The Portland Rhinoplasty Center THe Portland Rhinoplasty CEnter

Facial Plastic Surgery Questions and Answers: Part 02

Question: Fixing a wide dorsal area after hump removal after a Primary rhinoplasty?
Answer: Much more information is needed, such as a full set of facial photographs from all angles, a copy of the operative report, and an in-person examination. Revision rhinoplasty is more difficult than a primary rhinoplasty, so it is imperative to choose your surgeon wisely based on extensive experience. If osteotomies were not performed on the primary rhinoplasty hump removal, there’s most likely an open roof, flattop nasal deformity present. Medial and low lateral osteotomies are going to be required to narrow the bridge line.

Question: What can I do to get rid of the fat at the end of my chin? Chin reduction? Kybella?
Answer: There are fat deposits located above AND below the platysma muscle in your neck. Liposuction can only remove the fat deposits above the platysma muscle, while surgical extraction of the fat is required below the platysma muscle which also requires a platysma-plasty to significantly improve the jawline. This is considered a neck lift procedure, and no skin removal is required on patients less than 50 years of age. 

Question: How to fix my chin/neck?
Answer: From the one limited photograph, it appears there’s going to be fat deposits located above AND below the platysma muscle in your neck. Liposuction will be only partially effective, since it can only remove fat deposits above the muscle. Surgical extraction of the fat deposits below platysma muscle is required which also includes a platysma-plasty which significantly improves the jawline. This is considered a neck lift procedure to remove both compartments of. No skin removal is necessary for patients under 50 years of age. Kybella will be very ineffective.

Question: Am I possibly a candidate for chin liposuction?
Answer: The fat deposits in your neck can be removed with liposuction under local anesthesia as an outpatient procedure. At age 39, your skin tone should be acceptable and no skin removal should be necessary.

Question: Could I get a chin implant *without* rhinoplasty?
Answer: It is certainly possible to perform just a chin implant as a stand-alone procedure, or in combination with a rhinoplasty. It is a personal decision. Placement of the chin implant can be performed under local anesthesia, while a rhinoplasty must be for performed under general anesthesia. Digital computer imaging would be helpful and education process as to what you potentially would look like with either 1 of both procedures upon your facial features. 

Question: What could I have done to look more aesthetic?
Answer: Consider a closed rhinoplasty procedure to accomplish reduction of the dorsal hump, refinement of the bulbous nasal tip, and reduction of the hanging columella in addition to making the nose more aesthetically pleasing. All of the incisions are placed on the inside of the nose.

Question: I want to get surgery on my face to appear more attractive – What can I benefit from?
Answer: The side profile photographs demonstrate an overly projecting nose with a dorsal hump, and a recessive Chin profile. Consider a closed rhinoplasty to reduce the overall projection of your nose, shave down the dorsal hump, in addition to narrowing the bridge line. All incisions are placed on the inside of the nose. Also consider placement of the chin implant to augment your jen forward for better facial balance and proportions.

Question: What can I do to correct dents, lumps and hanging skin 8 years post chin liposuction?
Answer: Much more information as needed, such as a full set of facial and neck photographs taken from all angles in a chin neutral position, and your age. You also appear to have fat deposits located above and below the platysma muscle, which would require a neck lift procedure. This surgery accomplishes removal of both compartments of fat which also includes a platysma-plasty to significantly improve your jawline. If you have loose and inelastic skin in the neck, then a lower face and neck lift procedure is going to be required to tighten that loose neck skin. 

Question: Is it safe to have a rhinoplasty done at the age of 48? 
Answer: As long as you’re in good health, it is certainly acceptable to undergo a rhinoplasty at age 48. In our practice, We have performed Many rhinoplasty procedures in our practice on patients in their 40s, 50s, and 60s.

Question: Will combing forehead lowering + brow lift reduce the effectiveness of either procedure?
Answer: Both procedures are usually perform together under one anesthesia with one recovery period. Neither one of the procedures reduce the effectiveness of the other procedure. In our practice, we use a combination of permanent sutures holding the eyebrows in position, and sutures and staples which must be removed within the first week after that surgical procedure.

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