Facial Plastic Surgery Questions and Answers: Part 10

Question: Would I be good candidate for alarplasty?
Answer: It would be helpful to see a better set of pictures of your entire face and your entire nose to look at the relationship between how wide your nostrils are on your facial features and proportionate to your nose. An alar plasty simply involves removing a wedge of skin at the base of the nostrils and sewing it together. This effectively narrows the width of the nostrils. This procedure can be performed under local anesthesia as an outpatient procedure. General anesthesiais not required.

Question: How can I stop plasma bands & turkey neck at 28 getting worse?
Answer: The photographs are rather limited, and appears that you’re grimacing during these photographs. A full set of facial and neck photographs in repose from all angles in a chin neutral position would be required to make a determination about any surgical procedures. Consider Botox is your initial first treatment for theses bands. If that fails, then you can consider a necklift procedure which accomplishes removal of the fat in the neck along with a platysma-plasty. 

Question: Can a rhinoplasty correct a piggy nose that has occurred due to a lip lift? 
Answer: Much more information is needed, such as a full set of facial photographs in order make a determination about two different surgical procedures. In our practice, we do not perform a lip lift due to very poor scarring that we have seen from multiple patients having it done elsewhere. A closed rhinoplasty approach can accomplish making Refinements to your nose with all the incisions placed on the inside. No external incisions are required, and no painful packing is required either. Rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, so choose your surgeon wisely based on extensive experience.

Question: Will a rib rhinoplasty give me a successful frontal change?
Answer: It’s very important to understand that the nose is a three-dimensional structure, and adding a piece of rib to the bridge line will raise the height of your bridge from the side profile which would look odd. Your side profile looks great, it’s very important not to change it. You do not have a droopy tip. A closed rhinoplasty can accomplish refinement of the nasal tip cartilages to narrow them from the frontal profile, and osteotomies placed in the nasal bones to narrow the upper two thirds of your nose which is what you’re trying to accomplish. These are called medial and lateral osteotomy of the nasal bones. Choose your surgeon wisely based on extensive experience producing natural results. 

Question: How long after having cryptotherapy should I wait to get a revision rhinoplasty?
Answer: It is probably best to wait about three months to ensure optimum healing from the cryotherapy before undergoing a revision rhinoplasty. Revision rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery, so it’s important to choose your surgeon wisely based on extensive experience.

Question: How can you tell if a double chin is cause by excess skin or fat? Considering submental liposuction.
Answer: A full set of pictures would be more helpful to get a better determination about how best to proceed. From the one limited photograph, you have a recessive mandible and fat deposits located below the platysma muscle. It’s important to understand that there are two compartments a fat in the neck, above and below the platysma muscle. Consider placement of a chin implant to augment your chin forward for better structural support for the soft tissues in the neck. Liposuction can only accomplish removal of fat 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. A surgical neck lift with the chin implant would be your best option, and both procedures can be perform together as an outpatient procedure. 

Question: Nose is short and upturned – am I a candidate for a non-surgical nose job?
Answer: We do not recommend fillers placed in the nose for a variety of reasons, including skin necrosis. Much more information is needed, such as a full set of facial photographs from all angles, since the nose is a three-dimensional structure. Your second surgeon will probably also need a copy of the operative report as well. Revision rhinoplasty is more difficult than a primary rhinoplasty, so choose your surgeon wisely based on extensive experience.

Question: Is there a mini facelift (or any facelift) where the scars are all in the hair or behind the ear?
Answer: Placement of the incisions is very important to minimize detectability in addition to how much tension is actually placed on the incisions themselves. If all the incisions are placed completely in the hairline, your hairline will get shifted which will be counterproductive in front and behind the ears.

Question: Can a rhinoplasty to fix a dorsal hump also fix my nose sticking out so far?
Answer: From the 1 very limited photograph of yourself, it appears that you have an overly projecting nose and an under projecting chin. The lack of projection of the chin makes your nose look bigger than it really is. Consider placement of a chin implant to augment the chin forward for better facial balance and proportions. A chin implant can accomplish advancing the chin forward more than it possible to de-project the nose. It is only possible to de-project the nose a few millimeters. 

Question: Will it be possible to achieve a smaller nose?
Answer: Yes, it is certainly possible to achieve a smaller nose with a closed rhinoplasty approach with all incisions placed on the inside of the nose. The dorsal hump can be shaved down to give a more feminine profile, and the bridge line narrowed. Depending upon the thickness of the skin in the tip of the nose, some degree of refinement can be accomplished. 

Facial Plastic Surgery Questions and Answers: Part 09

Question: What surgeries can I get to improve my side profile?
Answer: Much more information is needed, such as a full set of facial photographs from all angles make a determination about how best to proceed with either a rhinoplasty or a chin implant.

Question: Is a drainless facelift more dangerous?
Answer: In our practice for over 25 years, we have used to Jackson-Pratt suction drains that are left in place for the first 24 hours after a lower face and neck lift procedure. These accomplish reducing the incidence of both hematoma and seroma formation. Since the blood is being removed from underneath the skin, there is significantly less bruising after the procedure. 

Question: Do deep plane facelifts last longer than SMAS lifts? Is there more potential for nerve damage with one or the other?
Answer: No, a deep plane facelift will not last longer than a traditional SMAS Facelift. In our practice, we perform a high-SMAS lower face and neck lift which accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls and removing fat deposits in the neck above and below the platysma muscle in addition to a platysma plasty. 

Question: Blepharoplasty or endoscopic brow lift?
Answer: The position of your eyebrows from the limited photographs are adequate, therefore a browlift is not necessary. Consider an upper blepharoplasty. This procedure can be performed under local or general anesthesia.

Question: What are all the techniques at surgeon’s disposal for straightening broken noses?
Answer: To straighten the broken nose requires medial and low lateral osteotomies placed in the nasal bones to straighten them. You will also require a cartilaginous spreader graft placed underneath the concave upper lateral cartilage on the patient’s left side. Also important to reduce the hanging columella by trimming back excess skin and cartilage in the columella. All this can be accomplished with a closed rhinoplasty approach with all the incisions placed on the inside of the nose. No external incisions are required and no painful packing is required. Rhinoplasty for a crooked nose is a very difficult endeavor, so choose your surgeon wisely based upon extensive experience. 

Question: Could I improve my facial profile with a combination of rhinoplasty, chin implant and buccal fat removal?
Answer: Yes, a closed rhinoplasty approach can accomplish narrowing the bridge line, shaving down the hump, and reduction of the bulbous nasal tip with all of the incisions placed on the inside of the nose. Placement of a chin implant can also be performed at the same time for the recessive chin profile. Augmenting the chin forward will help with facial balance and proportions. 

Question: Can eyelid surgery make your eyes appear larger?
Answer: A full set of facial photographs are required to make a determination about how best to proceed. The primary goal for upper eyelid surgery is removal of extra skin and a small amount of fat creating the hooded appearance of the upper eyelids.

Question: My nose gets big when I smile, what can I do?
Answer: An alar plasty can accomplish narrowing wide nostrils statically. To reduce the dynamic flare requires releasing the ligaments that are attached under the alar wings. This procedure can be performed under local anesthesia as an outpatient procedure.

Question: Can you advise on ethnic natural results? I like the structure of my nose
Answer: A closed rhinoplasty approach can accomplish narrowing your bridge line and refining the nasal tip. All of the incisions are placed on the inside of the nose. No external incisions are required, and no painful packing is required either. This procedure will just modify your existing anatomy of your skin, bone and cartilage to keep it looking very natural.

Question: Age 27, What injections/surgery could fix my under eye problem?
Answer: I assume your are referring to the puffiness in your lower lids created by the fat bags. If that’s the case, a very conservative fat removal through a trans conjunctival approach lower lid blepharoplasty performed under a brief general anesthesia can accomplish removal of those fat bags. The incision is located completely on the inside of the lower lids and there’s no external incision .

Facial Plastic Surgery Questions and Answers: Part 08

Question: Can a mini facelift be done under local anesthesia? 66 y/o female concerned about loose skin / wrinkles in the chin and neck. 
Answer: Much more information is needed, such as a full set of facial And neck photographs to understand what the right procedure would be. In our practice, we rarely perform min lifts because they give mini results. We perform a comprehensive high-SMAS lower face and neck lift procedure which accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, removal of fat deposits in the neck lifting jowls and performing at platysma plasty to significantly improve the jawline. This procedure is also performed under general anesthesia and monitored by a board certified physician anesthesiologist in our Medicare certified outpatient surgery Center for patient safety and comfort. Choose your surgeon very wisely based on extensive experience. Study for surgeon’s before and after facelift photo Gallery make sure the results look very natural. 

Question: Want to dramatically change my look: do I need a rhinoplasty, Botox, lip filler?
Answer: A rhinoplasty procedure can accomplish narrowing your bridge line and narrowing your nostrils from the frontal view, and shaving down the dorsal hump from the Sideview. Digital computer imaging would be helpful to understand what a new nose would look like upon your facial features.

Question: What can be done to relax the depressor septi muscle? Droops when I smile
Answer: You can try Botox which is the least invasive procedure. If that doesn’t work, then the ligament can be cut under local anesthesia as an outpatient procedure.

Question: Lack definition in my chin and jawline – what treatment would give me the best results?
Answer: Your photographs demonstrate a recessive mandible and chin, in addition to fat deposits in your neck located both above and below the platysma muscle itself. Consider placement of a chin implant to augment your chin forward. Also consider a neck lift procedure which can accomplish removal of fat above the platysma muscle with liposuction, and surgical extraction of the fat below the muscle which also includes a platysma-plasty to significantly improve the jawline. Liposuction along will be very ineffective since the majority of your fat is underneath the muscle, and necklift surgery is required to remove that component. Both a necklift and a chin implant can be performed simultaneously under one anesthesia which allows for one recovery. The noninvasive treatments that you are you referring to cannot accomplish what surgery can do. 

