Some patients arrive at Southwest Plastic Surgery carrying months of frustration on their lip.
They have been through the circuit: dermatology appointments, freezing treatments, prescription creams, injections. The growth is still there, still visible every time they talk, smile, or look in a mirror. By the time they meet Dr. Frank Agullo, what they want most is for someone to solve it rather than treat it again.
“When a lesion has resisted every medical treatment, sometimes the cleanest answer is to remove it surgically and rebuild the lip so it looks normal again,” Dr. Agullo says. The procedure he uses most for this is called a wedge excision, and it is one of the smallest operations on his schedule with one of the highest satisfaction rates.
Why the Usual Treatments Sometimes Fail
“That is one of the most common stories I hear,” Dr. Agullo says. “Months of dermatology visits, cryotherapy, injections, prescription ointments, and the lesion is still there. When something on the lip is painful, persistent, and has not responded to medical treatment, surgical removal becomes the most reliable option. The key is to take it out completely so it does not come back.”
What a Wedge Excision Is
“If the lesion takes up a meaningful portion of the lip, I remove it as a wedge,” he explains. “That means I take it out in a V shape and bring the edges back together, rather than just shaving the surface. A wedge closure lets the lip stay continuous and natural looking. If I only cut out the spot itself without reshaping, you would be left with a notch or a dip in the lip. By closing it as a wedge, it reads as a normal lip, just a little shorter than before.”
The Honest Trade-Offs
The two things every patient hears before surgery is scheduled, in Dr. Agullo’s own words:
“It will be a little smaller, and that is expected. The good news is that lips tend to stretch and settle over time. For people whose lip is on the longer side to begin with, that extra length gives us room to bring things back together without it looking tight. You will feel some tightness at first, and it takes a little getting used to, but most people tell me it feels far better than living with the growth.”
“There will be a fine line where I close the wedge, including a portion that runs down toward the chin, because I have to taper the closure so the lip does not pucker. In men who wear a beard, that line tends to hide well. Like any scar, it continues to soften and fade over the weeks and months after surgery.”
The Procedure and Recovery, at a Glance
| Question | Answer |
|---|---|
| Anesthesia | Local, outpatient |
| Procedure time | 30 to 45 minutes |
| Home the same day | Yes |
| Swelling settles | About two weeks |
| Scar | Fine line, fades over months |
| Tissue tested | Always sent to pathology |
Recovery is mostly patience. The lip is swollen for the first days and looks close to normal at about two weeks. Skin care and scar support through the Southwest Plastic Surgery Med Spa can help the line settle as it matures.
Every Specimen Gets Tested
Nothing removed in this procedure goes in the trash. Every specimen is sent to pathology, even when a prior biopsy was reassuring.
“Some lip growths are viral in origin, which means there is a small chance of recurrence,” Dr. Agullo notes. “I work to remove the lesion completely with a clear margin all the way around, and then we keep an eye on the area afterward. If anything starts to come back, we address it early.”
The Surgeon Behind the Small Procedure
Dr. Frank Agullo is the founder of Southwest Plastic Surgery in El Paso, Texas. He is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, and a Mayo Clinic plastic surgery fellowship alum. He has taught plastic surgery at the Texas Tech University Health Sciences Center Paul L. Foster School of Medicine since 2011 and has been a Castle Connolly Top Doctor for thirteen consecutive years.
His view on small procedures is simple: the lip is one of the most visible and expressive parts of the face, so even a thirty-minute operation deserves surgical planning, a rebuilt lip line, and pathology confirmation.
For Dr. Agullo’s own editorial take, see the companion piece on drworldwide.com. For the patient-facing clinical version, see agulloplasticsurgery.com.
Ready to Talk?
If a growth on your lip has outlasted every treatment, schedule a consultation at Southwest Plastic Surgery and get a straight answer. Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful
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