Facial Plastic Surgery Questions and Answers: Part 10

Question: Rhinoplasty for biracial male?
Answer: A rhinoplasty procedure can accomplish narrowing your bridge line, refinement of the nasal tip and narrowing the nostrils. Your nostrils can be narrowed with an alar plasty. The thick skin in the tip of your nose is going to prevent refinement in that area, so it is important have realistic expectations about how much refinement can be accomplished in the nasal tip area.

Question: Would alarplasty and tip plastic help me achieve this look?
Answer: A conservative alar-plasty can accomplish narrowing wide nostrils. Very important not to reduce your nostrils so much that it causes a airway obstruction. A tip-plasty will be only a minimal benefit due the fact that You have very thick skin in the tip of your nose which is different than your ideal wish pick who has thin skin. Also consider placement of a chin implant for the recessive chin from your side profile.

Question: Rhino gone wrong? What are my options?
Answer: Much more information is needed, such as a frontal view photograph, and a copy of the operative report to find out what was accomplished in the first procedure. It’s important to also know how much cartilage you have leftover on the inside of your nose for potential grafting purposes. You also appear to have thick skin in the tip of the nose, so give consideration to placement of a steroid shot in that supratip area. Best to wait at least one year before undergoing any revision surgery.

Question: Do you have to get Fillers dissolved before Brow lift and Upper Eyelid Surgery?
Answer: Depending upon how much filler material is present, you might want to consider getting the filler dissolved in the eyelids and forehead, since you have inflated the normal anatomy. The temporal filler does not need to be dissolved.

Question: What is needed to get done to improve my side profile?
Answer: Your side profile photograph demonstrates a recessive chin profile, for which a chin implant can improve. Placement of a chin implant is done through a small incision underneath the chin under local anesthesia as an outpatient procedure.

Question: What treatments can be combined? Can a mini facelift and lipo in several areas be performed together?
Answer: We frequently combine facelift procedures with other facial cosmetic procedure such as a forehead lift, eyelid surgery or rhinoplasty. Depending on what you’re trying to accomplish, it’s always best to make a consultation with three different surgeons in your area. Study your prospective surgeon’s facelift photo Gallery to make sure that it is extensive with natural results that you like. Also important to ask how long you’ll be placed under general anesthesia to accomplish your goals.

Question: Is it better to do open or closed rhinoplasty to reduce the chance of visible scarring?
Answer: Closed rhinoplasty completely avoids the visible scar across the columella. All incisions are placed on the inside of the nose.

Question: Can I get a neck/jawline lift without a facelift?
Answer: A full set of facial photographs from all angles are going to be required to make a determination about how best to proceed. In our practice, a neck lift only involves removal of fat deposits above and below the platysma muscle which also includes a platysma-plasty. This procedure is usually performed on the patient’s less than 50 years of age. A neck lift does not include skin removal. When patients are older than 50, skin tightening is required which will consist of a lower face and neck lift. 

Question: Can a lower facelift address just the lower face and not cheek shape?
Answer: The goal of the lower face and neck lift is to tighten loose facial and neck skin, tightened loose facial And neck muscles, lift the jowls, and remove any fatty deposits in the neck.

Question: Do I have a weak jaw and would a rhinoplasty ir nose / chin filler deliver the best results?
Answer: The limited side view profile photograph demonstrates an overly projecting nose and an under projecting chin. Fillers in the chin are very temporary, however a chin implant will give you a permanent augmentation to the chin area to give you better facial balance and proportions from the side profile with respect to your nose. Placement of the chin implant can be done under local anesthesia as an outpatient procedure. 

Facial Plastic Surgery Questions and Answers: Part 09

Question: How can my nose shape be improved? Do I have a deviated septum?
Answer: A closed rhinoplasty approach can accomplish straightening the nose, narrowing and straightening the bridge line, refining the nasal tip, and shaving down the dorsal hump with all of the incisions placed on the inside of the nose. You will also require spreader grafts placed in the midportion of the nose where it is pinched and asymmetrical. A thorough internal examination of the nose going to be required to make the diagnosis of a deviated nasal septum.

Question: Could a revision actually fix any of these issues and what exactly needs to be done?
Answer: A revision rhinoplasty can give some improvement to the nose, but there will be no perfect result. It is very important to know how much cartilage is left over on the inside of your nose for grafting purposes, since you will need a cartilage graft placed on the left side of your nose where it is indented. The hanging columella can be reduced and the tip lifted on the nose. 

Question: What would be the best procedures for getting rid of the fat under my chin and getting a better jaw line?
Answer: Much more information is needed, such as your age, and a full set of facial and neck photographs from all angles. Also important to determine if the fat deposits are above the Platysma muscle, then liposuction can accomplish removal. If the fat deposits are below the platysma muscle, then a neck lift with a platysma- plasty is going to be required. If you over 50, a lower face and neck lift is going to be required. 

