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Lip Reduction Surgery - Reduction
Cheiloplasty
Introduction:
Bigger Is Not Always Better
Not all of us may want larger,
fuller lips. Many people believe that their lips are too big, and
want them reduced. Many younger patients are often plagued by insecurities
brought on by having larger than average lips and are sometimes teased by their
classmates. Although one should wait until their mid to late teens to have their
lip size reduced due to maturing of the facial features.
This procedure really isn't
incredibly invasive but there are risks and complications so please read through
all of the information before agreeing to commit to any surgery. But for such a
small procedure it truly can make a big difference!
What Is
Lip Reduction?
Lip Reaction, also called
reduction cheiloplasty, is the procedure to
remove excess lip tissue to reduce the appearance of overly large lips. The
procedure can be performed under local and or regional anesthesia although some
surgeons may choose to perform it under Light Sleep anesthesia. The procedure
takes only about 15 to 30 minutes and takes about 2 weeks to heal. Swelling can
be an issue so please know this beforehand. Also asymmetry is possible so please
choose your surgeon wisely. Although a fairly simple procedure, complications
can and do happen.
Are
You a Candidate for Lip Reduction?
First and foremost, an
individual must be in good health, not have any active diseases or pre-existing
medical conditions and must have realistic expectations of the outcome of their
surgery. Communication is crucial in reaching one's goals. You must be
able to voice your desires to your surgeon if he/she is to understand what your
desired results are. Discuss you goals with your surgeon so that you may
reach an understanding with what can realistically be achieved.
You must be mentally
and emotionally stable to undergo an cosmetic procedure. No surgeon would agree
to work on a mentally unstable person. At least he should not. Surgery is not
getting a cavity filled. This is an operation which requires patience and
stability in dealing with the healing period. There is sometimes a lull or
depression after surgery and if there is already a pre-existing emotional
problem, this low period can develop into a more serious issue. Please consider
this before committing to a procedure.
If you find that
your lips are too large and may interfere in speaking or don't like them in
general, you may wish to consider this procedure. It is not a rather invasive
procedure but it will cause discomfort and swelling and you will have to take it
easy for a proper result so consider all of the above before deciding if this
may be a viable option.
What
to Expect at Your Consultation
After checking a few
surgeons' backgrounds and credentials, you will make an appointment for a
consultation. You will meet with these surgeons and discuss your goals and you
will disclose all information regarding your health; if you smoke, what
medications or vitamins you presently take, etc. -- this is very important.
Visit
the Medication & Supplements List for more
information.
You will discuss
your complaints and concerns and discuss the various looks one can achieve, the
amount that can and should be removed, etc. Your surgeon will explain the
technique and incision placements or methods that may be most appropriate for you
and should discuss the risks associated with lip reduction with you, as well.
You will also
discuss the available anesthesia that will be used for your procedure. Most lip
reduction procedures are performed local or regional, possibly with oral
sedation (valium usually). However, some surgeons may use Light
Sleep Sedation. Please read the All About
Anesthesia Page -- the risks regarding anesthesia should be considered for a
fully informed choice. You will of course not have General Gaseous Sedation as
your procedure is performed intra-orally (through the mouth).
If you would like
more information on consultations or a list of questions to ask your surgeon
please visit the Consultation Help Page.
If
you should choose to book or reserve a surgery date you will usually give a
deposit to hold your surgery date. Most times if you cancel a few days
beforehand, this amount is non-refundable. After paying your deposit and
scheduling a surgery date, you will also schedule a pre-operative appointment...
Your
Preoperative Appointment
This appointment
addresses more questions you may not have thought to ask at the initial
consultation, such as more surgical details, concerns and even ascertaining that
your surgeon is aware of what you desire from your procedure. Just as your
surgeon will make certain that you know what it realistically possible from this
procedure.
You will also
discuss your pre-operative instructions and speak about the recovery period
instructions and what to expect in the months ahead. You will be given
prescriptions for antibiotics, pain relievers, perhaps blood pressure medicines,
prescription anti-inflammatory drugs and perhaps a box or directions for gaining
a box of Arnica montana. Perhaps you will
be instructed to obtain Bromelain or other types of remedies, although many
surgeons would rather have you not take ANYTHING other than your prescription
medications, please do not go against your surgeon's wishes.
Would like to know more on the benefits of Arnica
montana? Remember, always ask your doctor before taking any of these
products.
Preparing
for Your Surgery
You should be given a
pre-operative information packet that explains everything you should do and know
before your surgery date. The packet should include a list of all the
medications you should not take starting usually at 2 weeks before your
surgery. These medications will include, but are not limited to, aspirin
containing products, stimulants, seratonin supplements, etc. Would you like to
view a typical Medication & Supplements List?
