Nose Job Surgery at The Seattle Rhinoplasty Center The Seattle Rhinoplasty Center, board-certified,plastic surgeon

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.

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