Question: Is it necessary to prep the thick oily skin for rhinoplasty?
Answer: No, there is no preoperative preparation for thick oily skin prior to a rhinoplasty. When patients have thick skin in the tip of the nose, but usually require several steroid went within the first few months after the procedure to manage the soft tissue envelope over the cartilaginous framework of the nose. This reduces scar tissue and fluid retention in the tip of the nose. 

Question: Coronal vs Endoscopic brow lift?
Answer: In our practice, we usually perform a coronal brow lift due to the fact there are significant limitations with the endoscopic lift. With the coronal approach, the goals are to either raise or lower the hairline, soften the horizontal and vertical lines in the forehead, adjust eyebrow asymmetry and simultaneously raise the eyebrows to the desired position. When there is significant dermal atrophy between the eyebrows, fascia grafts are placed.

Question: Remove cheek filler before facelift?
Answer: Filler does not have to be reversed prior to a facelift procedure. To make a determination about being a candidate for a facelift, a full set of facial photographs from all angles are needed. Most women at age 40 do not need a facelift. The majority of the facelifts performed in our practice are patients in their 50s, 60s and 70s.

Question: Mens Closed Rhinoplasty: am I a candidate given the tip ptosis and dorsal hump?
Answer: A closed rhinoplasty approach can certainly address removal of the hump and lift the nasal tip in addition osteotomies and placement of spreader grafts, if needed. All incisions are placed on the inside of the nose. For many examples, please see our closed rhinoplasty photo gallery.

Question: What can I do to shave my nose down?
Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump which is composed of both bone and cartilage. Osteotomy’s placed in the nasal bones are going to be required to narrow the bridgeline and the upper two thirds of the nose . All all the incisions are placed on the inside of the nose with a closed rhinoplasty.

Question: Droopy eyelids. Will blepharoplasty be my best option?
Answer: The photographs demonstrate droopy upper eyelids which are touching your eyelashes, and you appear to be excellent candidate for upper blepharoplasty procedure. This can be performed under local anesthesia or general anesthesia depending upon your desires. We would not recommend laser treatment to your eyelids.

Question: Would rhinoplasty be able to solve as much as I’d like?
Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, lifting and refining the nasal tip, and narrowing the entire bridge line. Also important to release the depressor septi ligament which dynamically pulls the dip down when smiling. All this can be done with one procedure with all the incisions placed on the inside of the nose. No external incisions are required, no painful packing is required either.

Facial Plastic Surgery Questions and Answers: Part 08

Question: Can this revision be done with local anesthesia? 
Answer: Much more information is needed, such as a Full set of facial photographs, an internal examination of the nose, and a copy of the operative report to find out what was performed in the first procedure. In our practice, what you’re asking for would need to be performed under General anesthesia, since this is a surgical procedure performed on the nasal airway, not a minor little procedure performed in an office setting. You will probably require a septoplasty to have to harvest cartilage grafts from somewhere inside the nose, and reconstruct the columella, the tip and and make sure all the components of the nose are balanced. 

Question: Liposuction and face lift for 44 male. Interested in doing surgery in my 40s rather than later in my 50s/60s
Answer: At 44 years of age, you do not need a facelift procedure. The photographs demonstrate a recessive chin profile, therefore consider placement of a small chin implant to increase the projection of your chin forward for better facial balance and proportions, in addition to better structural support for the soft tissues in your neck. You also have significant fat deposits located BOTH above and below the platysma muscle in your neck. A neck lift procedure involves making three small access underneath the chin and behind the ears to remove the fat deposits above the muscle with liposuction, and surgical extraction of the fat deposits below the muscle which also includes a platysma plasty to significantly improve the jawline. No skin removal is required at age 44. Liposuction alone will be ineffective, since most of your fat deposits are located below the muscle.

Question: Are the ligaments that are cut re-attatched during a Deep Plane Facelift?
Answer: In our practice, we do not perform a deep plane facelift procedure for multiple reasons. We perform a high SMAS lower face and neck lift procedure which accomplishes tightening the facia layers in addition to tightening loose skin, and removing fat deposits in the neck, lifting the jowls and tightening the platysma muscle in three locations in the neck to improve the jawline. 

Question: Is it LLC or ULC that needs fixing? 
Answer: A full set of facial photographs of your nose that are in focus from all angles are required to make a determination about how best to proceed.

Question: How long after deep plane facelift, endoscopic brow lift, and quad blepharoplasty can I put in beaded row hair extensions?
Answer: A month after your surgery should be an adequate amount of time to Start using hair extensions again. Always best to check with your operative surgeon.

Question: Is it possible to further straighten nose and balance profiles?
Answer: From the photographs presented, you have a Beautiful result and it is probably best to leave well enough alone. The amount of change you are requesting is not worth the risk undergoing a complete revision rhinoplasty. There is no perfect nose, just improvements.

