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Facial Plastic Surgery Questions and Answers: Part 05

Question: Middle Eastern nose & want it fixed! Any advice on what we can do?
Answer: A closed rhinoplasty approach and accomplish shaving down the dorsal hump, refinement and lifting of the nasal tip, and narrowing the bridge line. All incisions are placed on the inside of the nose. No external incisions are required, and no painful packing is required either. Also important to release the depressor septi ligament which dynamically pull your nasal tip downward when smiling. A septoplasty is performed when there’s a deviated septum present. Both A rhinoplasty and a septoplasty can be performed together when necessary. An alar plasty is performed for wide nostrils. 

Question: Will composite ear graft to bring down the alar rim give me an aesthetically pleasing result?
Answer: From these photographs, the alar retraction on your left side is minimal. You have an overly rotated, overly projected nose with a hanging columella. Consider a revision and rhinoplasty to reduce the over projection of your nose, reduce the hanging columella and de-rotate your nose. Once those maneuvers are performed, a composite graft may be performed once that hanging columella is addressed. You also have a recessive chin profile which makes your nose look over projected. Also consider placement of a small chin implant as a separate procedure or in combination with the revision rhinoplasty.

Question: Addressing all my problems with subtle results? Is it possible?
Answer: A closed rhinoplasty approach can accomplish improvements to your nose with all the incisions placed on the inside of the nose. A septoplasty is performed internally when there’s a deviated septum present blocking airflow. Both procedures can be performed together under one anesthesia with one recovery. If you’re looking for extremely subtle results, you may not see much of a difference in your before-and-after photographs. 

Question: 39, white female, what is the most cost effective saggy neck treatment?
Answer: From the one very limited photograph, it appears that you have a mild recessive chin for which a small chin implant can improve. You also have fat deposits in the neck most likely located both above and below the platysma muscle itself. If your skin tone is acceptable, then you can perform a necklift procedure which involves removal of both compartments of fat and a platysma plasty. No skin removal is performed. If you’re’s neck skin is inelastic, then a lower face and neck lift is going to be required to tighten loose facial and neck skin. An in person examination probably going to be required to make the determination about your skin tone in your neck.

Question: Laser liposuction or Facetite on the chin – which procedure would deliver noticeable results the fastest? 37 y/o
Answer: Noninvasive treatments simply will not be very effective. A full set of facial photographs from all angles would be helpful to make a determination about how best to proceed. If the fat deposits in your neck are located completely above the platysma muscle, then liposuction can accomplish a nice result. If you’re fat deposits are located below the platysma muscle, and then a neck lift procedure is going to be required to surgically extract fat deposits below the platysma muscle which also includes a platysma plasty to significantly improve the jawline. No skin removal is required. If there is a recessive Chin profile present, then consider placement placement of a small chin implant for better structural support for the soft tissues in the neck in addition to better facial balance and proportions. 

Question: Should I just go ahead and get the face lift or just better fillers in the right places?
Answer: A full set of facial and neck photographs from all angles are going to be required to make a determination about being a candidate for a face and neck lift. 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 fat deposits in the neck which also includes a platysma-plasty.

Question: Rhinoplasty for asymmetrical nostrils and bulbous tip?
Answer: A full set of facial photographs are going be required to make any determination about how best to proceed. Digital computer imaging would be helpful in the education process to understand what can be accomplished with your nose upon your facial features.

Question: Should I get a nose job for a smaller nose?
Answer: The nose is a 3-dimensional structure, and rhinoplasty is performed in all 3 dimensions, therefore a full set of facial photographs from all angles are going to be required to make a determination about how best to proceed. A closed rhinoplasty approach can accomplish narrowing the bridge line and slightly refining the nasal tip. All incisions are placed on the inside of the nose. 

Question: Will a revision rhinoplasty or any other procedures make my face more attractive?
Answer: A full set of facial and nasal photographs are going to require to make a determination about how best to proceed. Revision rhinoplasty is more difficult than a primary rhinoplasty, so always weigh the risk versus reward ratio. Also important to be very specific on what you are trying to accomplish with a revision rhinoplasty procedure on your nose. Digital computer imaging of your nose upon your facial features would also be helpful in the educational process. Thick skin in the tip of the nose is going to prevent refinement in that area, and will also require follow-up appointments for steroid shots after the surgery

Question: Would I benefit from eyelid surgery as I feel like my skin sags too much?
Answer: A conservative upper blepharoplasty procedure can accomplish removal of excess skin on the upper eyelids to raise the crease and get more eyelid platform show. The procedure can be performed under local anesthesia or general anesthesia as an outpatient procedure.

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