Tag: beverly hills lip lift

Hot Lips, Cold Sores

Posted on by Randal Haworth

 Stress, weather, chemicals and injury to the lip can all awaken the virus in your body. But needle punctures can be particularly triggering for cold sores.   As one of the Beverly Hills top lip injector of fillers, Plastic Surgeon Dr Randal Haworth does see the occasional cold sore erupt 1-2 days after a treatment. It is for that reason, Dr Haworth recommends antiviral prophylaxis is select cases.

Cold sore herpes Simplex Type I of the lips
Cold sore herpes Simplex Type I which can occur after any lip procedure.

Of course, you can be prone to cold sores, get a lip filler and have no sign of an outbreak. But it’s good practice to be precautious and minimize the risk.

Dr Haworth notes that any cosmetic procedure which causes stress to your skin has the potential to stimulate cold sore recurrence. Cold sores are a prevalent affliction and are generally due to herpes virus (HSV) type one particular (generally oral herpes), with the minority (10%) being due to HSV type 2 (usually genital).

Many main infections of HSV-1 are asymptomatic, while recurrent infections can present as fever blisters at the vermillion border. Although cold sores may well not cause any long-term skin damage, they do possess the potential to cause scarring at the contaminated area.

Roughly two-thirds of a global population under 55 are infected with HSV-1. Primary illness develops in childhood through non-sexual contact usually, for example by sharing utensils or towels, but it is regularly assumed to be solely caused by kissing. If symptoms do present with primary infection, they take place two to 20 days after direct exposure.

Aesthetic procedures such as for example lasers, injectables, microneedling and chemical peeling often require limited or deliberate, manipulated trauma to skin, which includes the potential to trigger cold sore recurrence. Dr Haworth, the world’s foremost lip reshaping expert (including upper lip and corner lip lifts) will even warn his patients that his signature lip enhancements can trigger a herpes simplex outbreak. When a fever blister shows up after an aesthetic treatment, it could be devastating for the individual due to distress, pain and potential skin damage of a cosmetically very sensitive area. You will find a particular likelihood of scarring after ablative types of procedures (lasers, peels).

Cold sore prophylaxis can be recommended in the subsequent circumstances:

-More than three spontaneous occurrences every yea
-Previous eruption at any time, as a result of a procedure
-Lip augmentation and HSV eruption regardless of date or time
-Facial resurfacing procedures; anything that breaches skin carrier, and especially medium or deep peels, facial skin lasabrasion, microneedling and microdermabrasion

Immunocompromised patients

Prophylaxis Dr Haworth recommends includes predosing with Valtrex 500mg daily for 2 days to continue for 3 after the procedure. He’ll substitute 1000 mg daily in particularly susceptible individuals.

Randal Haworth MD, FACS

Lip Lift status for 2014 and beyond

Posted on by omnispear

Lip lifts for 2014

Patients often asked me what are the differences between a skin-only lip lift and my muscle hemming technique. To put it simply, longevity, scarring and nasal distortion.

Skin Only Lip Lift

Until the late 90’s, the only lip lift I knew how to do was the skin only type. I would perform this by excising a certain amount of skin below the nasal base and sewing the lower edge of the excision to the upper edge which happens to be the skin of the nose.  The only thing now supporting this entire weight of the upper lip (which happens to move millions of times a day, eating, kissing, expressing and speaking) is the freshly closed incision at the skin level.  One can imagine that this provides little support for all the action occurring around the upper mouth area.  Consequently, the longevity of the lip lift itself is lessened, the nostrils are more likely to be pulled downwards while the resulting scar is more likely to stretch and thicken.

The results of a skin-only lip lift. Notice the widened scars, significant nostril distortion and recurrent long upper lip.
The results of a skin-only lip lift. Notice the widened scars, significant nostril distortion and recurrent long upper lip.

Muscle Hemming Lip Lift

After many years of observing the long-term results of skin-only lip lifts, I developed the muscle hemming technique.  By employing moderate principles of plastic surgery in which nip and tucks (such as a facelift) are improved by lifting and tightening the layers below the skin including muscle I have noted a significant benefit to my lip lifts in terms of scarring, longevity and less nasal distortion.  However, the recovery period was notably increased.  The muscle hemming technique involves placing slowly dissolvable sutures into the muscle layer below the skin and intern suturing that to the periosteum (lining) of the bone deep to the nose itself.  The lip lift is thus a solid one without relying on skin closure to achieve its  superior long-term results while lessening the chance of undesirable scarring and pulling around the nostrils.