Question: Brow lift or blepharoplasty?
Answer: From the limited photograph presented, the eyebrow position is normal, and a brow lift is unnecessary. Just consider an upper blepharoplasty procedure to get rid of the excess skin touching the eyelashes.

Question: For what reasons would a doctor recommend general anesthesia, instead of local anesthesia for chin liposuction?
Answer: There are many factors are going to that decision of general anesthesia versus local anesthesia. Some patients cannot tolerate local anesthesia because of anxiety. Liposuction will only remove fat deposits above the platysma muscle which can be performed under local anesthesia. When the fat deposits are located below the platysma muscle, surgical extraction with a neck lift procedure and a platysma plasty are going to be required. In this procedure should be performed under general anesthesia. A full set of pictures and an in-person examination going to be required to make that determination.

Question: Do I need chin lipo again or a neck lift?
Answer: Much more information is needed, such as a better set of photographs from all angles, in addition to your height and weight. If you have excess fat deposits below the platysma muscle, then a surgical neck lift is going to be required to Remove that compartment of fat which liposuction cannot accomplish. A platysma- plasty is also performed to significantly improve the jawline. At age 23, your skintone is acceptable and no skin removal is required.

Question: What is the best age for rhinoplasty?
Answer: As long as you’re an excellent health, you can perform rhinoplasty at any age. Digital computer imaging would be helpful to understand what can be accomplished with your nose upon your facial features. Study your perspective surgeon’s before and after rhinoplasty photo gallery to make sure that it is extensive with natural results that you like. 

Facial Plastic Surgery Questions and Answers: Part 07

Question: Lower face/chin widening. How can this be remedied?
Answer: I am almost 50 and have hallowing in the lower face next to my lips, is facelift the only way to correct this?

Question: Would a lower facelift help to remedy my issue?
Answer: More information is needed such as your age, and the status of the skin tone in your neck. If your skin tone is acceptable and you are less than 50 years of age, you may be able to get by with a neck lift procedure only which can accomplishes removal of fatty deposits above and below the platysma muscle in addition to the platysma-plasty to significantly improve the jawline. No skin removal is required. If you are over 50 and had significant facial and neck laxity, then a lower face and neck lift would be required. Also consider placement of a chin implant augment the chin forward for better facial balance and proportions along with improved structural support for the soft tissues in the neck.. Both procedures can be performed together under general anesthesia.

Question: What work do I need done on my nose?
Answer: A full set of facial photographs from all angles would be helpful to make a better determination about what needs to be done on your nose. A Closed rhinoplasty procedure can accomplish shaving down the dorsal hump, refining the nasal tip, narrowing the bridge line and reducing the hanging columella with all of the incisions placed on the inside of the nose. To make the diagnosis of a deviated septum requires a thorough internal examination of the nose.

Question: Would I be a good candidate for ptosis surgery, blepharoplasty or a brow lift?
Answer: A full set of eyelid photographs from all angles that are unadulterated are going to be required to make a determination about how best to proceed. From the limited photograph, your eyebrow position appears normal, And a brow lift is unnecessary. An upper blepharoplasty procedure can accomplish removal of excess skin on the upper lids. Ptosis surgery involves tightening the eyelid muscles when the upper eyelid margin is cutting across the black part of your pupil.

Question: How much can I expect to be able to shorten my nose, reduce nostril size and reduce bulges on the side of my nose?
Answer: A closed Rhinoplasty approach can accomplish shaving down the dorsal hump, decreasing the overall projection of the nose, reducing the hanging columella, and reduction of the bulbous nasal tip. Also important to release the depressor septi ligament which pulls the tip down dynamically when you smile. With a closed rhinoplasty, all the incisions are located on the inside of the nose. No painful packing is required. An alar-plasty is performed to narrow wide nostrils with a small incision at the base of the nostrils. 

Question: Is there a specific type of chin implant to make your chin wider over projection?
Answer: A full set of facial chin photographs going to require to make a determination about how best to proceed. Consider placement of a pre- jowl implant.

Question: What procedure is best for my jaw/underneath chin?
Answer: Simple liposuction can accomplish removal of the fatty deposits in your neck. If there is a recessive chin profile present, then consider placement of a chin implant as well. Both procedures can be performed under local anesthesia as an outpatient procedure.

Question: Would I be a good candidate for a chin implant?
Answer: The Side profile photographs demonstrate a recessive chin profile, therefore you are a good candidate for a chin implant. The implants themselves are manufactured in a large array of thicknesses, sizes, and shapes which is best determined at the time of the consultation. In our practice, we place the implants through a small incision underneath the chin under local anesthesia as an outpatient procedure.

Question: Would I be a good candidate for a rhinoplasty?
Answer: A closed rhinoplasty approach can accomplish reduction of the bulbous nasal tip, shaving down the dorsal hump, and narrowing the bridge line. All the incisions are placed on the inside of the nose. No external incisions are required, and no painful packing is required either. Computer imaging of your nose from several different angles would be helpful in the education process to understand what your new nose would look like upon your facial features. Choose your rhinoplasty specialist wisely based on producing natural results. 

