Q&A

It is advisable to consider revision surgery at least 6 months after the initial surgery. This is because it must be performed once the surgical tissues have stabilized, the scar tissue at the surgical site has softened rather than remaining hard, and the swelling has subsided. Accurate diagnosis is only possible after the tissues have stabilized and the swelling has resolved; until then, scar treatment is administered first while monitoring progress. Depending on the condition of the scar, the decision may be made after continuing scar treatment for an even longer period.

It is best not to rush. In the early stages after surgery, swelling and bruising are present, and the tissues are still firm, making it difficult to judge the final shape; an accurate diagnosis is only possible once the tissues have stabilized and the swelling has subsided. Even if issues such as scarring or depression are visible, you should first undergo non-surgical treatments such as medication or laser therapy and observe changes over sufficient time before deciding whether to proceed with surgery. This is because making a hasty decision for surgery can actually worsen the condition. There are also cases where the condition improves with laser or medical treatment, making surgery unnecessary.

We first evaluate the condition after you undergo scar treatment for about 6 months. If, after that period, the scarred area is large, the shape of the scar is noticeable, or the mouth shape has changed due to the scar, revision surgery is recommended. Surgery to remove scars around the mouth does not simply involve excising the scar; it requires redraping the tissues and suturing them in multiple layers from the deeper tissue upward so that the same tension does not recur, making it virtually equivalent to a revision surgery. The scars that primarily cause issues around the mouth are spread-out planar scars and raised hypertrophic scars.

Revision surgery is not simply repeating the first surgery; it is a process of redesigning balance by analyzing the remaining tissue and facial movements within an already altered structure. Therefore, we do not look only at frontal resting photos, but also examine which areas pull more when the mouth is closed, when smiling, and when speaking. Then, we determine whether the lip corners need to be lifted further, whether the horizontal length and outer lip line should be adjusted together, whether scarring and contracture need to be addressed first, or whether non-surgical procedures or observation are more appropriate than surgery. We also thoroughly consult on what can be improved through revision surgery and what cannot be corrected.

Excessively upturned mouth corners are a representative issue addressed in Perioral Revision Surgery. When only the tips of the mouth corners are sharply raised, the line leading from the center of the upper lip to the corner can appear excessively bent. Therefore, in revision surgery, rather than simply lowering the mouth corners, we design them so that they naturally reconnect with the surrounding lip line. If necessary, we also use a method of removing part of the outer upper lip skin to evert (turn outward) the lip and reduce the sharp angle. Where and how it connects is more important than simply raising it significantly. Results and recovery periods may vary depending on the individual.

We do not forcibly remove all of it. Once any tissue is excised, it is difficult to restore, and even scar tissue may be necessary to maintain structural shape. For this reason, we only trim the necessary extent of scar tissue and proceed with the surgery considering the overall shape. I believe the key to perioral revision surgery is to restore while preserving tissue as much as possible to minimize damage. When finishing, we also perform meticulous suturing to ensure that excessive tension is not concentrated on the suture site.

Morphological and functional problems caused by depressions, wrinkles, or scar contracture (a condition where scar tissue hardens and pulls) are restored by utilizing methods suited to the individual's condition, such as dermis grafts, flap surgery, fat grafting, PRP (platelet-rich plasma), and stem cell therapy. Next, with thorough hemostasis and precise suturing, the tissue is stably and meticulously secured again, aiming to rebuild the surgical direction you originally desired. Results and recovery periods may vary depending on the individual.

It is difficult. Because tissue that has once been excised is difficult to completely restore to its original state, the first surgery is critical. Revision surgery requires a higher level of surgical skill than the initial surgery because damaged skin tissue must be taken into account, and available spare tissue may be scarcer than in the first surgery. Therefore, rather than unconditionally aiming for a major change, we assess the range that can realistically be improved from the current condition; if the improvement from surgery will not be significant, it may be better not to rush into revision surgery. Results and recovery periods may vary depending on the individual.

Because a Lip Corner Lift removes skin at the outer corners of the mouth to lengthen the horizontal width, there is virtually no way to restore a lengthened mouth to its original length. However, if the outer ends of the upper lip evert and thicken after a Lip Corner Lift, the mouth may appear even wider horizontally; in such cases, a curtain-line reduction—excising the outer mucosa of the upper lip—can make the mouth appear visually less wide. It is advisable to decide on correction after observing progress over a certain period and having a thorough consultation. Results and recovery periods may vary depending on the individual.

In a Lip Corner Lift, triangular sections of skin on the outer upper lip are excised and the lip corners are elevated and sutured, which can slightly lengthen the mouth horizontally, cause the outer upper lip to evert and thicken, and pull up the corners of the lower lip, making them appear thinner. If the upper lip is narrow, curled inward, or shaped like an inverted V, this phenomenon can be even more pronounced. Correction is performed either through a curtain-line lip reduction, which appropriately reduces only the outer upper lip that has everted outward, or through mucosal advancement, which advances the inner mucosa of the thinned outer lower lip outward. The two procedures do not necessarily have to be performed together, but they may be performed simultaneously depending on the case. Results and recovery periods may vary depending on the individual.

Yes, there are patients who undergo revision surgery at Golden Diamant after having perioral surgery at another clinic. Because the size and characteristics of scars, the degree of skin damage, and the method of the previous surgery vary from person to person, revision surgery cannot be planned with a one-size-fits-all approach and must be tailored individually. Therefore, it is helpful to bring pre- and post-operative photos, as well as reference photos of the look you wish to achieve, to your consultation. The head surgeon directly oversees everything from design to surgery, and will also discuss the potential for any additional issues associated with revision surgery along with their solutions.