Facial Plastic Surgery Questions and Answers: Part 1

Question: What can I do to improve my profile? Should I do something to my nose?
Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump and reduction of the hanging columella and narrowing the bridge line with all of the incisions placed on the inside of the nose. No external incisions are required. Digital computer imaging would be helpful to understand what can be accomplished with your nose upon your facial features.

Question: What’s the difference between closed and open rhinoplasty and which works best for me if I want a big difference?
Answer: With closed rhinoplasty, all the incisions are placed completely on the inside of the nose. With open rhinoplasty there is a visible scar placed across the columella. You should be able to get a great result with either approach. Also consider placement of a chin implant to augment your chin forward for better facial balance and proportions, especially from the side profile with respect to the overly projecting nose.

Question: Can I get my bulbous nose and sinus surgery together?
Answer: yes, a cosmetic rhinoplasty, and functional endoscopic sinus surgery can be performed together under 1 anesthesia with one recovery period. Seek out a double board-certified ENT/facial plastic surgeon who can perform both procedures simultaneously.

Question: Will a nose job drastically change my face?
Answer: The side profile photograph demonstrates an overly projecting nose with a droopy tip. A closed rhinoplasty approach can accomplished decreasing the overall projection of the nose, shaving down the dorsal hump, and lifting the nasal tip slightly. It is very important to give a very natural appearing nose so that it does not look like it has been a rhinoplasty has been performed. The changes from the front will be very minimal, however the side profile changes will be moderate. Best to perform digital computer imaging from different angles to understand what can and cannot be accomplished with your nose.

Question: Will chin implant be beneficial if my top and bottom lip slightly don’t line up from profile view?
Answer: From the side profile photograph, you have a significant recessive chin profile for which a chin implant can certainly improve. Placement of a chin implant can be done as an outpatient procedure under local anesthesia. We make a small incision under the chin to insert implant. Digital computer imaging would also be helpful to understand what a new Chin might look like upon your facial features.

Question: Is it possible to place a graft to fix nostril flare?
Answer:You have a combination of alar retraction, a hanging columella, and A mild polybeak. All these can be addressed with a closed rhinoplasty approach with all the incisions placed on the inside of the nose. That alar retraction is best treated with the composite graft harvested from the ear.

Question: What should I do for my chin?
Answer: You have a recessive chin due to the fact that your mandible bone never grew far enough forward. If your teeth are significantly out of alignment, then you can consider a genioplasty performed by an oral surgeon under general anesthesia at a hospital setting with an overnight stay at the hospital. If you’re looking for a simple cosmetic improvement, then consider placement of a Chin implant to augment your chin forward for better facial balance, and proportions. Chin implants can be placed under local anesthesia through a small incision underneath the chin, which takes about 30 minutes in the office setting.

Question: Chin implant replacement after 35 years?
Answer: It is certainly possible to remove the old implant and insert a new chin implant. This time we would take the old one out and put the new one in through a small incision underneath your chin, and not go through the mouth again. This procedure can be performed under local anesthesia as an outpatient procedure which would take about 30 minutes.

Question: Want to get my nose done?
Answer: It’s very important to have specific goals in mind on exactly what you’re trying to accomplish with cosmetic rhinoplasty. The side profile shows that you have a slight dorsal hump and a slight hanging columella, which can be improved. The front profile demonstrates a bulbous nasal tip, which can be reduced, however if you have thick skin present, the amount of reduction will be limited. Digital computer, imaging of your nose upon your facial features would also be helpful.

Question: Would a septoplasty straighten my nose or only fix breathing problems?
Answer: A septoplasty will only fix breathing problems in the back of your nose as a result of the fracture. If you’re looking to straighten your nose, you’re going to need a cosmetic rhinoplasty. Both procedures can be done simultaneously under one Anesthesia with one recovery period. Rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery, so choose your surgeon wisely based on extensive experience.

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