Saturday, August 30, 2008

Lip plumping

Ok, so I saw Dr. Mehta yesterday for the lip plumping. His words....

"I know you wanted the lips to be fuller so that you can get closure. i know exactly what you are saying. The lips were fuller before from the swelling induced by the operation.

Dont worry - we can get them fuller again. That will be our goal. You are healing beautifully. It's moving a lot more than last time I saw you. I am very encouraged to see that movement at your lips. You look fantastic compared to before! I think if we now focus on lip augmentation, that would be great.

There are 2 ways to do it:

1) Restylane injection here in the office - can be a little painful even though we give you numbing medicine. not too bad.

Downsides of it: lasts for a few months - not long lasting. Also, very expensive although we have approval to do it today.

When it wears off, you can have it again if you liked it. Or go to second option:

2) minor surgery to augment lips using Alloderm - a material that we have in the O.R. It's artificial skin - works very well - lot of people use it for cosmetic purposes. Gives you nicer, fuller lips and will help you close better.

It's done under local anesthesia with maybe a little sedation. No fat is used, it's ready made material in a package. The procedure is easy to go through, takes less than an hour. Lips are a little swollen/bruised for a week. We just did this technique 2 days ago for a lady with facial paralysis. She likes it. She also had restylane before (twice) but it wasn't lasting long enough, nor making her lips full enough.

So it's up to you which option you want to do first."

(here i opted to try the restylane first. From start to finish it took about 20 minutes. Then we went back to discussion)

"I was hoping that a little restylane would do it, but that was wishful thinking. It looks better. The upper lip is not as thin. but your closure problem will just need a lot of volume which the other technique does well.

We used 1 full cc of restylane. Now, your lips are so thin that its going to require a lot of volume to get it to where we want. Even if were to use one more cc , it is not going to be enough. You may notice a little benefit - certainly they look better already but to get that closure you need, we will need a larger volume technique like the other option we talked about.

That's what I think will work best for you. Otherwise we will be injecting a ton of restylane into your lips for not a very long lasting effect. Your insurance also will not allow us to inject that high volume. You can see that the lips get fuller with restylane but you just need a lot more to get closure. From facial paralysis, the muscle in the lip gets so weak and thin. You already had thin lips and the facial paralysis has made it worse. Make sense?"

(Here I decided to go for the other procedure He will submit the request to the insurance today. Once it's approved, we will go ahead and just do it.)

"We will put in 2-3 strips of alloderm material per lip so it will be a lot more stuff in the lip than the restylane."
(I asked him, how will you gauge how much to put in?)
"It is sort of an art where you have to estimate. We can always do it again if we need to. the good thing about it is that is much more long lasting - likely permanent.

Thursday, August 28, 2008

So the insurance approved the Restylane injections
for my lips. That was fast! (for a change)
I go tomorrow (8/29) to have that done.
Dr. Mehta will do it there in his office.
Wonder what that will feel like?
Anybody know?
Anyway, afterwords, I should look exactly like Angelina Jolie.
Just kidding. ;-)
I start the chemo (Rituxan) next Wednesday (9/03)
This round of chemo will be one day a week, for four weeks.
Ding! Ding! Ding!

Monday, August 25, 2008

Fine tuning stuff....

No leak! It's all healed, yay!
For the 1st month or so, after the face operation,
I could easily make B, P, M, sounds. Plus I could close my mouth,
bring my bottom lip, to my upper lip, easily.
I was overjoyed with that!
But now I can't do that. ;-( The swelling has totally dissipated.
Now I can't make certain sounds, or close my bottom lip.
So, the plan is Restalyne (sp) injections, to plump up my lips, to restore a little of the swelling to that area. These injections would be similar to Botox. We are waiting on the almighty (coff coff) insurance to approve the Restalyne.
I just heard from my oncologist, Dr. Zu, that I am due for more Rituxan (chemo) this month. ugh! I thought I was done with that ;-( I haven't had any chemo since march! Oh well, bring it on!
In other news, the bike is done! Geo took saturday off and we hit highway 101 and put about 200 miles on it.

Friday, August 1, 2008


As far as the leak goes, I think its healed. Dr. Mehta has had me taking a medication to decrease my saliva output. Today is my last day taking that med. So, has the gland it healed? Or has the leak stopped due to the med? I guess I will find out when 'I turn the water back on.' Stay tuned....