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

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.

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