In short
- 🔑 First, and it is the most useful thing: before eight months almost nothing you see is final. Eight months is the minimum for considering an aesthetic revision, and twelve is better still.
- And there are two phenomena that mislead in that period: the scar gets worse between the first and third month — red, thickened, hard — and the swelling goes down asymmetrically, so one side can look different from the other.
- The real reasons for dissatisfaction have been described. In an analysis of 25 accounts from unhappy patients: the scar in 15 (60%), nasal or alar distortion in 6 and lip asymmetry in 5.
- ⚠️ The hardest one is having lifted too much, because excised skin cannot be put back. It is not impossible to address — there are reconstructive techniques for replacing skin in that area — but they are operations considerably more complex than the original.
- The scar does have treatment, and plenty of it. It is the most frequent reason for dissatisfaction and also the most tractable.
- Published reoperations are few: between 0.6% and 6.7% in the systematic review of 1,754 patients.
- ⚠️ The emotional impact, when it happens, is not trivial: in those 25 accounts, 59.3% scored in the severe distress range. It is not an aesthetic triviality and should not be treated as one.
- If you were operated on here and the revision is justified, its cost is greatly reduced compared with the primary surgery. And if you were operated on elsewhere, you are also operated on here: it is something done frequently.
This page is for two different people: someone who has already had surgery and is not happy, and someone who has not yet had it and wants to know what would happen if they were not.
The same information serves both, and it starts with something uncomfortable: not everything can be corrected, and of what can be, almost nothing is touched before eight months.
⚠️ This page does not assess any surgeon’s work or suggest negligence in any case. The described complications of this surgery can appear without anyone having done anything wrong: a pathological scar is unforeseeable, and the largest genetic study published puts its heritability at between 6% and 34% depending on ancestry. Nor does it give legal advice.
First of all: the clock
It is the information that prevents most distress and the one least often given.
Between the first and third month, the scar is at its worst. It turns red or purple, thickens, hardens and sometimes itches. It is the proliferative phase of healing — the body lays down collagen in excess before reorganising it. It is not a poor result: it is the result half-made.
The swelling goes down asymmetrically. The two sides do not settle at the same rate, so one side can look different from the other for weeks. One side looking different at three weeks does not mean the surgery has come out crooked.
And the criterion of the house: eight months at the very least, and twelve better still.
At 8 months it is already a good moment to consider an aesthetic revision. But waiting until 12 is usually more prudent — the plastic surgery literature places full maturation of a scar at around a year, when it reaches 80% of the strength of the original skin — because by then the scar has really matured and what you see is the result, not a stage of it.
🔑 That does not mean “put up with it and say nothing”. It means that before that point you cannot tell what is final result and what is process — and that operating on tissue that is still changing is the quickest way to make it worse. What you can and should do before then is get it looked at, which is another matter.
What really bothers people when something does
The analysis of 25 accounts published by dissatisfied patients after a lip lift puts the reasons in order:
| Reason | In the sample | Correctable? |
|---|---|---|
| Scarring | 15 of 25 (60%) | Yes, there is treatment |
| Distortion of the nose or nasal ala | 6 of 25 | Partially, and it is surgery |
| Lip asymmetry | 5 of 25 | It depends on the cause |
| Having lifted too much | — | 🚨 No simple way back |
⚠️ The obligatory warning about this table: these are 25 accounts selected for being negative. They tell you what hurts when it hurts; they do not tell you how often it happens. That is what the published revision rate is for: 0.6% to 6.7% across 1,754 patients.
What can be corrected
The scar — yes, and it is the most frequent. It is the number one reason for dissatisfaction and also the most tractable. There are treatments with varying degrees of evidence — from conservative management to laser and injection — and, if it is established and not improving, surgical revision of the scar itself. All of it is in scar improvement and in the post-surgical scar protocol.
🔑 And one fact that changes the urgency: the scar management literature holds that a hypertrophic scar that has not improved by six months is no longer evolving and should be managed actively. That is: there is a point at which you stop waiting, and it comes before the eight months for an aesthetic revision.
Asymmetry — it depends. The kind in the first few weeks is expected and resolves on its own. The kind that persists once the swelling has gone can have different causes — uneven healing, a difference in the excision, pre-existing facial asymmetry that now shows more — and correcting it depends on which. It is the one that most demands waiting before deciding.
Nasal distortion — partially, and it is surgery. When the traction of the closure has altered the shape of the ala or the nostril, correcting it moves into the territory of rhinoplasty. It is not a minor touch-up.
🚨 What cannot be undone
Having lifted the lip too much.
The skin that was excised cannot be put back. An upper lip that is too short — with too much tooth and too much gum on show, and with proportions that draw attention — is the most difficult result of this surgery, and there is no operation that undoes it cleanly.
✅ But it is worth saying what there is, because “cannot be undone” sounds like a dead end and it is not entirely one: there are reconstructive techniques capable of replacing skin in that area. They are considerably more complex operations than the one that caused the problem, with a scar of their own and limits of their own, and they do not give back the starting point. But they exist, and that is information someone in that situation wants to have.
⚠️ What does not change is the arithmetic of the decision: the existence of a complex reconstruction does not turn overshooting into a minor error. It is still far cheaper, in every sense, not to make it.
