Facial Plastic Surgery Questions and Answers: Part 09

Question: Asymmetric nostrils & crooked columella, what do you think about my rhinoplasty?
Answer: Your nostril asymmetry is within normal limits, since there’s no perfect nose. The biggest issue you have is your hanging columella. Once that is reduced, it will probably help straighten it as well. Best to wait at least one year after your primary rhinoplasty to undergo revision.

Question: Order of facial and scalp cosmetic surgeries?
Answer: Hairline lowering surgery and an eyebrow lift should be performed together. Hair transplant would be done separately. Facelift, eyelid surgery, rhinoplasty and chin implant can be performed together simultaneously under one anesthesia with one recovery. A full set of facial photographs from all angles are required to make a determination about being a candidate all these procedures.

Question: Can rhinoplasty cause nasal polyps?
Answer: No, polyps Located inside the nose recalled allergic nasal polyps, and are related to allergies, not previous surgery.

Question: Valve collapse on my left nostril?
Answer: Valve collapse on my left nostril functional nasal surgery such as surgery for a valve prolapse may be submitted to medical insurance once medical necessity and preauthorization have occurred with your medical insurance company. Anticipate co-pays and deductibles associated with your medical insurance. Placement of a alar batten graft or a spreader graft may be of some benefit. Making any other changes to the nose such as shaving down the dorsal hump, reduction of the bulbous tip, and narrowing the bridge line are all considered cosmetic, and must be paid for by the patient.

Question: Do I need a brow lift or upper blepharoplasty?
Answer: The eyebrow position is acceptable, and a brow lift is not necessary, because you look too surprised. Consider aconservative upper blepharoplasty to remove the excess eyelid skin and create more of a curvature to your upper eyelid fold.

Question: Trying to fix a bump on my nose that is trauma related I believe?
Answer: The limited photographs demonstrated dorsal hump which is composed of both bone and cartilage. A closed rhinoplasty approach can accomplish shaving down the dorsal hump, and then osteotomies placed in the nasal bones are going to be required to close the open roof nasal deformity created from the hump removal itself. Also important to straighten the nasal bones related to any trauma. Also important to evaluate if there is a deviated septum on the inside of the nose creating breathing difficulty.

Question: How is my front/side profile in terms of jaw and chin?
Answer: The side profile photographs demonstrate a recessive chin profile for which a chin implant can give improvement. The Implants can be performed under local anesthesia as an outpatient procedure which takes approximately 30 minutes.

Question: I’m 45 years old, very healthy. Am I a candidate for facelift, rhinoplasty and facial implants?
Answer: From the photograph presented, you do not appear to be a good candidate for a rhinoplasty procedure, since your nose looks quite good and very little improvement could be achieved. A neck lift alone can accomplish removal of the fat deposits above and below the platysma muscle in your neck along with the platysma plasty to significantly improve the jawline. A full lower face and neck lift would not be required as long as your skin tone is acceptable in the neck. You do appear to be a good candidate for upper and lower eyelid surgery. The goal of upper eyelid surgery is to remove the excess skin creating the hooded look, and the goal of lower eyelid surgery is to get rid of the fat bags creating the puffy look. Your midface does appear rather flat, and a set of small cheek implants can accomplish augmentation in that area.

Question: I was wondering if achieving a nose like this would be possible?
Answer: There are certainly improvements and refinements to your nose that can be made, but they may not be exactly like the model photographs. Digital computer imaging of your nose upon your facial features would be helpful to understand what can be accomplished with your current nasal anatomy.

Question: Rhinoplasty for breathing issues and cosmetic – should doctor be ENT too?
Answer: Rhinoplasty is one of the most difficult procedure to perform In the entire field of cosmetic surgery, so it is important defined and very experienced double board-certified ENT/facial plastic surgeon who could address both the functional surgery such as a septoplasty, and cosmetic rhinoplasty simultaneously. An internal examination of the nose is going be required for medical necessity and insurance prior authorization. Expect the patient for the cosmetic component yourself.

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