Facial Plastic Surgery Questions and Answers: Part 06

Question: Can my nose be improved without too much risk?
Answer: The photographs demonstrate an overly projecting nose with a bulbous nasal tip, and an under projecting chin. The underprojection of the chin makes the nose look bigger than it really is. A septoplasty is performed in the back of the nose to improve airflow dynamics and can be performed at the same time, if needed. A closed rhinoplasty approach can accomplish reduction of the bulbous nasal tip, decreasing the overall projection of the nose and narrowing and straightening the bridge line. Rhinoplasty is the most difficult operation to perform correctly in the entire field of cosmetic surgery, so choose your surgeon wisely based on extensive experience. Consider placement of a chin implant to augment the chin forward for better facial balance and proportions. Both procedures are complementary to each other.

Question: Is this normal after two rhinoplasties? Huge knot on bridge of my nose, no progress. What can I do?
Answer: The photographs demonstrate a residual bony and cartilaginous dorsal hump along with a wide tip and wide bridge. Best to wait a full year before embarking on another rhinoplasty procedure which can accomplish shaving down the dorsal hump which is composed of both bone and cartilage. Osteotomies placed in the nasal bones will be necessary as well. Also probably best to reduce the wide nasal tip so that all the components of the nose are balanced.

Question: Do I have a recessed lower jaw? Genioplasty candidate?
Answer: A genioplasty is performed by an oral surgeon under general anesthesia in a hospital setting with an overnight stay in the hospital, and is much more invasive. If you’re looking for just cosmetic improvement, a chin implant can be placed under local anesthesia is an outpatient procedure which takes about 30 minutes.

Question: What could be done with my nose for it to look more natural and in line with the rest of my face for a better symmetry?
Answer: A closed rhinoplasty approach can accomplish narrowing your nose from the front and shaving down the dorsal hump from the side profile. All of the incisions are placed on the inside of the nose. An alar-plasty can address narrowing your wide nostrils and those incisions are usually placed inconspicuously at the base of the nostrils. It’s important to release the depressor septi ligament which dynamically pulls your nasal tip downward when smiling. Thick skin in the tip of the nose is going to prevent refinement in that area, so it is important to have realistic expectations. Digital computer imaging of your nose upon your facial features would also be helpful in the education process to understand what can be accomplished with your nose upon your facial features. Rhinoplasty is the most difficult operation to perform correctly in the entire field of cosmetic surgery, so to choose your surgeon wisely based on extensive experience.

Question: Why do most doctors remove buccal fat during a facelift?
Answer: In our practice, we’ve never removed buccal fat during a facelift procedure. In our practice, the goal of a lower face and neck lift is too tighten loose facial and neck skin, tighten loose facial and neck muscles, lift the jowls, and remove any fat deposits in the neck which also includes a platysma- plasty to significantly improve the jawline. If you’re considering traveling for a facelift, Best to do that within United States to get the best results.

Question: Which surgery, neck lift or body work? Why such protruding stomach? Folds on hips
Answer: Congratulations on your 60 pound weight loss. Best to perform the procedure of your body part that bothers you the most. If your neck and jowls bother you the most, a lower face and neck lift is going to be required. In our practice a lower face and necklift accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and removing both of the fat compartments in the neck located above and below your platysma muscle which also includes a platysma plastic to significantly improve the jawline.

Question: Can a Septoplasty change the appearance of your nose?
Answer: No, a septoplasty does not change the appearance of your nose. A septoplasty is performed in the back of the nose for airflow improvement. A cosmetic rhinoplasty accomplishes straightening the crooked nose. Both can be performed together when necessary. To straighten the crooked nose requires osteotomies placed in the nasal bones, a spreader graft placed in the midportion of the nose under the concave upper lateral cartilage, and asymmetric nasal tip surgery when needed.

Question: Overprojected nose or chin augmentation?
Answer: Your nose looks great, and there’s no sense in redoing it. The reason your nose looks so over projecting is because your chin is so under projecting. consider placement of a chin implant to augment your chin forward for better facial balance and proportions. In our practice, this procedure can be performed under local anesthesia as an outpatient procedure.

Question: What can I do about the skin below my jaw/jowl area?
Answer: More information is needed such as your age, and BMI. The very limited photograph your side profile demonstrates fat deposits located both above and below the platysma muscle. Liposuction can only accomplish removal of the fat deposits above the muscle and will be only a minimal benefit. A surgical neck lift is required to remove both compartments of fat which also includes a platysma plasty to significantly improve the jawline.

Question: What procedure am I a good candidate for? My double chin disappears when I put my tongue on the roof my mouth.
Answer: A full set of pictures From all angles are required to make a determination about how best to proceed. It is important to understand there are two compartments a fat in the neck, and they’re located both above and below the platysma muscle itself. Liposuction can accomplish only removal of the fat deposits above the platysma muscle, while a surgical neck lift is required to remove the fat deposits below the platysma muscle which also includes a platysma plasty to significantly improve the jawline.


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