Question: 20 years post rhinoplasty – is fat grafting a good option to help address asymmetry? 
Answer: Fat grafting is not a very good option regarding revision rhinoplasty, and cartilage grafting is the preferred method to address your asymmetries.Much more information is as a full set of facial photograph from all angles to see what your issues are regarding your nose. It’s also important to know how much cartilage is left over on the inside of your nose for potential grafting purposes. Revision rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery, so choose your Surgeon wisely best on extensive experience, and have reasonable expectations.

Question: Columella continues dropping after 6 months. Do I need a revision?
Answer: Yes, the photo does demonstrate a hanging columella. Probably best to wait closer to a year before undergoing any revision rhinoplasty to reduce the hanging columella. This can be performed with a closed rhinoplasty approach with all the incisions placed on the inside of the nose. No external incisions are required, and no painful packing is required either.

Question: Unhappy with neck lift results & would like to know if there is a solution?
Answer: Much more information is needed, such as a full set of facial and neck photographs from all angles in a chin neutral position. It would also be helpful to have a copy of the operative report, and a copy of your preoperative Pictures as well. In our practice, we perform a high-SMAS lower face and neck lift which accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, removal of fat deposits in the neck, liposuction of the fat deposits in the neck, lifting the jowls, and performing a platysma plasty to significantly improve the jawline. 

Question: What is the risk of hypertrophic scarring after rhinoplasty with an alar base reduction, and possibly a lip lift?
Answer: A closed rhinoplasty approach avoids all external incisions. If you are looking to make a minor adjustment when narrowing the nostrils, that incision can also be made inside the nostrils. When your nostrils are very wide, then the incision is located at the base of the nostrils. We do not recommend the lip lift procedure due to extensive scarring we have seen with that procedure. 

Question: Can I reduce the height of the bridge without rotating the tip?
Answer: Yes, a revision rhinoplasty can accomplish shaving down the residual dorsal hump without upward rotation of the nasal tip. A closed rhinoplasty approach can accomplish your goals with all incisions placed on the inside of the nose. No external incisions are required and no painful packing is required. Digital computer imaging would also be helpful to understand what can be accomplished with a revision Rhinoplasty on your nose with your facial features.

Question: I have broken my nose twice now. Is rhino/septo worth it?
Answer: A septoplasty is performed in the back of the nose to straighten a deviated nasal septum which is blocking airflow. A septoplasty will not change the shape of the nose. Once medical necessity is determined after an examination, then preauthorization with your medical insurance can be accomplished before the surgery. Anticipate co-pays and deductables associated with your medical insurance. Changing the shape of the nose is considered a cosmetic rhinoplasty and is not paid by medical insurance. This would include shaving down the dorsal hump and narrowing the bridge line and refining the nasal tip.

Facial Plastic Surgery Questions and Answers: Part 07

Question: What can I do to make my nose look less wide?
Answer: A closed rhinoplasty approach can accomplish narrowing the bridge line, refining and narrowing the nasal tip, and narrowing the nostrils and the base of the nose if necessary. A full set of facial photographs from all angles required to make a determination about how best to proceed. Digital computer imaging also be helpful in communication process. 

Question: Eating and drinking instructions before rhinoplasty?
Answer: Its always best and to ask your surgeon and the anesthesiologist who is going to be placing you under anesthesia. In our practice, we ask that you refrain from eating and drinking from midnight the night before.

Question: Would PDO threads help my bumpy frown lines or is surgery the only option?
Answer: No PDO threads will not help with this issue. Botox injected into the muscle will help reduced coordinator muscle function On a temporary basis. If you’re tired of performing Botox, than a brow lift procedure can accomplish this permanently.

Question: What kind of treatment(s) would be most suitable for my hooded upper eyes?
Answer: An upper blepharoplasty procedure can accomplish improvement of the excess skin creating the hooded look on your upper eyelids. Your Eyebrow position is normal, therefore a brow lift is not necessary. An upper blepharoplasty can be performed under local or general anesthesia depending upon patient’s desires.

Question: What is the best non/less invasive treatment for jowl reduction and better jawline definition?
Answer: The frontal profile demonstrates a prominent pre-jowl sulcus which makes the jowls look bigger than they really are. A facelift or mini lift would not be necessary in your early 30s. Consider placement of a pre-jowl implant specifically designed for that purpose to give additional width to your chin. These implants are manufactured by Implantech and we have been using them for over 25 years in our practice. The implant can be placed under local anesthesia as an outpatient procedure which will take about 30 minutes.

Question: How is thin skin addressed during rhinoplasty to avoid the shrink wrap look?
Answer: A rhinoplasty procedure only involves reshaping bone and cartilage during the procedure. The skin is simply lifted off of the cartilage and bone and placed back down once the procedures done. If there is very thin skin, especially in the tip of the nose, minimal surgical changes to the tip cartilages themselves will usually result in better outcome. Depending upon the thinness of the skin, temporalis fascia graft can be placed over the tip cartilages can help camouflage any minor irregularities.

Question: Male facelift incision: why risk a scar in front of the ear? 
Answer: In our practice, we do make the incision behind the tragus for men undergoing a facelift procedure. We also trim back and cauterize the hair follicles in that area to help prevent hair growth on the tragus itself.

Question: Would I benefit from a brow lift in addition to a blepharoplasty?
Answer: When making the decision about a brow lift, your eyes must be open then we look at distance between your eyelids and your eyebrows. From the limited photographs, it appears that your eyebrows are in an acceptable position. You do have extra skin on the upper lids for which an upper blepharoplasty can improve. The goal of lower blepharoplasty is to remove fat bags creating the puffy look. 

Question: Best laser or treatment to tighten the neck and décolleté?
Answer: Much more information is needed such as your age and a full set of facial and neck photos from all angles. IPL is great for improving the rednes and broken capillaries, however a lower face/neck lift is required to tighten loose neck skin.

Facial Plastic Surgery Questions and Answers: Part 06

Question: Is the depressor septi muscle is always cut during a rhinoplasty?
Answer: In our practice, the depressor septi ligament is only cut when patients have a dynamic droopy tip. Releasing the ligament just prevents the tip from drooping when smiling.

Question: Male, going bald – is the incision different & smaller with Deep Plane vs High SMAS?
Answer: The deep plane versus hi-SMAS has to do with how the muscles and fascia layers are tightening underneath the skin, and has nothing to do with the skin incisions themselves. The length of the incision for the facelift is directly related to how much loose skin need to be tightened and removed.

Question: Early 30s with jowls/mid cheek depletion, what would help with volume loss?
Answer: From these photographs presented, your cheeks appear just fine and your volume is just fine for your age. You do not have jowls. You do have a recessive chin profile, so consider placement of a chin implant to augment your chin forward for better facial balance and proportions. If you add more volume to your cheeks, it will exacerbate the recessive chin issue. In our practice, placement of a chin implant can be accomplished under local anesthesia as an outpatient procedure which takes approximately 30 minutes. 

Question: Can a rhinoplasty correct a pig nose due to lip lift?
Answer: No, a rhinoplasty cannot correct a pig nose from as a direct result of a lip lift. From these photos, you don’t have an elongated upper lip, and you will probably be unhappy with the scarring across the entire base of your nose from the lip lift procedure. In our practice, we do not even perform that procedure due to the poor results we have seen from other offices. A closed rhinoplasty approach can accomplish Refinement of your bulbous nasal tip, shaving down the hump, narrowing the bridge line,and straightening your nose, with all the incisions placed on the inside of the nose itself. Rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, so choose your surgeon wisely based on extensive experience producing natural results. 

Question: Should I let my eyebrows grow in before a brow lift?
Answer: Yes, that’s probably good idea So that your surgeon can see exactly the position of your entire eyebrow, including asymmetric eyebrows. Another issue to be concerned about regarding your brow lift is important to know how high your hairline is which will determine the incision placement. Another issue to consider is the vertical and horizontal creases in the forehead and whether or not those muscles need to be softened as well. 

Question: Age 44, 5’2, 120lbs – what could be one to improve my double chin?
Answer: From these photographs, there are several issues present which all need to be addressed in order to give you a very Nice result with a natural look. There appears to be recessive Chin/ mandible, so consider placement of a chin implant to augment your chin forward for better structural support for the Soft tissues in the neck. It’s also very important to understand that there are two compartments of fat located in the neck, one compartment above the platysma muscle, and the other compartment below the platysma muscle. Liposuction can only accomplish removal of the compartment above the muscle which would be pretty much ineffective, since most of your fat is located below the platysma muscle. To remove the large deposits of fat below your platysma muscle, that is going to require a new neck lift procedure which accomplishes removal of both compartments of fat and a platysma- plasty to significantly improve the jawline. At age 44, your skin tone should be acceptable, so no skin removal is required. In our practice, a necklace involves three small access incisions. Both a neck lift and chin implant can be performed simultaneously under one anesthesia with one recovery period. Noninvasive treatments Will not be of any benefit for you.

Question: I want this nose so bad. How achieve is it, considering how big my natural nose is?
Answer: While that nose is certainly possible, it will not look natural, and looks over done. There’s too much ski slope present and hanging columella. Best to go on some consultations with surgeons who perform rhinoplasty with a very natural appearance. Have three rhinoplasty specialists for computer imaging for you to see what they think would look natural. 

Question: Best treatment for double chin/weak jawline?
Answer: The Photographs demonstrate a recessive mandible, and fat deposits in the neck. Consider liposuction to remove the fat deposits in the neck in addition to placement of a chin implant to augment the chin forward to give improvement for better facial balance and proportions. capital procedures can be performed under either local or general anesthesia through one incision underneath the chin. 

Question: What would you recommend for my face? Not sure if buccal fat, chin lipo or facial lipo is a options for me.
Answer: A Closed rhinoplasty procedure can certainly accomplish narrowing the wide nose with all the incisions placed on the inside. An alar-plasty is going to be required to narrow wide nostrils And that incision is located at the base of the nostrils.

