LAM FACIAL PLASTICS

Hi Dr. Lam,

Three weeks ago, I went to Korea and had paranasal implants using rib cartilage, also I had rib graft rhinoplasty using an open procedure. I have a scar on my columella.

I’m very satisfied with my rhinoplasty and the effects of the paranasal implants [it corrected my protuding mouth], however, the paranasals have caused my smile to be slightly deformed. The middle part of my lips does not really move while the corners of my mouth curl up (like the Joker). My upper lip became thin. The space between my upper lip and my nose has increased. Although I love my new nose, I believe the paranasal implants have made me uglier than before. I did not know about the risk of the smile deformation prior to my paranasal surgery.

I came across your website and love that you are a conservative, reputable surgeon. I am going to give myself 6months to one year to let my face heal from this recent surgery, but if my smile does not return to normal, I would really like to have a lip lift.

Can you please let me know if I am a good candidate for the lip lift; after healing properly, of course.

I’d also be happy to send photos.

• I heal easily from scars; what scars can I realistically expect?
• Will a lip lift interfere with any of these procedures?
• How long does it take?
• Can I go under IV sedation?
• Are lip lifts always drastic? I wish to have a very subtle effect, with minimal teeth showing.
• Will the lip lift change my smile, or ability to smile?

i am sorry to hear of your situation. i do not know if a lip lift would help your situation. it might be better to remove the implants. i personally do not like lip lifts in 99% of people. it changes smiles in unnatural ways and makes the upper lip look weird and balloon like. i only do lip lifts in older women who are willing to accept a scar (although typically they are not too bad) and who have very very long white lips that cover their teeth and very paper thin lips. i think even very subtle lip lifts look bad and that is why i really only perform them in the above type of candidate. i wish i could help your situation but i think the risk is too great with a lip lift.
best,
sml

Thank you for your honesty. Greatly appreciated!

Dr. Lam,

In your opinion, would my smile return to normal if I remove the paranasal implants?

If the muscles have been cut, I hear that the nerves don't grow back. So if there's a great chance that my smile isn't going to return, would it be useless to remove the implants? Thanks again.

when i do paranasal implants i do not cut the muscles so hard for me to say. sometimes the size and weight of the implant is what causes the problem. that is why i stopped putting large blocks in there because my patients also complained of the same problem. now i use diced cartilage which is less impressive but has not caused the smile issue.
best,
sml