Question: Is only chin/neck lipo needed for me?
Answer: Before undergoing any elective surgeryin the neck, you need to be at your ideal body weight with a BMI no greater than 32. When you’re at your ideal body weight, then consider neck surgery. The photograph demonstrates fat deposits and the neck which are located both above and below the platysma muscle in your neck. Liposuction will only accomplish removal of the fat deposits above the muscle, while a surgical neck lift is required to extract the majority of fat deposits Below the muscle. A platysma-plasty is also performed to significantly improve the jawline. You also have a recessive chin profile, so consider placement of a chin implant as well improve your side profile. 

Facial Plastic Surgery Questions and Answers: Part 06

Question: 30, Caucasian, female, 110lbs, fair skin, what surgery to lengthen top lip?
Answer: Consider performing a Closed rhinoplasty procedure to reduce the overall projection of your nose by shaving down the dorsal hump, reduce the hanging columella and nasal spine which is creating a tension upper lip. A properly performed rhinoplasty improve the look of your upper lip. Digital computer imaging would also be helpful see what your new nose would look like upon your facial features. Choose your rhinoplasty specialist very carefully based on producing natural results.

Question: Can I have rhinoplasty with Ehlers-Danlos syndrome & how to find a surgeon who specializes in this?
Answer: Yes you can have a rhinoplasty procedure with Ehlors-Danlos syndrome. It’s important to look for a rhinoplasty specialist, since rhinoplasty is the most difficult procedure to perform correctly in the in the entire field of cosmetic surgery. In our practice, we have performed Rhinoplasty on several patients with this syndrome and those patients have received an excellent result. Digital computer imaging of your nose upon your facial features would also be helpful to see what can be accomplished with the procedure. 

Question: Columella swollen or botched? Will this go away?
Answer: You have a hanging columella, and will not go away without surgical intervention. Best to wait at least a year to allow full healing before embarking on a revision rhinoplasty. A closed rhinoplasty approach can accomplish trimming back the excess cartilage and skin in that area. All incisions are placed on the inside of the nose.

Question: Want to slim down lower face and tighten skin – do I need chin lipo or filler? 
Answer: More information is needed such as a full set of facial photographs from all angles in a chin neutral position. You appear to have fat deposits located both above and below the platysma muscle in the neck which may require a neck lift procedure. Liposuction can only remove the fat deposits above the muscle and will be ineffective. No skin removal is required. 

Question: is like upper part of nose – do I need an osteotomy?
Answer: Yes indeed, you will require both medial and lateral osteotomies placed in the nasal bones in order to narrow the upper two thirds of the nose.

Question: Two different profiles after rhinoplasty – what went wrong and how can it be corrected?
Answer: As long as it’s been at least one year since your primary rhinoplasty, then you can consider undergoing a revision. The residual hump can be shaved down, and that concave upper lateral cartilage on your left side will need to be grafted with your own cartilage. It’s important to know how much cartilage is leftover on the inside of the nose for grafting purposes. Nostril asymmetry is normal to have before and after rhinoplasty surgery.

Question: Rhinoplasty doctor putting me not fully under to go in and scrape away scar tissue? I got a nose job 2 years ago
Answer: You have a mild convexity of your nasal dorsum just above your tip which is called a polybeak. This can be created from thick skin which is treated with steroid shots, or can be caused by residual cartilage which is going to require surgery. We perform all revision rhinoplasty procedures under general anesthesia for patient safety and comfort.

Question: What is the difference between deep-plane and SMAS lower facelifts?
Answer: A deep plane facelift involves dissection in the cheek area in Direct proximity of the facial nerve branches, and has a higher incidence damaging those nerves. A SMAS facelift involves tightening the Facial muscles/fascia safely without seeing the facial nerve branches. Study your prospective surgeon’s before and after facelift photo Gallery, which should be extensive with natural results that you like. In our practice, we do not perform endoscopic brow lift, but perform a coronal approach which can address not only raising the eyebrows, but adjusting asymmetric eyebrows, raising or lowering the hairline, and softening the vertical and horizontal Lines in the forehead as well. A full set of facial photographs from all angles are required to make a determination about how best to proceed with both surgical procedures.

Question: Will a lower facelift correct the loose skin under my chin, and lift the corners of my mouth?
Answer: The goal of a lower face and neck lift is to tighten loose facial and neck skin, tighten loose facial and neck muscles, remove the fat deposits in the neck with liposuction, and lift the jowls. The corners of the mouth are not lifted since you might look unnatural.

Question: How will weight loss affect a patient’s results after chin lipo?
Answer: It’s always best to lose the weight first, and then undergo chin liposuction from the diet resistant fat deposits. You get a better result.