Question: Have I developed a Saddle Nose Deformity? Would round 2 rhinoplasty be necessary to fix this issue?
Answer: You have a few minor irregularities of nasal bridgeline which include a small depression and residual cartilage just below it. A touchup rhinoplasty procedure should be able to file that small bump down and possibly place a small cartilage graft in the depressed area. The hanging columella can also be reduced as well.

Facial Plastic Surgery Questions and Answers: Part 05

Question: I dislike the way my face looks and I am considering some type of plastic surgery to adjust it. Possibly a rhinoplasty?
Answer: From the one very limited photograph, there appears to be an overly projecting nose and an under projecting chin. Consider a rhinoplasty procedure to shave down the dorsal hump and decrease the projection of the nose in addition to a chin implant which can augment the chin forward. Augmenting the chin forward can accomplish better facial balance and portions, especially with respect to the over projection of the nose itself. Can implants are manufactured in a large array of thicknesses, sizes, and shapes. It is only possible to reduce the projection of the nose a few millimeters, and chin implant can augment the chin forward much more than the nose to be deprojected.

Question: Platysmaplasty/Chin Tuck for 29 y.o.?
Answer: A platysma plasty is performed as part of a neck lift procedure when there is fat deposits underneath the platysma muscle in the neck. Based on your photographs and you are only 29 years of age, you can probably get by with only liposuction. The incision can be placed directly in the old incision which also includes a scar revision itself.

Question: Does harvesting septal cartilage for a columellar strut graft qualify the procedure as a septorhinoplasty?
Answer: A septoplasty is only performed for medical necessity to improve airflow dynamics in the back of the nose. Harvesting cartilage is part of a rhinoplasty procedure, and is considered cosmetic. In our practice, we do not recommend columellar strut grafts variety of reasons.

Question: Would a tip plasty suffice? I have never liked the side profile of my nose.
Answer: The side profile photographs demonstrate a large dorsal hump which needs to be shaved down in addition to refining the nasal tip cartilages. The far majority of patients must undergo a full rhinoplasty to ensure all of the components of the nose are balanced with themselves In a three-dimensional fashion, and the entire new nose is balanced with the patient’s facial procedures. Reducing the nasal tip cartilages will only make the dorsal hump worse, not better because it reduces the projection of the nasal tip cartilages themselves. You will need a full closed rhinoplasty to accomplish refinement of the entire nose. 

Question: What size chin implant would you recommend for me? Doc uses implantech anatomical
Answer: In our practice for over 25 years, we have used Implantech brand of solid silicone chin implants. We use the pre-jowl chin implant style. Based upon your photographs, a size small would give you more of a subtle result, while a size medium would get your chin in balance. Digital computer imaging of both your nose and chin would be helpful to understand what can be accomplished with both procedures. The digital imaging can also show you approximately what a size small, and approximately what a size medium can accomplish upon your facial features. Rhinoplasty is a very difficult endeavor, so choose your surgeon wisely based on extensive experience. It is also possible six months after your chin surgery to exchange the implant to a size medium or small depending upon your desires.

Question: Can a rhinoplasty actually reduce the length of my nose?
Answer: A Rhinoplasty procedure can accomplish decreasing the overall projection of the nose by shaving down the dorsal hump. The amount of change will only be a few millimeters to the de-projection of the nose itself. The tip of the nose also be lifted slightly in addition to preventing the tip of the house from drooping dynamically when smiling. Then I was causally made more narrow from the front profile.

Question: Would a genioplasty help me achieve more projection in the chin? Should I consider other procedures?
Answer: A genioplasty is performed by an oral surgeon under general anesthesia in a hospital setting with an overnight stay and is much more invasive than a chin implant. A genioplasty is usually performed when the teeth are significantly out of alignment. Placement of a chin implant is done under local anesthesia for purely cosmetic purposes. In our practice, we make a small incision underneath the chin and place the implant directly over the mandible to augment your chin to look very natural. The procedure takes about 30 minutes.

Question: Would i benefit from lower eyelid surgery? Concerned about under eye bags
Answer: From the one photograph, it appears that you have significant eyebags related to herniated fat in the lower lids. A trans conjunctival approach lower blepharoplasty can accomplish removal of those bags. The fat is removed from two small incisions on the inside of the eyelid. No external incisions are required. This procedure is performed under a brief general anesthesia as an outpatient procedure. 

Question: Is a “vertical” facelift different from a deep plane/SMAS facelift?
Answer: There are many variations on face lifting techniques amongst surgeons. Study your prospective surgeon’s before and after facelift photo gallery to make sure that it is extensive with lots of results that look natural. A full set of facial and neck photographs from all angles are going to be required to make a determination about how best to proceed.

Question: Am I a good rhinoplasty candidate for bulbous tip & nasal hump fracture?
Answer: From the photographs presented, your nose looks very nice, so be very cautious about embarking on a rhinoplasty procedure. The amount of change that what occur would be very minimal, and probably not worth the risk of undergoing the procedure.

Facial Plastic Surgery Questions and Answers: Part 04

Question: Will FaceTite and Morpheus help with my jowls and neck bands?
Answer: For treatment of just the neck bands, you can always try Botox first to see if that would address your issues. If Botox doesn’t address your issues, a lower face and neck lift can accomplish tightening those bands and Accomplish tightening the inelastic skin in the neck as well. Noninvasive treatments simply won’t help much.

Question: Age 43, looking for suggestions to correct facial structure deficiencies?
Answer: A full set of facial photographs from all angles are going to be required to make a determination about how best to proceed. From this one limited photograph, it appears that you have a mild recessive chin, so consider placement of a small chin implant to augment your chin forward for better facial balance and proportions. This procedure can be performed under local anesthesia as an outpatient procedure. 

Question: Is an early maintenance mini facelift really effective?
Answer: Facelifts are not performed for maintenance, they’re performed to correct the visual changes of aging once that has occurred. More information is needed such as a full set of facial and neck photographs from all angles, and your age to make determination about how best to proceed. Mini lifts tend to give mini results, and we rarely ever perform them. There’s no sense in putting someone through the whole process unless you can have significant results from a surgical procedure.

Question: 7 yrs post rhinoplasty, Interested in revision but concerned about outcome. How likely are my chances at good results?
Answer: First of all, you have a very difficult problem and revision rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery. Choose your second surgeon very wisely based on extensive experience. Your nose can be made better, but it’s very important to have realistic expectations, since it won’t be a perfect result. It’s also important to know how much cartilage is left over on the inside of your nose for grafting purposes since you will probably need some grafts on the side of your nasal tip where it is pinched. The bridge line of your nose can be narrowed where is excessively wide. Also important to know if you have any breathing difficulties out of your nose. A copy of the previous operative report would also be helpful to understand what techniques were performed in the first procedure. 

Question: Considering a rhinoplasty – will the age of my surgeon or technique used affect my results?
Answer: Rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, so it is imperative to choose your surgeon wisely based on extensive experience. You should probably seek out a double board certified ENT/facial plastic surgeon with decades of experience performing rhinoplasty, and is a rhinoplasty specialist. In our practice, we perform closed rhinoplasty which is much less invasive and gives a natural result. We also do not put any painful stents or packing on the inside of the nose. We also perform the procedure under general anesthesia (not local) monitored by a board certified physician anesthesiologist in a Medicare certified outpatient surgery Center. As a consumer, it’s important look at the before and after end results of your perspective surgeon’s rhinoplasty patients, and not get too bogged down in the very technical details of how a rhinoplasty is performed. 

Question: Male interested in columellar scar revision 6 years after open rhinoplasty – what are my options?
Answer: It’s going to be impossible to get rid of the actual scar itself, however you do have a significant hanging columella which exacerbates the visibility of your scar. A revision rhinoplasty can accomplish reduction of the significant hanging columella and adding a small pumping cartilage graft to the depression in the scar itself.

Question: Is this something that can be fixed with rhinoplasty? Crooked columella
Answer: Yes, a closed rhinoplasty approach can accomplish reduction of the hanging columella and straightening the caudal septum as well. All of the incisions are placed on the inside of the nose. No external incisions are required. This is usually performed under general anesthesia as an outpatient procedure.

Question: Is it possible to get a minor rhinoplasty for around $4000? My nose is comically too long for my otherwise pretty face
Answer: Rhinoplasty is the most difficult operation to perform correctly in the entire field of cosmetic surgery. Much more information is needed such as a full set of facial photographs, and a consultation to understand what you are trying to accomplish. Digital computer imaging would be helpful to give you an idea of what your new nose would look like upon your facial features. If you do not get the procedure performed correctly, and will Cost you wmuch more money in the long run to correct a cheap rhinoplasty. 

Question: Should I go for Kybella or CoolSculpting?
Answer: The photographs demonstrate a recessive chin profile and fat deposits in the neck. Liposuction can accomplish removal of those fat deposits in the neck, while a chain implant can accomplish improvement of the projection of the chin which gives a better definition of the jawline. Both procedures can be performed under local or general anesthesia as an outpatient procedure.

Question: Would I benefit from Rhinoplasty? Would it make my nose look more narrow/less round from the front?
Answer: A closed rhinoplasty procedure can accomplish narrowing the bridge line and refining the bulbous nasal tip. The septal piercing must be removed at least 3 months after the procedure.

Facial Plastic Surgery Questions and Answers: Part 03

Question: ow can I fix pinched nose from old nose job?
Answer: Much more information is needed, such as a full set of facial photographs from all angles and a copy of the operative report. It is also important to know how much cartilage is left over on the inside of the nose for grafting purposes.

Question: Can a non surgical nose job fix my nose from drooping when I smile?
Answer: To prevent the tip of the nose from drooping when smiling requires releasing of the depressor septi ligament which dynamically pulls the tip down. This is usually performed at time of a rhinoplasty.

Question: I’m 30 and have excess eyelid skin that results in a “third eyelid”. What procedures would be safe and would age well?
Answer: The photo demonstrates asymmetrical skin creases on the upper lids and then differing amount of fat in the 2 eyelids as well. An upper blepharoplasty procedure can accomplish a more symmetrical single eyelid crease and a small amount of fat grafting from the more full eyelid to the more hollow eyelid may be helpful as well.

