Facial Plastic Surgery Questions and Answers: Part 05

Question: Do I need a revision rhinoplasty?
Answer: Much more information is needed, such as a full set of facial photographs from all angles because the nose is a 3-dimensional structure. A copy of the operative report would also be helpful. It is very important to know if there is any cartilage left over on the inside of the nose for grafting purposes, since you may need spreader grafts and possibly a dorsal onlay graft as well.

Question: Should I consult for surgery? Or is it something I can correct on my own? 
Answer: The dorsal bump is composed of both bone and cartilage and becomes larger related to trauma. Massaging your nose will not help. You will require a surgical rhinoplasty to shave down the dorsal hump. You’re be may require a septoplasty for a deviated nasal septum which is blocking your airflow, but this must be confirmed at the time of the examination.

Question: What can be done for my alar retraction?
Answer: From the photographs presented, you have a right-sided alar retraction, and a hanging columella. You going to need a columella-plasty to reduce the hanging columella, and a composite graft from the ear and placed inside the nostril to reduce that alar retraction. There will be improvement, but there is no perfect nose, especially since this will be your tertiary rhinoplasty.

Question: Is this mock-up before and after photo a realistic representation of an achievable result for chin liposuction?
Answer: The before and after photo mockup is realistic, but not with just liposuction alone. It’s very important to understand that there are two compartments of fat in the neck, and you have both deposit is a fat above and below the muscle. Liposuction can only accomplish removal of fat above the muscle and will not give you those results by itself. A surgical neck lift not only accomplishes removal of the fat above the muscle with liposuction, but also surgical extraction of the fat deposits below the muscle which also includes a platysmaplasty to significantly improve the jawline. You will require a necklift procedure to get the results you’re looking for. Also, you might consider placement of a small chin implant to augment augment your recessive chin forward for better facial balance and proportions, especially with respect to the projection of your nose. Placement of the chin implant will also give better structural support for the soft tissues in your neck and give you a better jawline as well.

Question: Will rhinoplasty, fat transfer and lip lift help balance my overall face?
Answer: A closed rhinoplasty can accomplish shaving down the dorsal hump, refinement of the nasal tip, reduce the hanging columella and narrow the bridge line with all of the incisions placed on the inside of the nose. Digital computer imaging of your nose would be helpful to understand what can be accomplished with a rhinoplasty procedure upon your facial features. In our practice, we do not perform lip lift operations or fat injections for a variety of reasons.

Question: Neck surgery with Hashimotos, am I a good candidate?
Answer: Much more information is needed, such as a full set of facial and neck photographs from all angles, your age, BMI and the status of your skin tone in the neck. You will also need clearance by your endocrinologist prior to undergoing elective cosmetic surgery.

Question: Do you think this is an achievable and reasonable result from a rhinoplasty?
Answer: Yes, the digitally morphed photographs do appear realistic and achievable. Choose your surgeon wisely based on extensive experience, since rhinoplasty is the most difficult procedure in the entire field of cosmetic surgery.

Question: I am wanting a facelift, eyelid lift, and need treatment for wrinkles around my lips, any suggestions.
Answer: A full set of facial photographs from all angles with your hair pulled back behind your ears is going be required to make a determination about being a candidate for three different surgical procedures. 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 which also includes a platysma-plasty. The goal of upper eyelids surgery is to remove excess skin creating the hooded look. In our practice, significant upper lip wrinkles are treated with dermabrasion. For many before-and-after examples and our current price list, please see the link below. No hospitalization is required, since this is an outpatient surgical procedure.

Question: Can you perform an osteotomy on a nose with spreader grafts?
Answer: Yes, me both medial and lateral osteotomies can be performed after a patient has had spreader grafts placed on prior rhinoplasty. Osteotomy’s accomplish narrowing the upper two thirds of the nose and the bridge line.

Question: Will rhinoplasty make me look younger?
Answer: The nose is a 3-dimensional structure, so a full set of facial photographs 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 also be helpful to understand what can be accomplished with procedure. Rhinoplasty is a very difficult endeavor, so choose your surgeon based on extensive experience producing natural results.

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