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

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.

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