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

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.

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