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Facial Plastic Surgery Questions and Answers: Part 10

Question: How to fix short, rounded nose? 
Answer: A closed rhinoplasty approach can accomplish reduction of the bulbous nasal tip, and narrow the bridge line with all of the incisions placed on the inside of the nose. A full set of facial photographs from all angles are required to make a determination about how best to proceed.

Question: Will my nose injury 6 months ago return to normal? 
Answer: After six months, your noses not going to change any further. The Photos demonstrate wide nasal bonds, and narrow upper lateral cartridges. A closed rhinoplasty approach can accomplish narrowing the nasal bones and widening and supporting the upper lateral cartilages with spreader grafts harvested from patient’s own nasal septal cartilage.

Question: Can I get a non surgical nose job? Or do I need to get a revision rhinoplasty? 
Answer: In our practice, we do not recommend non–surgical rhinoplasty because it’s only temporary, is not FDA approved for that application, and can have significant complications such as skin necrosis. It’s also important to determine what is causing the polybeak. It could be extra excess cartilage, or thick skin. Each one of these issues are treated differently. Thick-skin is best treated with steroid shots, while extra cartilage is removed with a revision rhinoplasty procedure. If you’re attempting to build up the bridge of the nose, that can be accomplished with a cartilage graft harvested from inside the nasal septum. With any revision rhinoplasty it is important to know how much cartilage is left over on the inside of the nose for grafting purposes. A copy of the operative report would be helpful for your next plastic surgeon.

Question: How can I fix my large nose?
Answer: A closed rhinoplasty approach can accomplish narrowing the wide nose both statically and dynamically when you smile. The hanging columella can be reduced by removal of extra skin and cartilage in that area. An alar-plasty can accomplish narrowing wide nostrils. The cost of a rhinoplasty is dependent upon surgeon’s fees, operating room fees and anesthesia. Our current price list is located on our website link below.

Question: What is the best approach for correcting my saddle nose deformity caused by a feminizing rhinoplasty/septoplasty? 
Answer: A revision rhioplasty procedure with Cartilage grafting to the saddle nose depression is going to be required. It is important to know how much, if any cartilage is left over on the inside of the nasal septum for grafting purposes. Otherwise, ear cartilage may be required.

Question: My nose curves, droops and feels like the ridge has a bump. Is my goal photo possible with a rhinoplasty or fillers? 
Answer: A closed rhinoplasty approach can accomplish straightening your nose, refining the nasal tip, shaving down the dorsal hump, and reduction of the hanging columella. Digital computer imaging of your nose upon your facial features would be helpful in the communication process to understand what can and cannot be accomplished with the procedure. Rhinoplasty is a very difficult endeavor, so choose your surgeon wisely based on extensive experience.

Question: My nose curves, droops and feels like the ridge has a bump. Is my goal photo possible with a rhinoplasty or fillers? 
Answer: A closed rhinoplasty approach can accomplish straightening your nose, refining the nasal tip, shaving down the dorsal hump, and reduction of the hanging columella. Digital computer imaging of your nose upon your facial features would be helpful in the communication process to understand what can and cannot be accomplished with the procedure. Rhinoplasty is a very difficult endeavor, so choose your surgeon wisely based on extensive experience.

Question: Should I consider a rhinoplasty to fix my bridge? 
Answer: A closed rhinoplasty approach can accomplish straightening and narrowing the bridge line, refining the nasal tip, and adding a spreader graft to the depressed area in the midportion of the nose on the right side. All of the incisions are placed on the inside of the nose. No external incisions are required. A CAT scan of your sinuses will be required to make a determination about your sense of smell and whether not there’s any polyps on the inside of your sinuses creating chronic sinusitis. Functional sinus surgery and nasal breathing surgery can be performed simultaneously at the same time as a cosmetic rhinoplasty.

Question: Does ultrasonic rhinoplasty yield better results then traditional rhinoplasty?
Answer: There are many different ways to cut through the nasal bone which include knife, scissors, ultrasonic, or Chisel when needed for thick nasal bones. Ultrasonic is only a method of Cutting through the bone, and give the same results as all the other methods. Much more important is experience of the surgeon, not the cutting tool.

Question: Rhinoplasty for broad middle nasal dorsum without osteotomies? 
Answer: Osteotomy’s are mandatory to be able to narrow the wide nasal bones and corresponding upper lateral cartilages. Osteotomy’s are an integral part of a rhinoplasty to narrow the upper two thirds of the nose. If you only narrow the upper level cartilages, you’ll create an inverted V deformity.

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