Question: Would it be offensive & inconvenient to ask 2 Drs to operate on me at the same time? They offer both procedures
Answer: It is certainly possible to have one surgeon performing a rhinoplasty, and one surgeon performing your breast augmentation simultaneously under one anesthesia with one recovery period. Its best to check with your operative surgeons. There might be a bit of scheduling issues, that should be able to be worked out.

Question: How much weight should I lose before I go in for chin lipo?
Answer: Much more information is needed, such as your age, height, weight, BMI, and a full set of facial photographs from all angles. It is important that your ideal body weight with a BMI of less than 32 before being a candidate for elective cosmetic surgery in the neck. Liposuction is only designed for diet resistant fat deposits. Also important understand that liposuction can only accomplish removal of the fat above the platysma muscle in the neck, while a surgical neck lift is required to extract the fat deposits underneath the platysma muscle. A platysma plasty is also performed after the sub–platysmal fat has been removed which also significantly improves the jawline neckline. 

Question: Do I have a deviated septum or just cartilage difference?
Answer: A thorough internal examination of the nose is required to make a determination about having an deviated septum. A septoplasty is performed in the back of the nose to improve air flow dynamics when the septum is crooked. From the photographs, you have a crooked nose which is corrected and improved with the rhinoplasty. Both a septoplasty and a rhinoplasty can be performed together under one anesthesia with one recovery period. 

Question: Which procedure would give me a more defined chin and jaw?
Answer: Your side profile photograph demonstrates a recessive Chin profile, so consider placement of a chin implant to augment your chin forward for better facial balance and proportions. In our practice, we place chin implants through a submental incision under local anesthesia as an outpatient procedure which takes approximately 30 minutes.

Question: Osteotomy – too risky?
Answer: Osteotomies placed in the nasal bones are integral part of a rhinoplasty procedure, and are probably done 99% of every rhinoplasty procedure that we do. Both medial and lateral osteotomy are performed in almost every rhinoplasty procedure which is going to be required to narrow your nasal bones.

Question: Skin elasticity in older patients (47) – is reductive rhinoplasty possible? 
Answer: In our practice, we formed rhinoplasty I’m people in their 80s, and they have done just fine. The skin just simply re-drapes over the new framework. We also perform closed rhinoplasty with all of the incisions placed completely on the inside of the nose. No external incisions are required, and no painful packing is required either.

 

Facial Plastic Surgery Questions and Answers: Part 02

Question:  Suggestions on how to fix my sagging brow? Temporal brow lift?
Answer: From the photographs presented, you do not have sagging eyebrows, you have hooded upper eyelids. You’re not a candidate for a brow lift, since you would look very surprised permanently. Consider performing an upper blepharoplasty to rejuvenate your upper eyelids. The procedure can be performed under local anesthesia which takes about 30 minutes as an outpatient procedure. 

Question: Which should be done first – nose or lip lift?
Answer: In our practice, we definitely do not recommend a lip lift procedure due to very extensive poor scarring that occurs with that procedure. A full set of facial photographs are required to make a determination about how best to proceed with your rhinoplasty procedure.

Question: Concerned about eyelid retraction and ectropion – What are the chances of this happening?
Answer: First of all, a transcutaneous lower eyelid surgery can result in ectropion. Consider having the procedure performed as a trans conjunctival approach with the incision located on the inside of your lower lids. We do not recommend fat injections to the eyelids because we have seen very poor results from that procedure. Much more information is needed such as a full set of eyelid pictures to make a determination about a canthoplasty procedure that you’re considering undergoing.

Question: Is there anyway to perform lower blepharoplasty without changing the eye shape?
Answer: A trans conjunctival lower eyelid blepharoplasty accomplishes removal of the fat bags from inside the lower lid. There’s no external incisions, and it does not change the shape of the eye. The procedure simply gets rid of fat bags creating the puffy look. Make sure you seek out a surgeon who specializes in this type of procedure.

Question: Lower Bleph with Fat Removal vs. Repositioning – which would be more effective?
Answer: In our practice, we perform fat removal to rejuvenate the lower lids. Fat repositioning doesn’t work very well because the fat usually doesn’t stay put in the place that it is sewn down to. The fat is removed through two small incisions on the inside of the lower lid, and there’s no external incisions.

Question: Would a non-surgical rhinoplasty help to define my bulbous tip and upturn my nose? 
Answer: In our practice, we don’t recommend nonsurgical rhinoplasty, especially placement of fillers in the tip which will artificially inflate your anatomy. It’ll make your bulbous tip worse, not better, and it does Carry risks of skin necrosis. Consider a closed rhinoplasty procedure to accomplish reduction of the bulbous nasal tip with all of the incisions placed on the inside of the nose. A full set of facial photographs from all angles are going to be required to make a determination about how best to proceed. 

Question: What can be done to correct my flat face? Especially the side view
Answer: Start with fillers placed in the midface to add temporary volume to your cheeks to see if you like the results. For a permanent change, then consider cheek implants. In our practice, we use Implantech brand of solid silicone cheek implants that are placed through intraoral approach under a brief general anesthesia as an outpatient surgical procedure. 

Question: How to widen/open my eyes?
Answer: A full set of facial photographs at rest and in focus are going to be required to make a determination about how best to proceed. From the 1 Limited photo, it appears that there is extra skin in the upper lids and low brow position. You may be a candidate for a browlift.

Question: Would I benefit from a chin implant or injections in jaw/chin for a stronger jaw line?
Answer: The photograph is rather limited, but it appears that the projection of the mandible and chin is acceptable, therefore a chin implant is not required. Liposuction can accomplish improvement of the jawline by removal of fat in the neck.

Question: Would surgery fix my flared nose?
Answer: An alar plasty accomplishes narrowing wide nostrils at rest which involves removal of the portion of skin at the base of the nostrils. It is possible to release some of the muscle attachments to the sidewall of the ala to reduce the dynamic flaring. This is usually accomplished as part of a closed rhinoplasty procedure when necessary. A full set of facial photographs from all angles are going to be required to make a determination about making any other changes to the nose.

Facial Plastic Surgery Questions and Answers: Part 01

Question:  Should I do rhinoplasty?
Answer: The only person who can answer that question is the patient themselves. If there are features of your nose bother you enough, then consider undergoing a rhinoplasty procedure. It is possible to prevent the tip of the nose from drooping when smiling by releasing the depressor septi ligament. The dorsal hump can be shaved down, the tip slightly refined, and the bridge line narrowed a closed rhinoplasty approach. All incisions are completely located on the inside of the nose. 

Question: Where would scarring from an alar base reduction be and how severe?
Answer: In our practice, we place the incision for an alarplasty on the inside of the nostrils when there is minimal reduction required, and at the alar junction/floor of the nose when a large amount of width is reduced.

Question: Do you think I should postpone my mini-lift due to weight loss?
Answer: You should definitely lose the weight first before undergoing any type of facelift, especially 15-20 lbs. You will get better facelift result.

Question: Lower facelift/getting rid of jowls?
Answer: In our practice,practice we perform a high-SMAS lower face and neck lift which accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, removing fatty deposits in the neck, a platysma plasty, and lifting the jowls. We do not recommend a deep plane facelift because of the potential for facial nerve branch damage.

Question: Rhinoplasty nose tip problem. What options do I have?
Answer: Much more information is needed, such as a full set of facial photographs from all angles, and a copy of the operative report from the previous surgery. There appears to be a bossa created from the lower lateral cartilage on the nasal tip on the affected side. Depending upon the issue, this can be surgically modified.

Question: In breast cancer remission would like to undergo upper blepharoplasty and alar reduction Is it ok?
Answer: Probably best to wait for several months after all your treatments have been completed clearance from your primary care physician to make sure that urine excellent health before undergoing elective eyelid and nasal surgery.

Question: I am 45 with minimal skin laxity in my jawline, chin and neck. I want a more defined, sculpted looking jawline.
Answer: A full set of facial photographs from all angles are going to be required to make a determination about how best to proceed. Liposuction can only remove the fat deposits above the platysma muscle in the neck. When there is a hard fat in the neck, this must be removed with a surgical neck lift procedure. This involved surgical extraction of the fat below the platysma muscle in addition to a platysma plasty to significantly improve the jawline. When there is significant jowls present, then a facelift/ and neck lift is going to be required. 

Question: Genioplasty has recommended to me, feeling nervous about the aesthetics. Is it right for me?
Answer: A genioplasty is usually performed when the teeth are significantly out of alignment. It’s performed by an oral surgeon under general anesthesia in a hospital setting with an overnight stay, and is much more invasive.If you’re only looking for cosmetic improvement, then consider placement of a chin implant which can be performed under local anesthesia which takes approximately 30 minutes. If you’re a mouth breather, make an appointment with an ENT doctor to make sure you don’t have a deviated septum or some other type of nasal obstruction issue. 

Question: Facial rejuvenation procedures in stages or all at once?
Answer: At age 50, you’re aging very well. From the photographs, it appears that you really only need your upper eyelid blepharoplasty done. This procedure can be performed under local anesthesia as an outpatient procedure which takes approximately 30 minutes. You do not need a brow lift since your eyebrows are in excellent position. Performing a brow lift would make you look permanently surprised. You do not have any excess fat in the neck jowls or loose skin, therefore you’re not a candidate for a lower face and neck lift procedure. 

Question: I have a receding chin… what would be the best method to improve it?
Answer: Consider placement of the chin implant to permanently augment your process of mandible and chin profile. The procedure can be performed under local anesthesia which takes about 30 minutes. In our practice, we use Implantech brand of solid silicone implants and insert the implant through a submental approach.

