Facial Plastic Surgery Questions and Answers: Part 02

Question: Can a filler fix my weird nose problem?
Answer: You have prominent nasal bone “corners” and inverted upper lateral cartilages along with a bulbous nasal tip. The corners need to be filed down, and cartilage needs be harvested from inside the nose for placement of bilateral spreader grafts. Some minor adjustments to the nasal tip can also be performed as well. All this can be accomplished with a closed rhinoplasty approach. In our practice, we do not recommend fillers placed in the nose for a variety of reasons.

Question: Are my rhinoplasty wish pics realistic?
Answer: A full set of facial photographs of the patient are going to be required to make a determination about how best to proceed. Digital computer imaging of your nose upon your facial features would be helpful to understand what can AND cannot be accomplished with the procedure. It is important to understand that the nose is a 3-dimensional structure, and rhinoplasty performed in all 3 dimensions. The healing process also occurs 3 dimensionally. Because of this, look for a surgeon who has lots of experience.

Question: Should I get a second opinion? My nose is crooked and I have a bump at the top of the right side of my nose.
Answer: A closed revision rhinoplasty surgery can accomplish shaving down the residual hump, and straightening the nose. Revision rhinoplasty is more difficult than a primary rhinoplasty, so we always have to weigh the risk versus reward benefit ratio.

Question: I had a neck lift done 2/1/23. You can barely tell a difference. Have consult set up…how do I proceed?
Answer: Much more information is needed such as a full set of facial and neck photographs from all angles, and a copy of the operative report. It’s very important to understand that there are two compartments of fat in the neck, and they are located both above and below the platysma muscle. It’s important to know which compartment of fat was removed in your prior procedure.

Question: Can you get two different surgeries within a time span of about a week?
Answer: In our practice, we would recommend you do two general anesthetic procedures at least a month apart, due to the small risk of having a blood clot in your legs. That would also be accentuated by flying to Turkey. Rhinoplasty is the most difficult operation to perform correctly in the entire field of cosmetic surgery, so you should seek out a US-based rhinoplasty specialist for best results and for all of your follow up care.

Question: Do I need a revision to improve my nose tip?
Answer: Revision rhinoplasty is more difficult than a primary rhinoplasty, therefore, a full set of facial photographs from all angles are going to be required. A copy of the operative report would also be helpful. It appears that your tip drooped down after your surgical procedure. Steroid shots are only used for patients with very thick skin which does not appear to be the case from the one limited photograph. It’s also important to release the depressor septi ligament, which dynamically pulls your tip downward when smiling. A runny nose is not treated with cosmetic surgery, so that will continue to need to be treated with medical management.

Question: Insecure about nose tip, what do you think?
Answer: A full set of facial photographs from all angles, especially your side profile are going to be required to make a determination about how best to proceed with a rhinoplasty procedure. A closed rhinoplasty can accomplish reduction of the bulbous nasal tip, narrowing the bridge line and shaving down a dorsal hump. You can also reduce the droopy tip both statically and dynamically when you smile.

Question: Why does my nose look strange & how can I fix it?
Answer: Your nose does not look strange. You have a dorsal hump and a hanging columella. Both of those issues can be addressed with a closed rhinoplasty. Digital imaging would be helpful to understand what can be accomplished with the procedure.

Question: Will insurance cover my rhinoplasty if I have breathing issues?
Answer: A rhinoplasty is considered cosmetic and must be paid for by the patient. A septoplasty or turbinate surgery on the inside of the nose is performed when there is nasal obstruction which is considered functional, and is billed to patient’s medical insurance for medical necessity. Both functional and cosmetic surgery can be performed simultaneously. Look for a double board-certified ENT/facial plastic surgeon who can accomplish both the cosmetic and functional and cosmetic work simultaneously. Choose your rhinoplasty specialist wisely since it is the hardest procedure to perform correctly in the entire field of cosmetic surgery.

Question: How can I improve my weak side profile? Would it be a rhinoplasty & lip fillers or a genioplasty?
Answer: The limited photograph demonstrates the recessive mandible and chin. Consider placement of a chin implant under local anesthesia as an outpatient procedure.This will help with facial balance and proportions, especially with respect to your nose. If you’re interested in rhinoplasty, please post a full set of facial photographs.

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