The Portland Rhinoplasty Center THe Portland Rhinoplasty CEnter

Facial Plastic Surgery Questions and Answers: Part 06

Question: Is a rhinoplasty the way to achieve a more harmonious face?
Answer: Digital computer imaging of your nose upon your facial features would be a good way to understand what can and cannot be accomplished with your nose upon your facial features. A closed rhinoplasty approach can accomplish only a slight reduction in the projection of the nasal tip, but can certainly shave down the dorsal hump and narrow the bridge line. 

Question: Will orthodontic braces impede/interfere with rhinoplasty surgery?
Answer: It is certainly acceptable to undergo orthodontic braces while having a rhinoplasty procedure. A closed rhinoplasty approach can accomplish your goals by placement of all the incisions on the inside of the nose. The only exception to that will be an alar-plasty which involves an incision with removal of a wedge of skin at the base of the nostrils.

Question: Can blepharoplasty be done with local anesthesia?
Answer: In our practice, an upper blepharoplasty can be performed under local anesthesia quite comfortably. Some patients elect to undergo upper blepharoplasty under general anesthesia. For a lower blepharoplasty, we always recommend all patient’s undergo general anesthesia.

Question: Short, asymmetrical, flat, bulbous, you name it. Help! Is rhinoplasty right for me? I need your guidance doc
Answer: To build up the bridge of the nose requires either a cartilage graft, or a synthetic implant. Its possible to narrow your nasal bones with closed rhinoplasty, and narrow your nostrils with an alar-plasty.

Question: Best option for my chin to improve my profile?
Answer: The photographs demonstrate a recessive chin profile and fat deposits in the neck. Consider placement of a chin implant to augment the chin forward, and liposuction to improve your jawline. Both procedures are complementary to each other, and can be performed under local or general anesthesia.

Question: Crookedness & slight hump – would I benefit from a rhinoplasty, and/or septoplasty?
Answer: A septoplasty is only performed if there’s breathing difficulty, so if you don’t have any breathing difficulties you don’t need a septoplasty. Regarding a cosmetic rhinoplasty, you can certainly have the hump shaved down and the bridge line narrowed. Your nostrils are asymmetrical now, I will continue to be asymmetrical after the surgery. One nostril is higher then the other, and it’s not possible to correct that issue. This is due to nasal and facial asymmetry. Digital computer imaging of your nose would be helpful to understand what can be accomplished with the procedure.

Question: Nostrils asymmetry looks worse, what can be done about rhinoplasty results?
Answer: Much more information is needed, such as a full set of facial photographs from all angles, and not just looking up your nostrils. You appear to have alar retraction in one nostril. If that’s the case, a composite graft of skin and cartilage harvested from the ear can accomplish improvement. Your nostrils will never be perfect, just improved. Also need to wait at least a year before embarking on a revision rhinoplasty. 

Question: How could I nonsurgically make my nose look less prominent?
Answer: From the limited photographs, you have a mildly overly projecting nose, and an under projecting chin from the side profile. Consider temporary fillers placed in the chin which can be quite expensive in the long run, or a small chin implant for a permanent result. Placement of Chin implant can be performed under local anesthesia as an outpatient procedure. We do not recommend placement of fillers in the nose due to vascular occlusion and skin necrosis in that area. 

Question: Upper (maybe lower) eyelid lift and brow lift options?
Answer: The photographs demonstrate hooded upper eyelids and low-set eyebrows. An upper blepharoplasty can accomplish removal of the hooded extra skin, while a Coronal approach forhead lift can accomplish adjusting the asymmetry of the eyebrows, lifting the eyebrows, and surgically softening the muscles that create the 11’s between your eyebrows. Based on the placement of incision, you can actually lower your hairline if so desired. 

Question: Best options to treat sagging skin on the lower face of a 30 year old?
Answer: The pictures presented are inadequate to make a determination about how best to proceed. If you’re having significant fat deposits in the neck which are genetic, then a submental plasty/ necklift can accomplish improvement. This involves liposuction to remove the fat deposits above the platysma muscle and surgical extraction of the genetic fat deposits below the muscle and a platysma-plasty is performed to significantly improve the jawline. At age 30, your skin tone is excellent, so no skin removal is required. 

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