Facial Plastic Surgery Questions and Answers: Part 10

Question: What would you do to improve my face?
Answer: The photographs demonstrate a recessive chin, fat deposits in the neck, and hooded upper eyelids. Consider placement of a chin implant to augment your chin forward for better facial balance and proportions. The fat deposits in your neck appear to be located both above and below the platysma muscle in your neck, so a neck lift procedure with a platysma plasty would be required to significantly improve your jawline. An upper blepharoplasty would help your hooded upper eyelids. All three procedures can be performed under one anesthesia with one recovery.

Question: How long does a mini face lift last?
Answer: Mini face lifts tend to give mini results, and just don’t last very long since they’re minimally invasive. A full set of facial and neck photographs from all angles are required to make a determination about which is the best procedure for you. In our practice, a comprehensive lower face and neck lift accomplishes lifting the jowls, tightening loose facial and neck skin, tightening loose facial and neck muscles in three locations, removal of fat compartments in the neck above and below the platysma muscle, which also includes a platysma plasty to significantly improve the jawline.

Question: Half chinese & black, what surgery or non-surgery could make my nose holes smaller?
Answer: An alar plasty involves removal of a small wedge of skin at the base of the nostrils which accomplishes narrowing them. This procedure can be performed under local anesthesia.

Question: Brow lift or eyelid surgery?
Answer: The position of your eyebrows is acceptable, therefore, a brow lift is not necessary, otherwise you’ll look too surprised permanently. An upper blepharoplasty procedure can accomplish increasing your upper lid fold if you want to put more eye shadow make-up on.

Question: Jowl/chin recommendations needed?
Answer: From the limited photographs presented, it appears that you have loose and inelastic skin in the neck, early jowls, and platysma muscle cords in your neck. There’s also a small amount of fat in the neck as well. In our practice, to address all these issues would require a lower face and neck lift which accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, removing the fat deposits above and below the platysma muscle in your neck along with a platysma plasty to significantly improve the jawline.

Question: Which procedure would help minimize the appearance of my under eye bags and excess skin?
Answer: A lower blepharoplasty procedure can accomplish removal of the fat bags through a trans conjunctival approach on the inside of the lower lids. When there’s excess skin at rest (not when smiling), then a pinch of skin can be removed right below the lash line. In our practice we close this incision with tissue glue. There are no stitches.

Question: Where are the sutures for a lower face and neck lift generally placed?
Answer: The sutures for a lower face and neck lift are located up behind the hairline in the sideburn area, behind the tragus, and then behind the ear and back behind the ear up into the hairline as well. There’s also a 1 inch incision underneath the chin.

Question: Is a minilift that somewhat addresses the SMAS ever a worthwhile procedure?
Answer: With a mini lift, the SMAS may or may not be minimally tightened with a stitch or two, but it really depends on the plastic surgeon, since there are many different varieties of facial lifting techniques. Best to study your perspective surgeon’s facelift photo gallery and make sure that it is extensive with natural results that you like.

Question: How do I improve my profile?
Answer: The Side profile photograph demonstrates a mildly recessive chin, so consider placement of a small chin implant under local anesthesia as an outpatient procedure.

Question: 53 & re-entering the workforce, would mini-facelift or fillers help lines, neck, & general facial drooping?
Answer: A mini facelift is going to give you mini results, therefore we rarely ever perform them. To rejuvenate your face and neck is going to require a lower face and neck lift procedure. In our practice, this procedure accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and removing any fat deposits in the neck. This also includes a platysma plasty to significantly improve your jawline.

Facial Plastic Surgery Questions and Answers: Part 9

Question: What type of procedure would you recommend for my nose?
Answer: A closed rhinoplasty approach can accomplish refinement of the nasal tip, shaving down the dorsal hump, and preventing the nasal tip from drooping dynamically when you smile. All the incisions are placed on the inside of my nose. No external incisions are required and no painful packing is required either.

Question: Can a nose be broken easily or become fragile after completely recovered from a rhinoplasty?
Answer: After fully healed from a rhinoplasty procedure, it would take lots of force to break the nose and displace it.

Question: Is it possible to just get my nostrils reduced and if so, what type of anesthesia would be used?
Answer: An alar-plasty is performed to reduce wide nostrils. Incision is placed on the inside the nostrils at floor floor the nose, and this procedure can be performed under local anesthesia as an outpatient procedure.

Question: Can I get a nose job, chin lipo & a brow lift without a visible scar?
Answer: The position of your eyebrows is acceptable, and a brow lift is not necessary. You will look permanently too surprised. The photographs are inadequate to determine how much fat is located underneath your chin, so a full set of facial photographs from all angles are going to be required. If there’s a small amount of fat in the neck, liposuction can be performed. A closed rhinoplasty approach can accomplish refinement of the nasal tip, narrowing the bridge line, shaving down the dorsal hump and preventing the tip of the nose from drooping when smiling with all incisions placed on the inside of the nose. No external incisions are required. Digital computer imaging of your nose would be helpful.

Question: Can I still do a chin implant after doing jaw surgery?
Answer: Yes indeed, you can certainly add a chin implant to give additional projection and width to your mandible, even though you have already had previous jaw surgery.

Question: Can you replace a chin implant with a larger sized implant?
Answer: Yes, you can upsize, or downsize a chin implant. A full set of facial photographs are going to be required to make a determination about how best to proceed. In our practice, we place chin implants under local anesthesia as an outpatient procedure which takes approximately 30 minutes. There will be less bruising and swelling with the secondary procedure.

Question: Slight hump and nasal drooping when smiling. Am I a candidate for rhinoplasty?
Answer: It would be helpful to see if picture of your nose from the front to see if you require any narrowing of the nasal bones or your nasal tip. You have a very small bump which can be shaved down, and the depressor septi ligament can be released, which helps with the droopy dynamic tip when smiling.

Question: Can I fix hanging columella and possible alar retraction with revision rhinoplasty?
Answer: Yes, a closed rhinoplasty approach can accomplish reduction of the hanging columella, and placement of composite skin grafts from the ear to reduce the alar retraction. Revision rhinoplasty is one of the most difficult Operations to perform correctly in the entire field of cosmetic surgery, so it’s important to choose your plastic surgeon very wisely based on extensive experience.

Question: I was wondering if there are any doctors with experience with my type of nose (bulbous)?
Answer: At the present time, you actually have a very nice nose, so they would only be a minimal Amount of improvement. Thick skin in the tip of the nose prevents refinement in that area, so it’s important to have realistic expectations. In addition, when patients have thick skin in the tip of the nose, they usually require several steroid shots in the first few months after the surgery.

Question: Am I a good candidate for a Rhinoplasty?
Answer: A closed rhinoplasty approach can accomplish Narrowing the bridge line, refining the nasal tip, shaving down the small dorsal hump and reducing the hanging columella with all the incisions placed on the inside of the nose. All the incisions are placed on the inside of the nose. no external incisions are required, no painful packing is required either. An alar plasty can accomplish narrowing wide nostrils.

Facial Plastic Surgery Questions and Answers: Part 8

Question: Skin sagging or volume loss? Plus pronounced nasolabial folds and perioral mounds?
Answer: At age 23, you do not have loose skin. Your side profile photographs demonstrate a recessive chin, because your mandible bone never grew far enough forward. Consider placement of a chin implant to augment your chin forward for better facial balance and proportions. Placement of a chin implant can be done under local anesthesia as an outpatient procedure, which takes about a half an hour.

Question: Rhinoplasty for dorsal hump removal – are the results immediate?
Answer: Removal of the dorsal hump immediately causes multiple issues which are an open roof deformity and a hanging columella. Medial and lateral Osteotomies placed in the nasal bones are required to close the open roof created from the hump removal itself. Trimming back to excess hanging columella will also usually be required. Spreader grafts are usually required to prevent the upper lateral cartilages from collapsing inwards after the hump removal as well. Full healing after a rhinoplasty takes one year, so the results are not immediate. A callus might form 6 to 10 months after the surgery, if it’s going to happen.

Question: Lifting children after rhinoplasty – Any restrictions?
Answer: For the first two weeks after rhinoplasty surgery, it’s best you probably don’t lift more than 20 or 30 pounds and refrain from any type of exercise which would get your heart rate and blood pressure going, which could potentially give you a nosebleed. It’s also very important to make sure when you pick your children up to keep their head down lower than your nose so they don’t headbutt your nose after the rhinoplasty.

Question: Double Chin? Jowls? How to resolve?
Answer: The photographs presented are inadequate in order to make a determination about what is the correct surgical procedure for you. A full set of facial photographs from all angles when you’re not smiling are going to be required. Fat deposits located above the platysma muscle in the neck can be addressed with liposuction, however, fat deposits located below the platysma muscle require a surgical neck lift, which also includes a platysma plasty to significantly improve the jawline.

Question: 30 y/o, 21 BMI, can liposuction improve the contour of my neckline?
Answer: Liposuction can accomplish some improvement of your jawline, but if you’re looking to get the results in the after photo, you’re going to need a neck lift procedure to remove any fat deposits below the platysma muscle, in addition to a platysma plasty to significantly improve your jawline.

Question: I think I have a very large implant – how can this be treated?
Answer: It’s important to know what size, shape, and type of implant you have placed to make a determination about how best to proceed. If you currently have a large implant, potentially this could be downsized to a size small or medium. A full set of facial photographs from all angles are also required to make a determination, since the chin, the implant and the augmentation are all three-dimensional.

Question: Dr said I wouldn’t be happy with result – should I get a second opinion?
Answer: From the two photographs presented, you do appear to have a significant pre-Jowl sulcus on both sides of your chin. A side profile photograph is going to be required to make a determination about which type of implant you’re need, and what you’re trying to accomplish. If you’re only looking for width to fill in the pre-jowl sulcus, then consider a pre-Jowl implant. If you’re looking for filling in the sulcus in addition to augmentation of your chin forward, then consider a a standard chin implant. There are many different sizes and shapes of these implants, and they can even be custom carved when necessary for unique anatomy. Placement of a chin implant can be performed under local anesthesia as an outpatient procedure, which takes about 30 minutes.

