Facial Plastic Surgery Questions and Answers: Part 8

Question: Can I achieve my desired look with a rhinoplasty alone?
Answer: Yes, a closed rhinoplasty approach can accomplish improvement of the bulbous nasal tip, and shaving down the dorsal hump and reducing the overall projection and those with all the incisions placed on the inside of the nose. You appear to have thick skin, so be prepared for a few steroid shots to the Nasal tip to reduce swelling in that area after the surgery.

Question: Is radix augmentation necessary for dorsal hump removal if you have a low radix?
Answer: In our practice, the far majority of people do not need radix augmentation. We rarely use this grafting technique as long as the radix is in an acceptable position. Digital computer imaging of your nose upon your facial features would be helpful to understand what can be accomplished with a closed rhinoplasty.

Question: What’s the best course of action to treat my platysmal bands?
Answer: Consider a lower face and neck lift procedure with a corset platysma-plasty, and a myotomy of the actual platysmal bands themselves. It’s also best to get Botox placed in the platysmal bands about a week before the surgery so that the bands do not grow back together after the myotomy. A lower face and neck lift will accomplish tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and removing fat deposits in the neck with liposuction, in addition to the platysma plasty to significantly improve your jawline.

Question: Do I need a sliding genioplasty?
Answer: A sliding genioplasty as performed by an oral surgeon under general anesthesia in a hospital setting with an overnight stay, and is much more invasive and expensive than a simple chin implant. A sliding genioplasty is usually performed when the teeth are significantly out of alignment. It is not performed in conjunction with a rhinoplasty. Chin implants are placed through a small incision underneath the chin under local anesthesia which usually takes about 30 minutes. You can perform a chin implant with a rhinoplasty under general anesthesia as an outpatient procedure. For many examples of this combination, please see the link below.

Question: Should I get a chin implant or jaw surgery to move my mandible forward and (hopefully) define my jaw? Or jaw implants?
Answer: Jaw surgery is performed by an oral surgeon under general anesthesia in a hospital with an overnight stay and is much more invasive. It usually done with the teeth are significantly out alignment. Placement of a chin implant can be performed under local anesthesia which takes approximately 30 minutes. In our practice we placed the implant through a small incision underneath the chin under local anesthesia as an outpatient procedure. The fat compartments in your neck are located both above and below the platysma muscle, therefore a neck lift will be required to remove both compartments of fat in addition to a platysma-plasty to significantly improve the jawline.

Question: Rhinoplasty advice to make my nose look more feminine and not so bulbous, wide and long?
Answer: A closed rhinoplasty approach can accomplish refinement of the nasal tip, shaving down the dorsal hump, decreasing the overall projection of the nose and narrowing the bridgeline. All of the incisions are placed on the inside of the nose, and no external incisions are required. No painful packing is required either. Open rhinoplasty involves placement of an external incision across the columella. An alar-plasty is performed when there are wide nostrils present from the base view. Digital computer imaging would be helpful to understand what can be accomplished with your nose upon her facial features. If you have thick skin in the tip of the nose, this may prevent refinement in that area, so it is important to have realistic expectations.

Question: What should I get done to my nose to remove the bone off the sides?
Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, straightening the nose and significantly narrowing the nasal bones where they are excessively wide. All the incisions are placed on the inside of the nose. Medial and low lateral osteotomies placed in the nasal bones accomplish narrowing and straightening the nose itself.

Question: Is it my chin or my jaws that are receded, would sliding genioplasty grant me a big improvement?
Answer: The limited photographs demonstrated a recessive chin profile for which a chin implant can improve. If your teeth are significantly out of alignment, then consider a sliding genioplasty performed by an oral surgeon in a hospital setting with an overnight stay. Chin implants are placed under local anesthesia as an outpatient procedure through a small incision underneath the chin.

Question: Is 56 too old for a mini MACS lift?
Answer: Mini lifts give mini results and therefore we rarely perform them. A full set of facial photographs from all angles with your chin in a neutral position with your hair pulled back are going to be required to make a determination about being a candidate for a lower face and neck lift procedure at age 56. The goal of a lower face and neck lift is to tighten loose facial and neck skin, tighten loose facial and neck muscles, lift the jowls, and remove fat deposits in the neck with liposuction in addition to a platysma plasty.

Question: Can change in this morph be achieved?
Answer: The photographs are rather limited, however the morphed photos do appear realistic. It is important to understand the nose is a 3-dimensional structure, and rhinoplasty is performed in all 3 dimensions. Rather than relying on morphing, look at your prospective surgeon’s before and after photo Gallery and make sure that it is extensive with results that you like.

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