Facial Plastic Surgery Questions and Answers: Part 4

Question: I am thinking about getting a Alar Reduction. What techniques would I use to narrow my nose?
Answer: An alar plasty is performed to narrow wide nostrils. This procedure involves removal of a wedge of skin at the base of the nostrils under local anesthesia.

Question: Why do opinions vary from doctor to doctor regarding the best treatment for loose neck skin and jowls?
Answer: In our practice, a lower face and neck lift accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, removing fat deposits in the neck located above and below the muscle lifting the jowls and performing a platysma-plasty. This is the procedure that you need based upon the photographs presented which demonstrate loose skin, neck cords, and residual fat deposits in the neck and addition to jowls.

Question: Do I need chin implants and a rhinoplasty?
Answer: A chin implant and a rhinoplasty can be performed together or separately. Chin implants if done separately can be done under local anesthesia as an outpatient procedure, while rhinoplasty must be performed under general anesthesia. You would get more of an improvement from a chin implant itself, since your nose looks pretty good already.

Question: Would a mini facelift help define my jaw better?
Answer: A mini facelift does not address your neck. You need a neck lift procedure, which includes removal of the fat deposits located both above and below your platysma muscle, in addition to a platysma plasty to significantly improve the jawline. At age 32, your skin tone is fine, and no skin removal is necessary. You also have a recessive chin profile, so give some consideration to placement of a small chin implant to augment your chin forward, which will also help improve your jawline and be complementary to the neck lift procedure.

Question: After 1st Rhinoplasty everyone thinks I have cheek filler now. What should my next steps be?
Answer: From the photographs presented, it does appear from the frontal profile that you had a nice conservative improvement to your nose that looks very natural. Revision rhinoplasty is more difficult than a primary rhinoplasty, so it’s important to have realistic expectations. You should be able to get another conservator improvement by narrowing your bridge line and performing an alar plasty to narrow your nostrils. The thick skin and the tip of your nose is going to prevent refinement in that area.

Question: What is my nose shape , is it big, and does it need a nose job?
Answer: From the limited photographs, you have a dorsal hump, which is composed of both bone and cartilage on the bridge line of your nose. A closed rhinoplasty can accomplish removal of the dorsal hump with all of the incisions placed on the inside of the nose. You also have a recessive chin profile, so strongly consider placement of a chin implant for better facial balance and proportions, especially with respect to your nose from the side profile.

Question: What would be the best treatment for my chin?
Answer: From the one very limited photograph, you have fat deposits located both above and below the platysma muscle in your neck. Noninvasive treatments simply aren’t going to work. A surgical neck lift involves liposuction of the fat deposits above the muscle, and surgical extraction of the fat deposits below the muscle, which also includes a platysma-plasty to significantly improve the jawline.

Question: Ok to lipo jowls as part of chin/jawline lipo?
Answer: In our practice, we never liposuction the jowls because you’ll get irregularities which will be quite visible in that location. If you have jowls, you’re a candidate for some sort of facelift procedure.

Question: What would the surgical plan of action be to achieve a nose shorter in length and closer to face?
Answer: A closed rhinoplasty approach approach can accomplish shortening the nose, decreasing the overall projection, and reducing the hanging columella with all the incisions placed on the inside of the nose. This is a major rhinoplasty. Only a very small amount of change will occur from the frontal view.

Question: Is it possible to reduce projection but keep a slim nose?
Answer: The Side profile photographs demonstrate an overly projecting nose and under projecting chin. A closed rhinoplasty approach can accomplish shaving down the dorsal hump and decreasing the overall projection of the nose in addition to straightening it and refining the nasal tip and bridge line with all of the incisions placed on the inside of the nose. Consider placement of a chin implant to augment the recessive Chin forward for better facial balance and proportions, especially with respect to the overly projecting nose from the side profile.


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