Question: 23, 183cm and 64kg, how can I achieve this side profile?
Answer: The before photograph demonstrates a recessive chin, and fat deposits located mostly below the platysma muscle in your neck. Consider placement of a chin implant to augment your chin forward for better structural support for the soft tissues in your neck, and a surgical neck lift, which involves removal of the fat deposit above the muscle with liposuction, and surgical extraction of the fat deposit below the muscle, which also includes a platysma plasty to significantly improve the jawline.

Question: Am I a candidate for chin liposuction or will it need more intense surgery?
Answer: The photographs are really inadequate in order to make a determination about how best to proceed. Please post another set of full face and neck photographs from all angles to make that determination. The limited photographs appear to show a recessive chin profile for which a Chin implant can improve along with fat deposits located above and below the platysma muscle in the neck. A neck lift procedure can accomplish removal of fat deposits above and below the platysma muscle in addition to a platysma plasty to significantly improve the jawline.

Question: Lower facelift + closed rhinoplasty + tummy tuck – Okay to go to the same surgeon and do these together? 
Answer: Trying to perform all three of those surgeries at one time is probably a bit too much, but it’s also important to ask your plastic surgeon how long of time it’s going to take to accomplish all three procedures. You may not be a candidate for outpatient surgery, and might have to be admitted to a hospital. Probably best to do the closed rhinoplasty and lower face neck lift as one surgical procedure, wait about a month and then you can undergo the tummy tuck procedure. In our practice, a lower face and neck lift with a closed rhinoplasty would take about 3 1/2 hours under general anesthesia. Closed rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery, so choose your rhinoplasty specialist wisely, based on extensive experience producing natural results.

Facial Plastic Surgery Questions and Answers: Part 7

Question: What can I do to improve this hanging columella 4 months after rhinoplasty?
Answer: It’s best to wait a year to allow full healing before undergoing any type of revision rhinoplasty to include reduction of the hanging columella. To reduce the hanging columella requires excision of excess skin and cartilage in that location Through a closed rhinoplasty approach with all the incisions placed on the inside of the nose. No external incisions are required across the columella itself.

Question: Could I get an alar base reduction by itself?
Answer: Yes, it is certainly possible to undergoing an alar base reduction as a stand alone procedure To reduce the width of your nostrils. This procedure involves removal of a small wedge of skin at the base of the nostrils under local anesthesia as an outpatient procedure.

Question: Should I or should I not get fat transfer/repositioning with my lower blepharoplasty?
Answer: In our practice we do not perform fat transfer on the lower lids, and only on specific instances on the upper eyelids. We do not perform fat injections in the lower lids either. Consider a straightforward trans conjunctival approach lower blepharoplasty for fat removal. The procedure is performed under general anesthesia which takes approximately 30 minutes. Anticipate approximately 10 days a visible bruising and swelling. The incisions completely located on the inside of the eyelids. No external incision is required.

Question: Help! I’m 34 with a saggy neck – suggestions?
Answer: Much more information is needed which includes a full set of facial and neck photographs from all angles, and any other associated medical history as to why there’s such significant laxity in your neck at such a young age. Was there a massive weight loss situation? When there is significant laxity such as noted in the photographs, a lower face and neck lift may be required.

Question: 30, 137lbs, 5’9, recommendations for undefined jaw/chin fat?
Answer: From the photographs presented, you have fat deposits located both above and below the platysma muscle in your neck. These fat deposits are most likely genetic, especially the deposit underneath the muscle. A surgical neck lift is required to move the fat above the muscle with liposuction, and surgical extraction of the fat below the muscle, and then perform a platysma-plasty to significantly improve your jawline, especially when you put your chin down.

Question: Aging eyes – What are my options with my upper and lower eyelids?
Answer: An upper and lower blepharoplasty can accomplish significant improvement to rejuvenate your eyes. The primary goal of upper eyelid surgery is to remove the extra skin and a small of fat located in inner corner. The incision is placed directly in the upper lid crease. Regarding the lower lids, the primary goal is to remove the fat bags creating the puffy look. The fat is removed through trans conjunctival approach on the inside of the lower lids. When there’s excess skin present on the lower lids, a pinch technique is performed to tighten the lower lid skin, and we place tissue glue on that incision at the eyelash line.

Question: What can I do to fix my chin?
Answer: The photographs demonstrated recessive chin profile for which a Chin implant can improve. Placement of a chin implant can be performed under local anesthesia as an outpatient procedure which takes approximately 30 minutes. In our practice, we insert the implant through a small incision underneath the chin.

Question: Am I at 41 years old a candidate for a neck lift after prior liposuction under my chin?
Answer: The photographs appear to show platysma bands which can be addressed with a platysma-plasty which is part of a neck lift procedure. Age 41, your skin tone should be just fine, however in the event that your skintone is quite loose, You’ll need a lower face and neck lift. This will probably need to be sorted out in-person.

Question: 36 year old male. What is the best approach for the tip of my nose?
Answer: A closed rhinoplasty approach can accomplish Shaving down the dorsal hump, reducing the bulbous nasal tip, reducing the hanging columella, and narrowing the bridge line with all the incisions placed on the inside of the nose. A closed septoplasty maybe you’re a part of your having a deviated nasal septum in the back of the nose blocking airflow. Both procedures can be performed simultaneously if necessary. You do not have alar retraction. Digital computer imaging of your nose upon your facial features would be helpful the communication process.

Question: What changes can I expect for wide nose, thick nostrils and hump removal?
Answer: Digital computer imaging of your nose would be helpful in the communication process to understand what your potential new nose might look like upon your facial features. A closed rhinoplasty approach can accomplish shaving down the dorsal hump, narrowing the bridge line, and refining the nasal tip with all the incisions placed on the inside of the nose. No external incisions are required. An alar plasty would be required to narrow the wide nostrils. Thick skin in the tip of the nose will require steroid shots in this first few months after the surgery.

Facial Plastic Surgery Questions and Answers: Part 6

Question: What happened to my nose after getting a nose job? What can be done to fix it?
Answer: A Full set of facial photographs from all angles are required to make a determination about how best to proceed.It appears that your upper lateral cartilages have collapsed, which will necessitate placement of spreader grafts. It’s important to know how much cartilage is left over on the inside of the nose for grafting purposes and to also obtain a copy of the operative report from the previous procedure to find out what was accomplished. 

Question: My nose bridge is not normal – how can I fix it?
Answer: A closed rhinoplasty approach can accomplish narrowing the bridge line, refining the nasal tip, and making your nose straighter. There’s no perfect nose, just improvements. With closed rhinoplasty, all of the incisions are placed on the inside of the nose, and there’s no painful packing required either.

Question: How to fix under the chin? Kybella? Botox? Something else?
Answer: The side profile photograph demonstrates a recessive chin profile, which causes poor structural support for the soft tissues in the neck. You most likely have fat deposits located below the platysma muscle in your neck, which is genetic. A surgical neck lift is required to remove the deposits of fat above the muscle with liposuction, and surgical extraction of the fat deposits below the muscle, which also includes a platysma plasty to significantly improve the jawline. Both a neck lift and a chin implant would significantly improve your side profile.

Question: Would a procedure be able to fix this? What is this condition even called?
Answer: From the very limited photograph, it appears that you have sub-platysmal fat located deep below the platysma muscle in your neck. A surgical neck lift is required to remove that fat. Liposuction can only remove the fat deposits above the muscle. A platysma plasty is also performed to significantly improve the jawline.

Question: Closed tip grafting – Would like to add a little more tip to the front of my nose. Is this realistic?
Answer: Placement of any type of cartilage grafts in the nasal tip will make your tip bigger, not smaller. Consider shaving down the dorsal hump, narrowing your bridge line and refinement to the nasal tip, with all the incisions placed on the inside of the nose, which is called closed rhinoplasty. An alar plasty can accomplish narrowing wide nostrils when necessary as well. Choose your closed rhinoplasty specialist wisely, because this is one of the more difficult procedures to perform correctly in the entire field of cosmetic surgery.

Question: What will help my nose look more balanced?
Answer: Much more information is needed, such as a full set of facial photographs from all angles in addition to a copy of the operative report find out what was accomplished in the first procedure. It’s also important to know how much cartilage is left over on the inside of your nose for grafting purposes, since it appears that you’ll need some type of grafts and osteotomies to straighten your nose from the frontal profile.

Question: Risks to vision when undergoing rhinoplasty?
Answer: In over 35 years, we’ve never seen or heard of blindness from a rhinoplasty procedure. Make sure you seek out a rhinoplasty specialist for best results, since rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery.

Question: Facial balancing vs. rhinoplasty?
Answer: The reason that your nose is more prominent is because chin recession. Consider placement of a chin implant which can be performed under local anesthesia as an outpatient procedure. A full set of facial photographs from all angles are required to make a determination about a rhinoplasty.

Question: Would a lower transconjunctival blepharoplasty Eyelid Surgery help me?
Answer: The photographs demonstrate herniated fat bags in the lower lids, and you’re a Candidate for a trans conjunctival lower blepharoplasty to remove those fat bags creating the puffy look. The incision is located completely on the inside of the lower lids. The procedure is performed under a brief general anesthesia as an outpatient procedure which takes approximately 30 minutes. Anticipate two weeks of visible bruising and swelling.

Question: Acne scars treatment before or after rhinoplasty?
Answer: It is certainly acceptable to undergo facial acne scar treatment immediately before or after rhinoplasty procedure, as long as you’re not doing any treatments on the skin of the nose itself right around the time of the rhinoplasty procedure. Choose your rhinoplasty specialist wisely due to the fact that this procedure is one of the most difficult to perform correctly in the entire field of cosmetic surgery.

Facial Plastic Surgery Questions and Answers: Part 5

Question: Can a Revision Rhinoplasty revise the tip of my nose?
Answer: A full set of facial photographs from all angles are required to make a determination about how best to proceed, since revision rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery.

