Facial Plastic Surgery Questions and Answers: Part 03

Question: Significant bumps on my nose after rhinoplasty. How should I go about revision?
Answer: You have fullness in the supra tip area of the nose, which could be related to thick skin, fluid retention or additional cartilage present. Steroid shots may be of some benefit if it is thick skin and scar tissue. A surgical revision rhinoplasty is going to be required if the bumps are related to additional cartilage left over. Best check with your operative surgeon.

Question: Second rhinoplasty? Uneven bridge and droopy tip?
Answer: Your nose looks excellent from the photographs presented. A revision rhinoplasty can accomplish releasing the depressor septi ligament which dynamically pulls the tip down when smiling. The tip can also be lifted slightly at rest as well. An in-person examination is going to be required to make a determination about the irregularities along the bridge line which are not perceptible on these photographs.

Question: Will a chin implant give me more facial balance?
Answer: Yes indeed, a small sized chin implant will give you better facial balance and proportions, especially with respect to your nose from the side profile. In our practice, chin implants are usually placed under local anesthesia as an outpatient procedure which your takes about 30 minutes. They’re placed through a small half-inch cut underneath the chin.

Question: Can a Blepharoplasty help hooded eyes and uneven folds?
Answer: Yes, a skin only conservative upper blepharoplasty can accomplish removal of the small amount of extra skin and the extra skin fold that you have on the one eyelid. This procedure can be performed under local anesthesia as an outpatient procedure. A properly performed blepharoplasty does not change the shape of the eyelids.

Question: Can endoscopic brow lift make my eyes worse?
Answer: Much more in information is needed, such as a full set of facial photographs to determine if your candidate for the procedure, and it history of any eyelid or forehead surgery. Also important to know how dry your eyes are, if that is an issue already.

Question: Would alarplasty or rhinoplasty would be better for my nose?
Answer: An alar-plasty and a rhinoplasty can be performed together or separately. The alar plasty accomplishes narrowing wide nostrils. A closed rhinoplasty approach can accomplish refinement of the nasal tip, shaving down the small dorsal hump, and narrowing the bridgeline with all of the incisions placed on the inside of the nose.

Question: Am I a candidate for a columellaplasty? Would it alter the look of my nose or help make it symmetrical?
Answer: There does appear to be a hanging columella with the deviated caudal septum. A columella-plasty can accomplish removal of the excess skin and cartilage in that area to reduce the hanging columella. A closed rhinoplasty approach can accomplish your goals. Open rhinoplasty is not required.

Question: What procedures would most benefit me?
Answer: From the limited side view photographs, it appears that there is fat deposits in the neck. A surgical neck lift can accomplish removal of both fat deposits above and below the platysma muscle which includes a platysma-plasty to significantly improve the jawline. At age 39, your skin tone should be acceptable, and a facelift should be unnecessary.

Question: Brow lift before or after eyelid surgery blepharoplasty?
Answer: If the hooded and extra skin on your upper lids is all that is bothering you, then perform a conservative skin only upper blepharoplasty. This procedure can be performed under local anesthesia. The eyebrow position appears normal. When performing a browlift, the entire forehead comes up as a unit including both eyebrows.

Question: Would eyelid surgery work for me, or should I take another route?
Answer: If the only thing that is bothering you is the heaviness in your upper/outer eyelids, then consider conservative skin only upper blepharoplasty. This can be performed under local or general anesthesia. A brow lift may make you look too surprised.


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