lip or an improperly reduced lip, then a surgical revision is in order. i would have to review your case.
best,
sml

Thanks for your reply Dr. Lam. The surgery should have reduced at least the size of my lip permanently and my surgeon, Dr. ---- agreed that it had grown back and said that the pathology report of what was removed suggested Chornic Sialadenitis. I would consider additional surgery but of course, I am very concerend that it will grow back and develop more surface "bubble-like" or blister type appearance or that it will look more deformed than it does now. Any suggestions? This feels like an episode of a science fiction movie

Kind Regards.

hi,
i reviewed your private history, your photos, etc. I think I have a feeling what is going on. First, I removed your doctor's name out of courtesy to him. I believe what I am seeing looks very much like mucoceles, which are trapped salivary glands, and that is what your pathology report indicates. I have done hundreds of lip reductions and have encountered a handful of mucoceles but nothing to the level that I am seeing in your lip. Unfortunately, if they do not resolve by themselves, the only treatment that I am aware of is another reduction.

I have a good feeling that if I did your reduction you most likely would have fewer mucoceles but could not guarantee that you would have none. I would also take care not only to reduce your lip but also carefully remove any mucoceles I encounter. I think the reason that I see so few mucoceles besides being lucky is that I tend to be very careful when dissecting near the glands.

I have a good feeling that I can help you but obviously I cannot guarantee anything. I hope that makes sense as a start.
best,
sml

Thanks Dr. Lam. I am wondering if these mucoceles that you see are inside the lip as I cannot actually see or feel them and a google search showed me something very different from what I have. I may not understand the physiology behind this so that is why I am asking since my problem is basically what you see on pic#2 of my email (surface, not inside)....are the mucuceles resulting in that swollen apperance on thesurface of the lips?.... I would like to take the next step in terms of maybe speaking with you on the phone and/or contacting your office for a price quote. Regards.

Yes, these mucoceles are in your lip. If you would like a phone consultation/surgical date please call 972-312-8188 or 888-866-3388 tomorrow morning after 9 am CDT. Boarding a plane to run a course in St. Louis so will be incommunicado in a few minutes. Look forward to take care of you.

Dr. Lam, Thanks for your email. I will call your office tomorrow AM to schedule a consultation. I am attaching a pic. here of my lips (close up). My concern is not so much the size of my upper lip (the one with the problem) but rather the surface of it. It seems as though the ridges (not sure if that is the right term) are full of air or simply inflammed... My lip is soft, does not hurt, and if I press down on the areas that look like inflatted bubbles (but are not), they just go down as if it was a balloon that is getting defated, then it fills up again and it hangs. Most TERRIBLE thing I want to change about my lip is the way it looks from the side. My profile looks as though I have something hanging. If you can help with this I can fly out to Dallas. I am sorry about the long message Regards.

to be clear, i think your upper lip is too big vis-a-vis your bottom lip and would merit reduction. in addition, i think the hanging effect of the sides is definitely causing it to look unnatural. the little lines will be harder to manage but i can work on them i believe to soften them. the deflating inflating thing i am not too certain about honestly. i think overall i can help you but i want to make sure that i can regarding the inflating deflating aspect.
best,
sml

Dr. lam, do you ever recommend cortisol shots on the lips to reduce swelling ... I am asking in particular because I wonder if that is the solution the surface of my lips ..I realize the other part needs surgery and I took care of all paperwork, payment etc to have a call with you this friday AM. I am just anxoius to figure this out asap and very afraid that my lips will get further damaged...

i find steroids to be risky and ineffective in most cases so in short no. i tend to use 5-FU for scarred tissues but not for mucoceles. i really think a lip reduction with a focus to remove the mucoceles should be considered in the future.
best,
sml

Dr. Lam, I had a biopsy of my upper lip and they found no mocouceles but rather chronic inflamation, due to silicone. I had no idea that what was injected was silicone I was told something else but I am not surprised to hear it. This was over 12 years ago..what can be done now? prior surgery did not remove the swelling, bubble-like look, and I am feeling hopeless, what is it that you would do? It is not the size but the top of my lips (the surface) that look strange and like little sausage links. HELP! I need to figure out what to do.