We have a printer-friendly version as
well. Also, if your surgeon advised that you may take Arnica montana, Bromelain,
Vitamin K, etc. for swelling and bruising you should either have this in your
packet or begin shopping for your necessities.
It is quite possible
that you will have preliminary blood work performed. This is normally an
extra out-of-pocket expense that the patient must participate in to check your
white and red blood cell count (complete blood count, CBC)which ultimately
alerts your surgeon to disease or disorders beforehand. If
you are a female they may take an extra vial for a pregnancy test. Some surgeons
ask that you have physical. This can be yet another out of pocket expense so ask
at your consultation what will be needed when you are quoted a price.
So many things to
do... so little time. Surgery will be here before you know it so visit the Preparing
For Surgery page and relax. This section contains, printer-friendly
pre-op lists, tips and advice as well as things you must do to prepare for your
big day.
How
a
Lip Reduction is Performed
A lip
reduction procedure normally takes about 20 to 40 minutes to perform.
First,
you will be given your choice or your surgeon's preference in anesthesia as
discussed prior to your surgery date. For this operation it is often simply
injections of Lidocaine, epinephrine (as vasoconstrictor) and possibly
bicarbonate to neutralize the acidity of the preservative in Lidocaine. This
will cut down on the sting of the Lidocaine.
If you had been given an oral
sedative or valium prior you usually could care less what they are sticking in
you. if you are planning to have other work performed, they will more than
likely insert an IV for a saline drip to keep you hydrated and have a vascular doorway should the need arise.
If you haven't been given a sedative,
it is more stressful for some patients. Having an IV inserted feels sort of like
blood being drawn, but for a shorter period of time. It's the initial placement
of the IV that may sting a bit. After the needle is injected into the vein it is
pulled out and a little plastic tube is left in your vein. This is called a
catheter, which is taped to your skin so it is not knocked out and
is ready to be used as a sort of entryway for anything the surgical team deems
suitable for your body. This is usually done before you get into the actual O.R.
-- by a nurse -- and you have a saline bag hooked up to you. The medications will
usually be given with a drip system with this saline. As I said, the saline
will keep you hydrated both during and post-operatively.
Some people get their IV
placed in the crook of the elbow, some the hand. I dislike the hand ones as it's
a nasty place for a bruise to be, at least with the arm you can hide it -- it all
depends upon your veins though. So if your veins are not very prominent
this can be a problem. You
are then brought to the O.R. if you aren't on the table yet.
If you have chosen
an IV Liquid Sedative, they will insert a hypodermic into your tube that you are
attached to or they attach the bag of it with a drip system to add a few drops
every few seconds and when they spring open the stopper and it starts heading
towards your body. The the effects of the anesthesia are felt soon after
injection or opening the stopper -- a few seconds in fact. It feels like heat going into you veins then creeping up your arm - then it
jumps from your shoulder to a metallic-like taste under your tongue
and then you are blissfully anesthetized.
Your surgeon will make an incision the length
of your lip inside of your mouth and will remove a strip of skin from one or
both lips, depending upon your desires.
The surgical team then performs a sponge and
instrument count and your surgeon then closes your incisions with, more than
likely, a non-dissolvable type suture. Some surgeons may use a dissolvable type
though, it truly depends upon preference. You may have an antibiotic-soaked
piece of gauze placed between your lips and your gums at
first. Of course there may be differences in surgical technique depending upon
the preference of your surgeon.
You are then gently
awakened and brought into the recovery room where the recovery nurse will
monitor your vital stats until you are ready to be released. This is dependent
upon the individual but may take up to two hours. Your lips and mouth may feel
tight and quite tender as the anesthesia wears off. You may even feel emotional
or upset - this will depend upon your body's reaction to anesthesia.
You
may also experience rigors or shivering. This may feel
uncontrollable and is usually from the medications -- more than likely
epinephrine that is used as a vasoconstrictor. The recovery nurse usually has
wrapped you in a warm blanket but if not, request one. It certainly makes things
more tolerable.
Some patients feel
nothing different although if you have had General you may feel a little sick --
hopefully your surgeon gave you something to lessen this. Your prescribed
medication should alleviate this pain and discomfort. However, if you believe
your pain to be out of the ordinary once you get home, call your surgeon or the
on call staff immediately. You will be driven home by your spouse, significant
other or friend as you will not be able to see, much less drive yourself home.
The
Road to Recovery
You may be groggy
from the anesthetic and or oral medications and probably won't remember much of
the first day or two if you were under Light Sleep sedation or deeper. You will
have to take it easy and sleep on two pillows to keep your head elevated for 7
to 14 days -- or however long your surgeon suggests. When you wake up you will
notice that your face will look even more swollen in the first 3 days. But, as
the days go on the swelling will dissipate. There may be bruising, but this will
go away, as well. So make a mental note of this or you may be shocked into a
depression. Bruising and swelling are a normal occurrence in most surgeries.