Facial Plastic Surgery Questions and Answers: Part 05

Question: Is the removal of a chin implant a difficult process?
Answer: Your chin implant can be simply removed, or replaced with another one under local anesthesia. An in-person exam would be required to choose another implant, since there are many options. Also important to know what size and style of implant was placed.

Question: Would a chin Implant give me ideal results?
Answer: From the limited photographs, it does appear that your candidate for a chin implant to augment your chin forward for cosmetic purposes. A sliding genioplasty is performed when the teeth are significantly out of alignment. Placement of the chin implant can be performed under local anesthesia as an outpatient procedure.

Question: Hi there, I just want to understand what is *wrong* with my jawline, any ideas?
Answer: The limited photographs demonstrate a recessive chin profile and fat deposits in the neck located above and below the platysma muscle in the neck. Consider a chin implant augment the chin forward for better facial balance and proportions, and improved structural support for the soft tissues in the neck. A neck lift procedure can accomplish removal of fat deposits above and below the platysma muscle which also includes a platysma plasty to significantly improve your jawline. No skin removal is required below 50 years of age.

Question: What can I do about my nose? Am I going to need a nose job? Will my nose be able to be restored to its original shape?
Answer: Trauma to the nose can cause of issues such as a displaced nasal fracture, a non-displaced nasal fracture, dislocation of the upper lateral cartilages off of the nasal bones and a deviated septum. A closed rhinoplasty can accomplish shaving down the dorsal irregularities, narrowing the nasal bones, placement of spreader grafts to the concave upper lateral cartilages in the mid-vault. All of the incisions are placed on the inside of the nose. 

Question: Is isolated alarplasty possible for my nose?
Answer: Yes it is possible to only perform an alar-plasty on your nose. This can be done under local anesthesia.

Question: Do I have alar retraction? Can this be ‘easily’ fixed? Not using rib or ear cartilage (and hence seeing scars).
Answer: You have both alar retraction and hanging columella. A columella-plasty is required to reduce the excess cartilage and skin hanging down below your nostril rim. This will also help camouflage the obvious open rhinoplasty incision scar. Composite skin/ cartilage grafts harvested from the ear are going to be required to reduce the alar retraction. This revision rhinoplasty procedure can be accomplished with a closed rhinoplasty approach which avoids the visible external scar across the columella. 

Question: Could I get similar results to Penelope Cruz?
Answer: A full set of facial photographs from all angles of your nose are going to be required to make a determination about how best to proceed. Digital computer imaging of your nose upon your facial features can give you an idea what can AND cannot be accomplished with a rhinoplasty. Thick skin in the tip of the nose is going to prevent confinement in that area, so it is important have realistic expectations.

Question: Weak jawline/genetic double chin?
Answer: At age 37, you do not need a facelift. A mini lift will not address your neck issues. The Photographs demonstrate a recessive chin profile and fat deposits in the neck with a poor jawline angle. Consider placement of a chin implant augment the chin Forward for better facial balance and proportions, especially with respect to the projection of your nose. A neck lift procedure can accomplish removal of fat deposits above and below the platysma muscle which also includes a platysma-plasty to significantly improve the jawline. Both of these procedures are performed through one incision underneath the chin under general anesthesia as an outpatient surgical procedure. 

Question: Are the rhinoplasty results shown in my photoshopped pictures achievable?
Answer: Yes, a closed rhinoplasty approach can accomplish shaving down the dorsal hump, lifting the nasal tip, and reducing the hanging columella with all incisions placed on the inside of the nose. No external incisions are required and no painful packing is required. It is also important to release the depressor septi ligament which also pulls the nasal tip down dynamically when smiling. 

Question: Approximate price for rhinoplasty in SF Bay Area?
Answer: Those price quotes do sound a bit high, it’s also important to make sure that you’re looking at all costs which include the operating room, anesthesia fee, and surgeon’s fees. It’s also best to find a more affordable surgeon within United States, Since you may require some follow-up care. In addition too finding a more affordable surgeon, look for rhinoplasty specialist with an extensive portfolio of before-and-afters. Rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, so choose your surgeon wisely based on extensive experience. Our current rhinoplasty price list is located on the website link below.

Facial Plastic Surgery Questions and Answers: Part 04

Question: My polly beak keeps returning. Will 5FU shots help, or is revision rhinoplasty the only way?
Answer: Poly beak can be caused by residual cartilage left behind, or thick skin. Revision rhinoplasty is required to remove residual cartilage, while Kenalog mixed with 5-FU can treat thick skin. Best to follow up with your operative surgeon for those shots.

Question: Loose skin and fat on chin, neck, jaw. How can this be treated?
Answer: Congratulations on your first 50 pounds of weight loss. You need to lose the additional 50 pounds before contemplating any type of lower face and neck lift procedure. Your BMI should be less than 32 for optimal results. You have significant fat deposits in the neck located both above and below the platysma muscle. The goal of a lower face and neck lift is to tighten loose facial and neck skin, tighten loose facial and neck muscles, remove diet resistant fat deposits in the neck, and lift the jowls. 