Skin Flap Lip Lift

Which brings me to today.  For the last 3 years I have been employing a skin-flap technique which provides all the benefits of the muscle hemming technique but with half the recovery.  Suturing of the muscle is minimized in this technique but none of the longevity and superior scarring is sacrificed. The period of significant distortion and swelling has been halved from 2 weeks to less than 1.  Additionally, the results are “softer” in appearance with minimal to no distortion of the nostril area.

Patient with subliminal long upper lip with minimal upper toothshow
Patient with subliminal long upper lip with minimal upper tooth show
After skin -flap lip lift by Dr. Haworth of Beverly Hills. Notice significant improvement tooth show, natural shortening of the upper lip with minimal nasal distortion. Being a lip lift expert, he developed surgery during to further his evolutionary journey into perfecting the ideal upper lip lift. This new technique also produces softer results those from the skin-only at muscle-hemming techniques.
After skin -flap lip lift by Dr. Haworth of Beverly Hills. Notice significant increase in tooth show and natural shortening of the upper lip with minimal nasal distortion. Being a lip lift expert, he developed this surgery to further his evolutionary journey into perfecting the ideal upper lip lift. This new technique also produces softer results those from the skin-only and muscle-hemming techniques.

Performing the modern lip lift with minimal-to-no-scarring and achieving a permanent beautiful result is challenging .  It requires attention to minute detail and appreciation of how the oral region plays a central role in facial harmony.  The vast majority of patients are thrilled with the subtle yet powerful results of this operation, but it has taken over 2 decades of  unwavering dedication and imagination to get this far.

The Tricky Rhinoplasty and Upper Lip Lift Combination Surgery

Posted on by omnispear
While many surgeons feel uncomfortable with performing an upper lip lift, let alone one simultaneously with a rhinoplasty, it can be safely done. The concern revolves around the fear of losing vital blood supply to the columella (the fleshy straight partition that exists between the nostrils), because if the blood flow is compromised to this area then necrosis or loss of the columellar skin can result. This, in turn, can lead to a possible unsightly scar. If the nose job is performed through an endonasal or closed approach ( whereby all incisions are strictly confined to within the nose itself) there should be little concern for this. However, caution must be exerted when the rhinoplasty is performed with an open technique- one that involves making a scar across the columella in order to gain better access and therefore better visualization and control of the operation. In a normal open technique the incision is placed about halfway up on the columella. Since an upper lip lift necessitates making an incision at the base of the columella (where it joins with the upper lip), the incision needed for the open rhinoplasty can also be the same one- so the incision will be used for two different purposes.

Scar placement for rhinoplasty alone and in combination with an upper lip lift



The situation becomes more complicated, however, when a persisting scar stemming from a previous open nose job is present. In this situation, the plastic surgeon must carefully plan his incisions so as not to compromise the blood supply. More often than not it is safer to keep the upper lip lift incision separate from the rhinoplasty’s in these revision cases. The planning becomes even more critical when the nostrils need to be narrowed during the nasal aesthetic surgery ( Weir excisions). Not only does the upper lip lift need to be blended well onto the columella, but it also needs to be conformed to a freshly narrowed nasal base, with minimal undesired tension across the final scar ( which can increase the chance of it being noticeable). Intricate surgery along with an intimate knowledge of the regional anatomy and the biophysics of an upper lip lift are key ingredients to a beautiful outcome in this combination surgery. Following are two examples of before and afters of this combo surgery.

To view more upper lift results go to:http://www.drhaworth.com/procedures/upper-lower-lip-lifts/

Patient 1.Preop: 52 year old female



After Rhinoplasty with Weir excisions, Upper lip and corner Lip Lifts along with a lower V-Y plasty

Note the improved visual interplay between the nose and upper lip along with youthful tooth show and narrower oral span.



Patient 2.Preop: 35 year old. Note lack of upper tooth show and nasal tip disharmony

Postop after Rhinoplasty, upper lip lift, lower V-Y platy and lip fat transfer