You will more than
likely experience some discomfort for several weeks. Having had intraoral
incisions, your diet may be restricted. You should ascertain all fresh fruits and
vegetables have been washed, no raw fish (sushi), very rare meat or other types
of foods that may contain high amounts of bacteria. Eating foods such as this
may increase your risk of infection due to the incisions being in the mouth.
You
may be instructed to rinse with Listerine several times a day. DO NOT PICK or tongue your incisions or sutures!
Although any
discomfort should be alleviated by your prescribed pain medication if you have
excessive pain, redness, pus or other symptoms that do not appear normal,
contact your surgeon immediately! Take your temperature regularly.
An
elevated temperature could mean an infection. Take those antibiotics on time.
Also, don't forget if you are a female taking birth control pills that some
antibiotics can interfere so in the event that you do have relations, use
another form of protection as well.
Your sutures will
more than likely be taken out by your surgeon at a week to 10 days
postoperatively if your sutures were the non-dissolvable kind. Even though you
may feel better, you must take it easy for the first 3 weeks. Be careful not to
bend over or lift heavy objects. And be careful not to raise the blood pressure
for at least 3 weeks as this could cause internal bleeding at your treatment
area. Your blood vessels dilate to allow increased blood flow when you raise
your heart rate. This may cause problems at internal wound sites. Do not
participate in contact sports for at least 6 to 8 weeks -- although ask your surgeon
what he recommends specifically.
Your swelling will
subside within a few weeks, although usually the end result will be seen at 3
months postoperatively. You may notice a change in your smile, odd
sensations of hollowness, tingling, the sporadic sharp pain, or pulling, burning, and cold sensations.
These usually subside within
the first few weeks.
Risks
& Complications of Lip Reduction
Unfortunately, all
surgery has risks and complications. With lip reduction, these include allergic
reaction to the anesthetic used and infection. There is the chance of asymmetry,
dissatisfaction, hematoma, seroma, infection, and general dissatisfaction.
Numbness is
possible, it usually subsides within the first few weeks but it may become a
permanent issue. Excess scar tissue and lumps are possible as well, but are
usually rare. The possibility of asymmetry can be corrected easily so this
should not worry you extensively but should be considered.
The
Least You Need to Know About Lip
Reduction
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What:
lip
reduction
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Why:
to
reduce the appearance of larger, fuller lips
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When: from
mid to late teens to whenever one desires.
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Who: A
skilled plastic surgeon with a good background and experience in performing
this operation.
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Where: Accredited
Surgical Suite or hospital
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Risks: Please
see above
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incisions/scars: non-visible,
intra-oral incisions
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Anesthesia:
oral sedation with regional or
local anesthetic, Light Sleep IV Sedation or General IV Read
All About Anesthesia
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Duration:
15-30 minutes, depending upon extent of work to be done.
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Pain
Factor: moderate, pain
meds should alleviate any discomfort. If not, call your surgeon immediately.
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Swelling:
moderate to possibly severe --
depending upon individual's health, and habits such as smoking, protein
consumption, iron level, etc.
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Bruising:
mild - depending upon
individual
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Post-operative
instructions: Have someone
there to help care for you during your recovery, keep elevated - even when
sleeping. A recliner works best.
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1st
Post-op visit: usually
to remove sutures at 7 to 10 days post, sometimes earlier. Although sometimes
surgeon may use dissolvable sutures.
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2nd Post-op
visit: check up usually at 3 weeks for exercise/activity release
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Return
to work: usually at 5 to
7
days -- but depends upon type of wok. Sedentary (desk job) with little or no
amount of talking. If your job requires high impact activity you may need
more time off, please ask your surgeon.
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Activity:
No exercise until at least 3
weeks post-operative. Be careful not to raise your blood pressure for
several weeks, you don't want to inhibit proper healing. Check with your
surgeon.
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Sun
exposure: n/a
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End result: usually
can be seen within 3 to 4 months
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Loss of
Sensitivity: It is possible to
lose sensation along the incision lines, on chin and lips. Long term or
permanent loss of sensitivity is possible.
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Other
complications: Possible
eyebrow and eyelash loss from medications. Possible asymmetry as well.
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Longevity:
permanent
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Special Notes:
Disclose all your medical background. If you are a smoker, if you are taking
medications, or if you have any other medical concerns. Be realistic in your
expectations. No plastic surgeon can perform miracles, he or she can only
try and improve upon what you have beforehand.
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The average
prices for: lip reduction may be from
$900. to 2000.US for both or for one
lip and largely depends upon the surgeon and region as well as if the
surgeon has his or her own surgical suite. With procedures performed in a
hospital or under General with a certified anesthesiologist -- prices are
usually be higher.
References
Yale Medical Core
Curriculum
Merriam-Webster Medical Dictionary
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