🔑 It is the underlying reason this whole site insists that in the lip lift the conservative option wins, and why a surgeon who proposes lifting less than you expected is not being timid. The literature on the design of this surgery states as an explicit aim avoiding exaggerating the look and reducing the need for revision.
⚠️ And it is also the reason this page exists: so that anyone who has not yet had surgery knows that this is the error that cannot be put right, and bears it in mind when choosing how much to lift and with whom.
If you had surgery elsewhere and want a second opinion
It is a frequent situation and it is worth handling without drama.
What it helps to bring to the consultation:
- Photographs from before the surgery, if you have kept any. They are the most valuable thing: without them it is hard to know what was there before.
- The operation note or any documentation of what was done.
- The exact date of the operation. It determines where you are on the clock.
- Photographs of the progress, if you have been taking them.
⚠️ What an honest second opinion does and does not do. It does: explain where you are, what is to be expected and what is not, and what options exist if something is not. It does not: assess another professional’s work or pronounce on whether there was negligence. That is not a medical consultation and this page does not give legal advice.
✅ And yes: patients operated on at other centres are seen and operated on here. It is something done frequently, not an exception. On what financial terms depends on the case, and it is said in the consultation with the quotation in front of you.
Book an appointment
You can book your own appointment. Pick the day and time from the free slots in the diary, in a panel that opens right here, without leaving this page.
Frequently asked questions
Three months have passed and the scar is worse than at the start. Is that normal?
Yes, and it is what is expected. Between the first and third month the scar turns red, thickens and hardens before beginning to improve. It is covered in the lip lift scar.
One side is different from the other. Was the surgery done badly?
Not necessarily. The swelling goes down asymmetrically. The asymmetry that matters is the one that persists once the swelling has gone completely, and that is not known in a few weeks.
Can I ask for my lip to be lowered again?
It is the hardest question on this page and the honest answer is that excised skin cannot be put back. There are approaches for particular cases, but not an operation that returns the lip to its previous state. That is why the room for decision is beforehand, not afterwards.
How long do I have to wait for a revision?
At least 8 months, and preferably 12. For the scar, by contrast, the management literature holds that at 6 months without improvement it should be treated actively. They are two different clocks: one for operating again and another for treating a scar that is not keeping up.
Who pays for a revision?
If you were operated on here and the revision is justified, the cost is greatly reduced compared with the primary surgery. If you were operated on at another centre, it depends on the case — it is assessed and quoted for.
🔑 And wherever it is, this is a question worth having answered in writing before surgery, not after. It is exactly one of the reasons for dissatisfaction that appear in the accounts from unhappy patients.
I am in a terrible state about this and I do not know if I am overreacting.
You are not overreacting. In the analysis of those accounts, 59.3% scored in the severe distress range and another 25.9% in the moderate range, and by domain 54.8% reported appearance-related distress. It is a documented impact, and it deserves to be treated as such at any serious consultation.
Sources
- Skochdopole A, Dibbs RP, Sarrami SM, Dempsey RF. Scar Revisions. Seminars in Plastic Surgery, 2021;35(2):130-138. PMID 34121948. — Full maturation of a scar is not reached until around a year, when its strength reaches 80% of the original skin, and that is when a surgical revision can be considered.
- Hayat J, Alfadhly A, Jafar AB. Patient-Reported Dissatisfaction After Lip Lift: Insights From a Thematic Analysis of RealSelf Reviews. Aesthetic Surgery Journal Open Forum, 2025. PMID 41230113. — Qualitative thematic analysis of 25 public accounts from dissatisfied patients after a lip lift, most operated on in the United States; scar-related concerns were the most frequent (15 of 25, 60%), followed by nasal or alar distortion (6) and lip asymmetry (5); assessment of emotional impact with the PHQ-9 placed 59.3% in severe distress and 25.9% in moderate, and by FACE-Q domain 54.8% reported appearance-related distress, 35.7% psychological and 9.5% social; the authors conclude that, although the lip lift is generally well tolerated and with favourable results, a significant minority report aesthetic dissatisfaction and psychological distress.
- Komisarek O, Banasiak Ł, Olichwer V, Burduk P. The Bullhorn and Beyond: Evidence-Based Review and Clinical Recommendations for Lip Lift Techniques. Journal of Cosmetic Dermatology, 2026. PMID 41731334. — PRISMA 2020 systematic review of 7 studies and 1,754 patients; predominantly mild and transient complications, with revision rates between 0.6% and 6.7%.
- Son D, Harijan A. Overview of surgical scar prevention and management. Journal of Korean Medical Science, 2014. PMID 24932073. — Hypertrophic scars that have not improved by six months should be managed actively; care of a surgical scar should be maintained for a year, with review appointments looking for signs of hypertrophy.
- Talei B, Pearlman SJ. CUPID Lip Lift: Advanced Lip Design Using the Deep Plane Upper Lip Lift and Simplified Corner Lift. Aesthetic Surgery Journal, 2022. PMID 35583637. — The stated aim of the design is to avoid accelerating the appearance of ageing and exaggerating the look, and to reduce the need for revision.
Book your consultation
If you have had surgery and are not happy, the first thing is to locate yourself on the clock: to know whether what you see is a result or a process. An assessment consultation with your previous photographs and the date of the operation answers that, and from it comes what can be done, what is worth waiting for and when to look at it again.
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Last reviewed: 6 September 2026. This content is for information only and does not replace an individual assessment by a healthcare professional.