Question: Getting rhinoplasty done, but not sure if I should also look at correcting my chin?
Answer: A Rhinoplasty procedure can accomplish shaving down The dorsal hump most evident from the side profile. A closed rhinoplasty approach can accomplish not only shaving down the dorsal hump, but narrowing the bridge line and refining the nasal tip with all incisions placed on the inside of the nose. Digital computer imaging of your nose upon your facial features would be helpful in the communication process.

Question: Is the blood draw typically done on surgery day for Rhinoplasty?
Answer: No, blood draws are typically not performed routinely unless there’s a specific medical condition for which the blood draws are needed. If there’s a medical condition requiring you to have a blood draw, then you need to talk to your plastic surgeon and anesthesiologist ahead of time to address those issues two to three weeks prior to the surgery, not on the day of the surgery.

Question: Is it too risky to get a third rhinoseptoplasty – second Revision Rhinoplasty?
Answer: Much more information is needed, such as a full set of facial photographs from all angles, and copies of the operative reports to find out what was performed in the previous procedures. There’s always a risk versus reward ratio that must be it discussed prior to any Time you’re performing a revision rhinoplasty

Question: Can another facelift/necklift revision fix this sagging?
Answer: The inelasticity in your neck Will require a revision lower face and neck lift, which would accomplish tightening loose facial and neck skin, tightening loose facial neck muscles, Performing scar revision, lifting the jowls, and removing any residual fat deposits in the neck.

Question: What can I do about my chin/lower face?
Answer: The Limited Photographs demonstrate a recessive chin profile And fat deposits in the neck. Consider placement of a chin implant to augment the chin forward, and give additional width in the pre-Jowl sulcus area. A neck lift procedure with removal of fat in the neck and a platysma plasty would significantly help your profile. At age 39, no skin removal should be required.

Question: Should I consider neck liposuction before my jaw surgery or after?
Answer: From that one limited photograph, it appears to be a recessive chin profile and fat deposits located above and below the platysma muscle in the neck. It’s important to be at your ideal body weight before any elective surgery in the neck. Liposuction can only remove the fat deposits located above the platysma muscle, while a surgical necklift is going to be required to remove the fat deposits below the platysma muscle. This also includes a platysma-plasty to significantly improve the jawline. Consider placement of a chin implant at the same time to augment the chin forward for cosmetic purposes. If you’re going to perform a sliding genioplasty, that should be performed first by an oral surgeon before any neck work.

Question: Will a revision rhinoplasty be able to address my concerns?
Answer: Revision rhinoplasty can certainly address shaving down the residual dorsal hump on the bridge line of your nose. You can also ask your previous surgeon about steroid shots placed in the tip of the nose to help manage the swelling after the surgery, since thick skin tends to swell much more than thin skin.

Question: What are my rhinoplasty options to change my side profile?
Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump and reducing the bulbous nasal tip, with all incisions incisions placed on the inside of the nose. No external incisions are required. Anticipate a cast applied across the bridge of the nose for one week, and two weeks of visible bruising swelling.

Question: Can I do revision rhinoplasty and fat transfer to the face at the same time?
Answer: Yes, both procedures can be performed simultaneously. Revision rhinoplasty is one the the most difficult procedures to perform correctly in the entire field of cosmetic surgery, so it’s important to choose your surgeon based on extensive experience.

Facial Plastic Surgery Questions and Answers: Part 4

Question: 45, I would love surgery to look my best now, what do you recommend? 
Answer: It really depends upon what is specifically bothering you. From your side profile photographs you have a recessive chin, so consider placement of a small chin implant which would not only help with the augmentation in the forward projection, but also give a bit of augmentation on the side of your chin just in front of your jowls which is called pre-jowl sulcus. You also have jowls, and significant fat deposits in your neck located both above and below the platysma muscle in your neck. To address those issues would require a lower face and neck lift procedure. In our practice, this accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and removing both compartments fat above and below the platysma muscle and a platysma-plasty to significantly improve your jawline. Choose your surgeon wisely based on producing lots of natural looking results.

Question: Age 52, loose skin after 3 RF micro, now I feel like I need a neck lift?
Answer: It’s important to look at a full set of facial photographs from all angles in a chin neutral position in order to make a determination about either a neck lift, or a lower face and neck lift. If you have loose and inelastic skin, you’re probably going to be a candidate for a face and neck lift procedure. In our practice, a lower face and neck lift accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and removing fat deposits in the neck, in addition to a platysma plasty to significantly improve your jawline.

Question: Thread lift after skin only facelift? 
Answer: A mini facelift, or a skin only facelift, would be a very poor choice, because all of the tension is now placed on only the skin, which will give poor/visible scars. It’s very important to tighten the muscles underneath the skin, and not put in any tension on the skin itself when performing a lower face and neck lift procedure. Thread lifts have minimal to no benefit.

Question: What can I do to minimize the appearance of red surgery scars 7 months post op?
Answer: Unfortunately, too much tension has been placed on you skin creating the red scars. You’ve got wide and hypertrophic scars, in addition to improper placement of the previous incision. You also have a pixie ear lobe on both sides. You should probably wait at least a year, and then, if there’s enough laxity in your face, you need to undergo another facelift procedure in order to be able to place the incisions in a much more inconspicuous position. The amount of facial laxity will be a key driver on what you can accomplish trying to completely remove these old incisions. The pixie earlobes can also be repaired simultaneously. Choose your second surgeon very wisely based on extensive experience producing natural results. Study your prospective surgeon’s before and after facelift photo gallery, and pay attention to the detectability of the incision itself in the after photos. 

Question: Would chin lipo help “snatch” my jaw, or is my hyoid bone too low?
Answer: Neck liposuction can only accomplish removal of the fat deposits above your platysma muscle. Based on your photographs, most of your fat deposits are located below the platysma muscle which is going to require a neck lift procedure to remove that compartment of fat surgically, and liposuction to remove the fat deposits above the muscle. After the fat has been removed,A platysma plasty also gives significant improvement to your jawline. Choose your surgeon wisely based on extensive experience producing natural results.

Question: Would Morpheus8 minimize the appearance of deep lines and wrinkles?
Answer: Non-invasive treatments only give minimal benefit at most. You have significant wrinkles on your upper and lower lip which would require medical grade dermabrasion to improve. The laxity of skin in your face will require a lower face and neck lift procedure. Choose your surgeon wisely based on a extensive experience producing natural results.

Question: Can you tell me risks, healing time and what to expect with skin pinch?
Answer: If there’s excess skin at rest, (not upon animation when smiling only then can you consider a very conservative pinch of skin. The Incision is located directly under the lower lash line, and we close that incision in our practice with tissue glue. No sutures necessary. Expect a visible pink line for a few weeks after the plastic surgery.

Question: Can a Rhinoplasty make my nose more attractive?
Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, narrowing and straightening the bridge line, and refining the nasal tip with all incisions placed on the inside of the nose. No external incisions are required, and no painful packing is required either. Digital computer imaging of your nose upon your facial features would be helpful to understand what can be accomplished with the procedure.

Question: What is the best option for treating my turkey neck?
Answer: A full set of facial and neck photographs from all angles are usually required to make a determination about how best to proceed. The laxity in your neck will require a lower face and neck lift procedure to tighten that skin in that location.

Question: Do I need a brow lift?
Answer: You only have a small amount of eyebrow ptosis on your left eyebrow. If the position of your eyebrows bothers you a lot, then consider a brow lift procedure. Very important not to get over-elevated because you’ll look permanently surprised. One option would be to just perform your upper eyelid surgery to make your eyelids look more symmetrical, which can be done under local anesthesia as an outpatient procedure. If the position of your eyebrow still bothers you several months after the eyelid surgery, then consider a brow lift.

Facial Plastic Surgery Questions and Answers: Part 3

Question: Am I a good candidate for a rhinoplasty?
Answer: A full set of facial photographs from all angles are required to make a determination about how best to proceed. A closed rhinoplasty approach can accomplish shaving down the dorsal hump, decreasing the overall projection of the nose, narrow the bridge line and the nostrils, and refining the nasal tip with all of the incisions placed on the inside of the nose. No external incisions are required, no painful packing is required either. Digital computer imaging of your nose upon your facial features from different angles would also be helpful in the communication process, since the nose is a three-dimensional structure.

Question: Crooked nose after surgery – what are my surgical and nonsurgical Revision Rhinoplasty options?
Answer: A closed rhinoplasty approach can accomplish straightening the crooked nose and reducing the hanging columella with all the incisions placed on the inside of the nose. No external incisions are required. There will still be some degree of asymmetry with your nostrils. This procedure is performed under general anesthesia as an outpatient surgical procedure. It’s also important to know how much cartilage is leftover on the inside of your nose for grafting purposes. A spreader graft will be required to be placed on the concave side of the nose.

Question: Will doing an external osteotomy Rhinoplasty create the illusion or effect of a new dorsal hump?
Answer: A closed rhinoplasty approach can accomplish internal osteotomies placed in the nasal bones to narrow the bridge line. No external incisions are required. Osteotomies just accomplish narrowing the bridge line to close the open roof, flat top deformity resulting from only shaving down the dorsal hump. A full set of facial photographs would be helpful along with a copy of the operative report to understand what procedures were accomplished in your primary rhinoplasty. Also best to wait at least six more months before under going another rhinoplasty procedure.

Question: Deformed columella – can this be fixed?
Answer: A closed revision rhinoplasty can accomplish reduction of the hanging columella. All the incisions are completely located on the inside of the nose. No external incision is required, and no open rhinoplasty is required.

Question: Would Chin Liposuction improve my side profile?
Answer: The photographs from the side profile demonstrate a recessive chin For which a chin implant can improve. The fat deposits in your neck are located both above and below the platysma muscle. Liposuction will be minimally effective, Since the majority of the fat is located below the muscle which requires a neck lift procedure and a platysmaplasty to significantly improve your jawline.

Question: I was thinking of a facelift but not sure. What can I do to look better?
Answer: The photographs demonstrate a hanging columella on the nose, a recessive Chin profile, and normal changes in your neck at your age. Consider a tip rhinoplasty to reduce the hanging columella,Placement of a chin implant, and a lower face and neck lift. A lower face and neck lift accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and removing the fat deposits in the neck along with a platysma-plasty which significantly improves the jawline.

