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Scohr

Excision messed up my smile

Had an excision a couple years ago to remove a fairly large acne scar off the side of my nose.
The plastic surgeon essentially cutt off a couple of cm of skin and then sewed it to the side of my nose. My smile line on one side now starts about an inch lower than the other side (on the left side of the picture it starts mid nostril, on the right side it starts above the nostril)

I've seen a few different derms and plastic surgeons. Some think the swelling caused protein and collagen to build up on the side, thus affecting the smile line. Others think removing the skin changed the tension on my face. Regardless it's worse.
Has anybody heard of this happening and heard of any solutions?
 

IMG_0149.PNG

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Im really sorry to hear about this. Did the dermatologist offered any possible solutions? I have researched a little about possible treatments, and it does appear excision is very hit and miss. The problem is if you are not a good healer, then this can backfire. I really hope you find a solution to make you happy. 

 

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3 hours ago, ScarRight said:

Im really sorry to hear about this. Did the dermatologist offered any possible solutions? I have researched a little about possible treatments, and it does appear excision is very hit and miss. The problem is if you are not a good healer, then this can backfire. I really hope you find a solution to make you happy. 

 

Thank you. Yeah he injected a steroid in the area which didn't do anything. And then offered to do the other side to make it match -_-

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To be frank your smile lines / nasolabials look normal to me, this is what happens as we age or loose fat. Most simply inject further up by the temples to pull it up. I would not mess with it to much or things can get worse as you have seen. 

Here are your choices.

  • Have a plastic surgeon reattach the skin on the proper stress point / axis. 
  • Use HA filler to overcome the imbalance
  • Put filler farther up the crown of the cheek on the bone. Pull up the skin towards the temples to see what it looks like. 
  • Use a energy device to thin down the fattier area of tissue to match the other area.
  • Botox for non-movement of your facial structures. 
  • PRP injections for imrprovement in the area

All of this must be done by  a experienced practitioner who understands facial anatomy (plastics should know this). There are arteries / veins around this area, you cannot just fill the smile lines / naso labial folds. 
 

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Honestly, it is very hard to see what you are describing.  Granted the pic is quite blurry and dark.    I agree, you can try a filler first to the more hollowed out side and hopefully that would reduce any asymmetry.  

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Difficult to assess without animation. Once again BA has it covered, if I could add that if you see a Plastics or Dermatologist that understands the actual problem and can isolate (within reason) the muscles involved in animation, only 2-4 units of Botox can correct this. This goes way beyond normal cosmetic Botox, and in the realm of medical Botox. This is not uncommon, especially following skin cancer surgery when large amounts of tissue need to be removed. A good plastics or dermatologist will assess you at rest, and animation and formulate neurotoxin- fillers as required. Scar revision of a scar always carries the chances of more fibrosis. Most good - experienced specialist will be very conservative in this case.  

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