Question: What can be done/used during a revision rhinoplasty to fix missing bone on top of nose bridge?
Answer: You don’t have any missing bone, but you have an inverted upper lateral cartilage that is not in alignment with your left nasal bone. You will require an osteotomy placed in the left nasal bone and a cartilage spreader graft placed along that concave upper lateral cartilage in the midportion of your nose. It’s important to know how much cartilage is left over on the inside of the nose for grafting purposes, so it’s best to get a copy of the operative report. You’ll also have to remove the piercing for at least a few months after the procedure.

Question: How long should I wait after CO2 Laser to have a Deep Plane Facelift?
Answer: It’s probably best to wait at least 2 to 3 months between procedures to allow optimum healing. There are many different types of lasers and facelifts, so make sure you ask all the right questions to your prospective surgeon, and study their before and after photo Gallery for both procedures which should be expensive.

Question: What are my options to treat the bump on my nose?
Answer: There appears to be a relatively small bump and an inverted upper lateral cartilage on your right side maybe also related to that injury. It’s also important to know if there’s any breathing difficulties related to a deviated septum which also can be caused from the injury itself. A closed rhinoplasty procedure can accomplish improvement of your nose, but it won’t be perfect, and the amount of change looks like it might be rather minimal. 

Question: Can you go back to work in 4-5 days after MyEllevate?
Answer: More information is needed, such as a full set of facial and neck photographs from all angles to make a determination about the most appropriate procedure. The most likely reason that liposuction failed for you is because you probably have fat deposits located below the platysma muscle in the neck. If that’s the case, it take a surgical neck lift to remove those compartments of fat in addition to a platysma plasty to significantly improve the jawline. Most patients take at least a week off from work. 

Question: Why does my nose look like this on the left?
Answer: The residual convexity on your nasal bridge can be related to many different healing issues which include residual cartilage and bone left from the actual surgery itself. That convexity can also be related to hypertrophy of thick sebaceous skin. Thick skin is treated with steroid shots, while surgical intervention including a revision rhinoplasty is required to shave down residual cartilage and bone. 

Question: Tip only rhinoplasty possible for me?
Answer: You are not a candidate for a tip only rhinoplasty due to the fact that once you narrow the tip, your bridge line will be excessively wide and disproportionate from your nasal tip. In our practice, we perform all rhinoplasty procedures under general anesthesia for patient safety and comfort. Patients are monitored by a board-certified physician anesthesiologist in our outpatient surgery center. There are too many nerve endings in the nasal tip to be comfortable to even try to undergo this type of surgery under local Anesthesia.

Question: I’ve got a dent on the side of my nose after a rhinoplasty. What can I do to get rid of it?
Answer: From the one very limited photograph, you have significant asymmetry on your nasal bones, and cartilages within your nose. You’re going to need a revision rhinoplasty procedure. Choose your second surgeon wisely based on extensive experience producing natural results. Also remember there is no perfect nose, just improvements.

Question: Endoscopic (trichophytic) browlift, any advantage to having this done under general anesthesia?
Answer: In our practice, we perform all brow lift procedures under general anesthesia monitored by a board-certified physician anesthesiologist for patient safety and comfort. We also perform mostly coronal approach brow lift procedures which can not only raise the eyebrows, but a address asymmetries, and soften both of horizontal and vertical frown lines in addition to raising or lowering the hairline. 

Facial Plastic Surgery Questions and Answers: Part 03

Question: I’m 50 years old, would you recommend a facelift?
Answer: The photos demonstrate early jowls, fat deposits in the neck and platysma muscle cords in the neck. In our practice , we perform a high SMAS lower face/neck lift which accomplishes lifting the jowls, tightening loose facial and neck skin, tightening loose facial and neck muscles, and removing fat deposits in the neck above and below the platysma in addition to a platysma-plasty to improve the jawline. 

Question: Can I get similar results to the pictures attached?
Answer: A rhinoplasty can accomplish narrowing the nasal bones and refining the tip. Thick skin in the nasal tip will prevent refinement, so its important to have realistic expectations. An alar-plasty can accomplish narrowing wide nostrils. Digital imaging of your nose upon your face would be helpful in the communication process.

Question: What type of rhinoplasty operation can be done on my asymmetrical nose?
Answer: A closed rhinoplasty can accomplish straightening the crooked nose with osteotomies placed in the nasal bones and a cartilage spreader graft placed underneath the concave left upper lateral cartilage in the mid-portion of the nose. All of the incisions are placed on the inside of the nose. No external incisions required, and no painful packing is required either. Releasing the depressor septi ligament will prevent the nose from drooping dynamically when smiling. 

Question: Am I a good candidate for a sliding genioplasty / liposuction?
Answer: Consider placement of a chin implant to augment your chin forward along with liposuction of the fat deposits in the neck. Both procedures can be performed under local anesthesia thru the same incision. Expect 2 weeks of swelling and minimal bruising.

