LAM FACIAL PLASTICS

Hi Dr Lam,
I am most impressed by your web site, expertise, and detail in facial surgery. I am an African American female and had lip reduction done 7 weeks ago. It has been a difficult recovery for me because there is asymmetry of tthe top lip. I also have lumps some are fixed and some move slightly under the skin. Believe it or not these are not my greatest problems. The swelling was significant but did subside within a reasonable time. I have tingling, numbness, my lips always feel dry to me but are fine to the touch they also look very dark in color compared to before. My lips feel very tight the only description I can think of is that they are pursed or puckered and bound with a rubber band. This happens mostly after sleeping or if I haven't been talking or eating for a couple hours. Consequently I have to open my mouth slowly and do mouth exercises until the feeling goes away. I also have an area in the center of the upper lip on the inside that pulls and prevents me from smiling fully. To me it seems as though the frenulum that stretches from my gums to the inside of my lip is always pulling to one side. I completely understand that it takes three months to completely heal. For me six weeks later there are days where I feel as if it is getting worst. The only reccomendation the doctor has right now is to massage my lips. I am trying to be very patient and hope that this inquiry is not too premature. In your opinion and experience will any of this resolve? Is the feeling of tightness when at rest nomal? As for now it does interfere with me being able to sleep. Will the lumps go away on thrie own? Will my lips ever feel normal again? I realize that the top lip especially will need correction. At this point I feel very dissapointed and regretful it may be due to my lack of knowledge. I have tried to do resarch and have been unable to find any information about the specific issues which I face. I hope you can help and give me a bit of insight. I hope to consult with you in the near future.

Thank you
:(

Hi,
I am sorry that you are going through so much discomfort. My patients really don't go through all of that. I am not too certain how the lip reduction was undertaken. I know that I had one patient who had a lot of swelling afterward that lasted about 3 months and now is just gotten smaller than before her surgery. That is unusual though. Some numbness is normal and will probably take a few months to get there.

Oftentimes, we are obsessed with asymmetry after a procedure when it really is not so bad. Please read my blog on symmetry. Go to the LFP blog and find that blog entry. It is important that you read that.

I really have not had a patient complain of tightness. Perhaps I remove less than your physician does or my patients are not as vocal. I think at this point you should try not to get in an obsessive mode about your lip because negative thinking will only hurt you. Try to focus on positive things and let the lip heal. Take all your mirrors away and stop staring at your lip 100 times a day. I am just trying to help but please read my symmetry blog. You have to search a bit for it since it is archived far back.

Best,
SML

Hi Dr. Lam,

I had a lip reduction done in 2002, and I do have permanent asymmetry, particularly in my upper lip where the two sides are not even in size or shape.

I would like to ask you if I were to undergo a revision, are the chances of asymmetry still the same as for the original surgery?

Thank you.

PS, to the thread starter, don't worry about the lumps and tightness. I had the similar hardness and tightness as you, and they went away with time. After about six months, my lips felt normal again. However, I do have asymmetry so if you have asymmetry now, it could be permanent. I noticed the symmetry as soon as the day after the procedure. The surgeon told me it was just swelling distorting my lips, but the asymmetry remained. Checking my scars inside the lips, the shape and location of the incision look very different on the two sides. I hope that's not the case for you.

perfect symmetry is always elusive. however, i should hope to make your lips more symmetrical without a guarantee. you can watch my video on symmetry under postop video companions (self perception) to help you understand how sometimes we are too obsessed with symmetry. if yours is obvious, we can work on it.