Question: Does a small chin implant make that much of a difference in the front?
Answer: There are many different sizes and shapes of chin implants, so it depends upon which implant your plastic surgeon is talking about. In our practice, we use implantech brand of solid silicone chin implants. We use the Mittleman pre-jowl chin implant, and usually size small in a woman. The chin, the mandible, and the implants are all three-dimensional, and that augmentation occurs in all three dimensions. A full set of facial photographs are required to better answer your question.

Question: Is this a droopy columella or still swelling? It’s been 4 months. Do I need a revision?
Answer: You do have a hanging columella, and they’re still swelling present since it is only been four months since your surgery. Important to wait at least one year before undergoing any further revisions.

Question: Inverted v? Open roof? 
Answer: Revision rhinoplasty is more difficult than a primary rhinoplasty, so a full set of facial photographs from all angles are going to be required to make a determination about how best to proceed. Best to obtain a copy of the previous operative report to find out what was accomplished in the first procedure, and it’s also very important to know how much cartilage is left over on the inside of your nose for potential grafting purposes. The inverted V is treated with combination of spreader grafts and low lateral osteotomies. An open roof deformity is treated with medial and lateral osteotomies.

Question: Considering neck lift. Can this be improved with a single incision?
Answer: From the photographs presented, there is significant laxity in both your face and neck. When that is the case, a traditional lower face and neck lift is going to accomplish tightening loose facial and neck skin, tightening loose facial and neck muscles, removal of any Fat in the neck itself, and lifting the jowls. This will require incisions in front and behind the ears due to the significant skin laxity and the shift of skin posteriorly.

Facial Plastic Surgery Questions and Answers: Part 2

Question: Only side profile rhinoplasty?
Answer: You cannot just shave down the dorsal hump, since you’ll be left with a flat top- open roof deformity from the frontal profile. Osteotomies placed in the nasal bones are required to close the open roof created from the hump removal itself. You also have a very recessive chin, which gives the illusion that your nose is bigger than it really is. Consider placement of a chin implant at the same time as a rhinoplasty for better facial balance and proportions. Study your perspective surgeon’s rhinoplasty photo gallery to make sure that it is extensive with natural results.

Question: Prominent nasolabial folds and sagging face?
Answer: In our practice, a lower face and neck lift can address loose facial and neck sagging by tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and remove any residual fat deposits in the neck when present. This also includes a platysma plasty to significantly improve your jawline. Nasolabial folds won’t be helped very much with a facelift procedure. You also appear to have lost volume in the mid face, so you can consider filler placement on a temporary basis, or consider cheek implants for a permanent, mid face augmentation. The Peri-oral wrinkles are best treated with dermabrasion. All three of these procedures can be performed together or independently.

Question: Facelift or Other Options?
Answer: From the two Limited photographs presented, you look fantastic for your age and are NOT a candidate for a facelift procedure. If you’re trying to augment your left cheek, consider placement of fillers.

Question: Should I have a full rhinoplasty or should I only have tip plasty?
Answer: To ensure that all of the components of your nose balance with each other in a three dimensional fashion, a full rhinoplasty is going to be required.

Question: What are my options for my weak neck/jawline?
Answer: Liposuction can only accomplish removal of fat deposits above the platysma muscle. You most likely have fat deposits underneath the muscle which will require a Neck lift surgery with a platysma plasty to extract the fat underneath the muscle and tighten the muscle together to give a significant improvement in the jawline. As long as your less than 50 years of age, no skin removal is required.

Question: What can I do to accept potential risks and mitigate them? 
Answer: The risks that you have mentioned are exceedingly rare, and we have never seen them in over 30 years. Much more likely is that even in the best of hands, there’s a 10% chance of requiring you to need a touch up surgery one year after your primary rhinoplasty. There’s also a small chance of getting a nosebleed after the surgery which would require nasal packing. Rhinoplasty is the most difficult procedure to perform in the entire field of cosmetic surgery, so choose your plastic surgeon based on extensive experience producing natural results consistently. Study your prospective surgeon’s before and after rhinoplasty photo gallery, which should be extensive with results that you like.

Question: Under-eye and mid face rejuvenation options?
Answer: The mid face does not descend vertically with aging process, but loses volume. For a temporary augmentation, consider fillers in the midface. For a permanent augmentation, consider cheek implants.

Question: My neck and face blend in together – what surgery would help most?
Answer: A full set of facial photographs from all angles that are in focus are required to make a determination about which procedures are going to be best for you. If you’ve already had liposuction with no success, you probably have fat deposits located underneath the platysma muscle in your neck which requires a surgical neck lift to get rid of that compartment of fat. A platysma plasty is also performed as well to significantly improve the jawline.

Question: What procedures would you recommend I have to rejuvenate?
Answer: A full set of facial photographs from all angles including your neck are going to be required to make a determination about how best to proceed. Mini lifts give mini results,and are usually not very effective.

Question: Bleph before or after facelift?
Answer: It does not matter which procedure is done first or second if you’re doing them separately. We frequently perform both procedures together under one anesthesia with one recovery. Performing them separately will give you two weeks of visible, bruising and swelling for each procedure. In our practice, just an upper blepharoplasty can be performed under local anesthesia, however, the facelift procedure is performed under general anesthesia. Study your perspective surgeon’s eyelid and facelift photo gallery very carefully to make sure that your surgeon is very experienced producing natural results consistently.

Facial Plastic Surgery Questions and Answers: Part 1

Question: Advice on what needs to be done on my nose for an African American Rhinoplasty?
Answer: Thick skin in the tip of the nose prevents refinement in that area, so Don’t expect a lot of improvement. To narrow the bridge line requires osteotomies placed in the nasal bones. Too narrow wide nostrils requires an alar plasty which involves removing a small wedge of skin at the base of the nostrils to narrow them. A full set of facial and nasal photographs from all angles are hard to make a determination about how best to proceed.

Question: Considering a revision rhinoplasty – am I a good candidate?
Answer: Overall, your nose looks very good, however you are couple very small issues that can be improved give you even better looking nose. You have a very small residual cartilage hump just above your nasal tip which is called a poly beak which can be shaved down to give you better side profile. You also have a small hanging columella which can be reduced as well. You might also consider placement of a chin implant for the recessive chin profile which will help with facial balance and a portions from the side profile with respect to your nose. 

Question: How long do I have to wait to get a facelift after having cataract surgery?
Answer: It’s probably best to wait at least a month after your plastic surgery before undergoing a lower face and neck left procedure which is performed under general anesthesia.

Question: Am I a good rhinoplasty candidate to fix my wide, bumpy bridge and bulbous tip?
Answer: The photographs demonstrate an overly projecting nose and and an under projecting chin. A closed rhinoplasty procedure can accomplish reduction of the bulbous nasal tip, shaving down the dorsal hump, and narrowing the bridge line with all of the incisions placed on the inside of the nose. Consider placement of a chin implant to augment the chin forward for better facial balance and proportions, especially from the side profile. Digital computer imaging of your nose and chin upon your facial features would be helpful in the communication process to understand what both procedures can accomplish for you.

Question: Do I need Kybella to improve my jawline?
Answer: From the one limited photograph, it appears that you have a recessive chin, and fat deposits in your neck, most likely located both above and below the platysma muscle in your neck. Consider placement of a chin implant to augment your chin further forward for better facial balance and proportions. This will also help with your jawline. If the fat deposits are only located above the muscle, then liposuction can accomplish improvement. A neck lift procedure can accomplish surgical removal of the fat deposits below the muscle, which also includes a platysma plasty to significantly improve the jawline. No skin removal is needed. Both a chin implant and necklift surgery can be accomplished together under one anesthesia with one recovery.

Question: Neck Lift & mandible implant – What should I have done first if different surgeons are performing doing it?
Answer: In our practice, we perform a lower face and neck lift and chin implants simultaneously under one anesthesia with one recovery period. In addition, the chin implant goes through the facelift incision underneath the chin. No sense in undergoing two separate surgeries. Find a physician you can do both procedures for you simultaneously. 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 any fatty deposits in the neck. The chin implant is placed through a submental incision directly under the periosteum of the bone and augments the chin forward.

Question: Can fillers improve my lower face sagging?
Answer: Much more information is needed, such as your age, and a full set of facial photograph from all angles to make a determination about how best to proceed. Nasolabial folds are best treated with fillers. You do not have jowls. You have a prominent pre-Jowl sulcus and a bit of a recessive chin profile, therefore consider either fillers in that location on temporary basis, or a chin implant for a permanent result. A neck lift requiredRemove fat deposits in the neck and tighten skin.

Question: Could I get these results (specifically the tip)?
Answer: A full set of facial photographs of all angles are going to be required to make a determination about how best to proceed, since the nose is a three-dimensional structure. Thick skin in the nasal tip is going to prevent refinement in that area, so it’s important to have realistic expectations. Digital computer imaging of your nose upon your facial features would also be helpful.

Question: Can you decrease the width of the nose (nostrils, tip, bridge etc.) without altering the overall shape?
Answer: It is possible to narro wthe bridge line, narrow the nasal tip and narrow the nostrils, but your nose will not look good from the side profile when doing so. It’s very important to remember the nose is a three-dimensional structure, and rhinoplasty is performed in all three dimensions. You will need to shave down the dorsal hump in order for the notice to be balanced.

Question: Did I get a botched nose job or is this natural?
Answer: From the limited photographs, you have what’s called an inverted V deformity as a result of your nasal bones being left too wide, and a collapse of the upper lateral cartilages in the mid portion of the nose. A revision rhinoplasty through a closed approach can accomplish placement of spreader grafts and osteotomy’s to repair the inverted V deformity. All the incisions are placed on the inside of the nose. Make sure you seek out of rhinoplasty specialist, since revision rhinoplasty is very difficult. It’s also very important to know how much cartilage is left over on the inside of your nose for grafting purposes.