Question: Can I change the droopy nose when I smile?
Answer: Releasing the Depressor Septi ligament can accomplish preventing the tip of the nose from drooping when smiling.

Question: I had a rhinoplasty in 2010. Since my rhinoplasty, I’ve had a bump/bubble on the left side. How can I have this fixed?
Answer: There appears to be a concave nasal tip cartilage on the right and a convex nasal tip on the left. A revision closed rhinoplasty can accomplish improvement. All of the incisions are placed on the inside of the nose.

Question: Am I candidate for chin liposuction or would a neck lift be more appropriate?
Answer: The photos demonstrate a recessive chin and fat deposits located above AND below the platysma muscle in the neck. Consider placement of a chin implant to augment the chin forward for better facial balance and proportions. Neck liposuction will only remove fat deposits above the platysma muscle, while a neck lift will remove the fat above and below the muscle which also includes a platysma-plasty to significantly improve the jawline.

Question: Is it possible to get a mini neck lift when getting a chin implant removed?
Answer: Yes, both procedures can be performed at the same time. Consider removal of your existing chin implant and proper sizing and placement of a new chin implant. A neck lift removes fat above and below the platysma muscle and includes a platysma-plasty. There is No skin removal.

Question: How can I best improve my appearance while on a budget?
Answer: A closed rhinoplasty can accomplish narrowing your wide nasal bones and refine the nasal tip with all of the incisions placed on the inside of the nose. Thick skin in the tip of the nose will prevent refinement in that area, so its important to have realistic expectations. Digital computer imaging would be helpful in the communication process.

Question: What alarplasty technique would you use on my nose?
Answer: An alar-plasty can accomplish narrowing the nostrils statically thru a small incision at the base of the nostrils. To help with the dynamic widening when smiling requires release of the ligaments at the base of the ala. That release occurs thru the alar-plasty incision. A full rhinoplasty would be required to straighten the crooked nose. Digital imaging would be helpful to understand what your new nose would look like upon your facial features. 

Facial Plastic Surgery Questions and Answers: Part 02

Question: Look good from left side, wonky on right. What procedures can I get to fix this? 
Answer: A full set of facial photographs from all angles are required to make a determination about how best to proceed with a rhinoplasty procedure. The nose is a three dimensional structure, and surgery is performed in all three dimensions. A closed rhinoplasty approach can accomplish refinement of the nasal tip, shaving down the dorsal hump, and narrowing the bridge line. Releasing the depressor septi ligament will prevent the tip of the nose from drooping down dynamically when smiling.

Question: What can I do to correct my asymmetrical nose?
Answer: A closed rhinoplasty approach can accomplish improvement the symmetry of your nose, but it’s important to understand that there is no perfect nose. You have a very small dorsal hump which can be shaved down. There’s a small exaggerated depression at the supratip area of your bridge line which can be softened with a cartilage graft. The convexity of your nasal tip on the left side can be shaved down, and small cartilage grafts will probably be required on the right side which is concave. The nostrils are asymmetrical now and will continue to be so after the surgery.

Question: Is there a way to change the dorsal hump of my nose while maintaining my original nose tip size?
Answer: Is there a way to change the dorsal hump of my nose while maintaining my original nose tip size
It is possible to shave down the dorsal hump, but you will require osteotomies placed in the nasal bones to close the open roof created from hump removal itself. No tip work is necessary as long as your tip is within balance for the new bridge line without the hump. A closed rhinoplasty approach can accomplished your goals with all the incisions placed on the inside of the nose. No external incisions are required, and no painful packing is required either.
 

Question: Would an ethnic rhinoplasty help me achieve my desired results?
Answer: Yes indeed, an ethnic rhinoplasty would improve your nose like the images posted. To narrow the bridge line would require osteotomies placed in the nasal bones which can narrow them and narrow the entire bridge line. An alar-plasty would be required to narrow wide nostrils.

Question: ge 32, what procedure would correct the puffiness and shadows under my eyes?
Answer: To make a determination about being a candidate for lower blepharoplasty will require pictures of both eyes looking straight into the camera. Looking upwards will make the fat bags worse. If you have bags at on forward gaze, then consider a trans-conjunctival lower blepharoplasty procedure to remove the fat bags creating the puffy look. The Incisions are completed located on the inside of the lower lids. This procedure is performed under brief general anesthesia as an outpatient procedure. 

Question: Can I do rhino, lip lift & lower blepharoplasty all in one?
Answer: Yes, it is certainly possible to do all 3 procedures under general anesthesia with one recovery period. I our practice, we do not perform the lip lift procedure due to extensive scarring we have seen from patients having had that procedure done elsewhere. Start by looking for a rhinoplasty specialist, since rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery. 

