Facial Plastic Surgery Questions and Answers: Part 2

Question: Seeking a more balanced profile, chin or nose first? Do I have any jaw issues? 
Answer: From your description, it sounds as though you have an overly projecting nose, and an under projecting chin. A full set of facial photographs from all angles are required to make a determination about how best to proceed with two surgical procedures. In our practice, we frequently perform a rhinoplasty to shave down the dorsal hump simultaneously with placement of a small chin implant to augment the chin forward for a better facial balance and proportions. If you have a recessive chin, that makes the nose look bigger than it really is. Digital computer imaging of your both your nose and your chin would be helpful to understand what can be accomplished with both procedures. If you’re looking to only perform the chin implant, that can be done under local anesthesia as an outpatient procedure, which takes about 30 minutes. Rhinoplasty requires general anesthesia.

Question: Facelift after tightening procedures? 
Answer: The previous non-invasive treatments that you have will have no effect moving forward performing a lower face and neck lift procedure. Study your prospective surgeon’s before and after facelift photo gallery to make sure that the results look very natural.

Question: Facelift did not fix/ tighten my jowls – I look exactly the same after facelift. What can I do to fix this?
Answer: A full set of facial and neck photographs from all angles are required to make a determination about how best to proceed. You’re gonna need to wait at least one year after the primary facelift before embarking on another procedure to allow full healing first. Your incisions are still very fresh, and you have significant edema behind your ears. your next plastic surgeon they want to see a copy of the operative report as well.

Question: Should I wait for fillers and Botox to dissolve before having a facelift and a neck lift?
Answer: Botox and fillers will have no effect on a lower face and neck lift procedure, So it is very acceptable to undergo a surgical treatment you are interested in performing.

Question: When the nose bone is shaved down during rhinoplasty, how do you get out the shavings?
Answer: The dorsal hump is composed of both bone and cartilage. The cartilage is cut with a knife, and the bone is cut with a osteotome. A small amount of rasping is done to smooth out the edges. Any other residual debris is also removed with the rasp.

Question: Kybella and Coolsculpting or neck lift to get rid of my double chin?
Answer: The photographs demonstrate fat deposits above and below the platysma muscle in the neck. Liposuction can only accomplish removal of some of the fat deposits above the muscle, while a surgical neck lift is required to remove the fat deposits below the platysma muscle. A platysma plasty is also required after the sub- platysmal fat deposits are removed, which will also significantly improve the jawline. Noninvasive treatments are simply ineffective.

Question: Would I be a suitable candidate for chin implants?
Answer: The side profile photograph demonstrates a recessive chin for which a chin implant can improve. Chin implants are manufactured in a large array of thicknesses, sizes, and shapes. In our practice, we place Chin implants through a small incision underneath the chin under local anesthesia as an outpatient procedure which takes about 30 minutes.

Question: What can be done to fix uneven nostrils?
Answer: From the limited photographs, there appears to be an overly rotated nose, and a crooked caudal septum along with a hanging columella. This can be improved with a closed rhinoplasty approach with all incisions placed on the inside of the nose.

Question: Could my nose be improved by fillers or surgery?
Answer: More information is needed, such as a full set of facial photographs from all angles to make a determination about how best to proceed, since the nose is a 3-dimensional structure, and rhinoplasty is performed in all 3 dimensions. Unfortunately, these photographs are inadequate to make a determination. We do not recommend fillers placed in the nose for a variety of reasons. 

Question: What can be done to improve my side profile?
Answer: The photographs demonstrate an overly projecting nose with a dorsal hump, and a recessive chin profile. Consider a closed rhinoplasty approach to decrease the projection of the nose and shave down the dorsal hump. All the incisions are placed on the inside of the nose. No external incisions are required, and no painful packing is required either. To augment the chin forward requires placement of a small chin implant which will help with facial balance and proportions, especially from the side profile with respect to the overly projecting nose.

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