Hi Dr. Yang – I had fat transfer to my lips about 8 years ago. My upper lip ended up asymmetrical, with one side thinner than the other. Not very pretty. Now that I’m older I would like to have it corrected, also my upper teeth barely show at all anymore. Even when I smile. My PS has done a few tiny injections of lipodissolve into my lip, with little change. (also stings like the dickens, and swells embarrassingly) Do you think a surgical lip reduction could help me? Have you ever done such a correction? Thanks for any insight!
Be careful with additional mesotherapy type injections, since skin necrosis is a possible side effect. The last thing you want is for this to happen to your lip. Google: “mesotherapy skin necrosis”
A surgical lip reduction is a possible option. It involves incisions on the inside of the lip, the mucosa (the non-skin portion of the inside of the lip.) For people with generally thick lips, soft tissue which can include some lip muscle, fat and also some mucosa can reduce the lip, and roll the thicker portions of the lip inwards to give the appearance of a reduced lip. In your case maybe the incision from the surgical lip reduction can be use to try to remove some of the excess grafted fat, depending on the location of the fat transfer. The other possibility is that the transferred fat is so blended with your lip muscle/lip soft tissues, it is impossible to distinguish what is grafted fat, and what is your original lip tissue.
No, I haven’t performed this type of correction. Removal or reduction of excess fat from Fat Transfer is very difficult in general. However, since the incision can be performed on the inside of the lip, instead of an external skin incision, that’s a good thing. I don’t know how difficult it will be to “trim,” contour” and reduce the excess fat.
Since I’m usually the voice of caution for people prior to considering procedures, I’d like you to consider that if the assymetry is not obvious, then consider leaving it alone. It’s like when someone gets “bangs” for their haircut. If it’s slightly higher on one side, the hairstylist/barber can even it out, but then the other side is higher, then they fix it again, back and forth, until the person has no “bangs” anymore. They look worse after all the attempted corrections than they did with a slight assymetry of the bangs. I hope that analogy makes sense. Another analogy is when table legs are uneven, and the carpenter keeps trying to even out the legs and ends up with a “coffee table.”
It is actually quite easy to cut hair or cut wood, but trimming soft tissue that has been injected with local anesthesia and swollen is much more difficult to get it very symmetric. But if the assymetry is really bad, any amount of reduction should at least bring an improvement in symmetry, but getting perfect or close to perfect symmetry will be very difficult. If some improvement is your goal versus perfect symmetry, then I think it is worth exploring.