Question: Agnes RF for submental fat, do you recommend it for fat reduction & face sculpting?
Answer: Much more information is needed, such as your height, weight, and a full set of facial and neck photographs from all angles too make a determination about how best to proceed with the most appropriate procedure. It’s also important to understand that in the neck there are two compartments of fat, and they’re located both above and below the platysma muscle in the neck itself. 

Question: Would a sliding genioplasty & chin liposuction fix weak & double chin?
Answer: A sliding genioplasty is performed by an oral surgeon under general anesthesia in a hospital setting with an overnight stay, and is much more invasive. Placement of a chin implant and neck liposuction can both be done under local anesthesia as an outpatient procedure.

Question: Use of Prednisone after deep plane facelift – does it really make a lot of difference in recovery?
Answer: We use prednisone pills on select patients who have more extensive swelling, and it does seem to shorten the recovery process. Always check with your surgeon or a family physician to make sure you’re okay to go on the prednisone.

Question: Lower Facelift Options / Considerations?
Answer: From the photographs presented, you have the normal changes of aging for a woman at 58. In our practice, a lower face and neck lift procedure accomplishes tightening loose facial and neck skin, lifting the jowls, tightening loose facial and neck muscles, and removing the fat deposits in your neck which also includes a platysma plasty to significantly improve the jawline. Most of your improvement will be in the neck itself. Study your prospective surgeon’s before and after facelift photo Gallery to make sure that the results are very natural and the incisions are minimally detectable. 

Facial Plastic Surgery Questions and Answers: Part 01

Question: Will rhinoplasty help to fix a long midface?
Answer: A closed rhinoplasty approach can accomplish shortening your nose give the appearance of a better midface balance. The dorsal hump can be shaved down, the hanging columella reduced and refinement of the nasal tip. All incisions are placed on the inside of the nose. No external incisions are required, and no painful packing is required either. Also consider placement of a small chin implant for the recessive and short Chin projection that you have. Both procedures would improve your facial balance and proportions. Digital computer imaging would also be helpful understand what either one or both procedures would look like upon your facial features.

Question: Can I change my nose tip with surgery?
Answer: approach accomplish her goals. Consider a chin implant to augment a weak and recessive chin forward for better facial Balance and proportions.

Question: I am interested in minimum neck lift but confused about all the different options. Advice?
Answer: tighten loose facial and neck skin, tighten loose facial and neck muscles, remove any residual fatty deposits in the neck, lift the jowls, and perform a platysma- plasty to improve your jawline. 

Question: Can Dermal Fillers help straighten my nose without nose surgery?
Answer: Fillers placed in the nose are not going to straighten the nasal bones and cartilages. Your nose is significantly crooked, and you will most likely have a deviated nasal septum on the inside of your nose as well. A closed rhinoplasty and a closed septoplasty are probably going to be required in order straighten your nose and breathe better. All incisions are placed on the inside of the nose. 

Question: Would I benefit from a chin implant? I feel like my jaw is weak- are there other ways to make my jaw appear stronger?
Answer: A full set of facial photographs from all angles, especially the side profile going to require to make a determination about how best to proceed. Chin implants augment the chin forward for better facial balance and proportions, since this is a bony augmentation.

Question: Would I be a successful candidate for a lower facelift and neck lift?
Answer: The photos demonstrate normal changes of aging for which a lower face/neck lift can improve. In our practice, we perform a high-SMAS lower face/neck lift which accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls and remomoving fatty deposits in the neck which also includes a platysma-plasty to significantly improve the jawline. 

Question: Seeking a 2nd opinion: Should I consider revision? (Closed rhinoplasty).
Answer: Consider following up with your previous surgeon for a revision to shave down the residual dorsal hump. This appears to be residual dorsal cartilage from the graft or leftover from the surgery itself. A closed revision rhinoplasty can certainly address this issue with all incisions placed on the inside of the nose. No external incisions are required. 

Question: Boney feeling bump 39 years later! Is there anything that can be done?
Answer: Revision Rhinoplasty is very difficult, therefore a full set of facial photos from all angles are required to make a determination about how best to proceed. Osteotomies placed lower on the nasal bones can accomplish improvement.

Question: Are SMAS facelifts worth it?
Answer: In our practice we perform a high-SMAS lower face and neck lift which safely accomplishes tightening loose facial and neck skin, tightens loose facial and neck muscles, lifts the jowls and removes fat above and below the platyma muscle and includes a platysma-plasty. The SMAS does not droop in 2 years, but pre- existing poor skin tone in the neck will be the limiting factor as to how long the facelift results will last. 

Question: Considering revision rhinoplasty 22 years after initial surgery. What is a realistic result? What does surgery entail?
Answer: A closed rhinoplasty approach can accomplish reducing the hanging columella and placement of a composite graft from the ear can help the alar retraction. Osteotomies can narrow the nasal bones and spreader grafts can widen the pinched upper lateral cartilages in the mid-vault of the nose, Wide nostrils can be reduced with an alar-plasty.

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