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Facial Plastic Surgery Questions and Answers: Part 7

Question: Asymmetrical side view and bump on bridge – should I keep trying non-invasive options or do I need revision surgery? 
Answer: You have what’s known as a poly beak, which can be caused from residual cartilage on the bridge line, or thick skin. Each one of those treated differently. Thick skin is treated with steroid shots, while residual cartilage is treated with a revision rhinoplasty. In our practice, we do not perform this under local anesthesia in the office. Rhinoplasty is performed under general anesthesia. In addition, the cartilage on the bridge line must be cut, and bone gets rasped. Most of your issue is either cartilage or thick skin. Also important follow follow up with your operative surgeon for steroid shots to manage skin envelope over the framework of the nose in the first several months after the procedure. You should wait at least a year before undergoing a revision rhinoplasty. Choose your plastic surgeon wisely based on extensive experience since revision rhinoplasty is more difficult than a primary rhinoplasty.

Question: How much would a nose job and blepharoplasty surgery cost?
Answer: Much more information is needed, such as a full set of facial photographs from all angles to determine being a candidate for a rhinoplasty procedure. In addition, unadulterated photographs of the eyelids specifically are going to be required. There does not appear to be any bags in the lower lids on the current photographs. In our practice, we do not recommend buccal fat removal. Our current price list is located on the link below.

Question: What procedures would I be able to do to correct my profile, nose and chin?
Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump and placement of a graft high in the bridge line where the glabellar is shallow. Placement of a small chin implant can augment the chin forward. Both procedures can be performed together under one anesthesia with one recovery period. Digital computer imaging would be very helpful for you to understand what can be accomplished with your current facial features and both procedures.

Question: Would I get the best results with just a tip plasty for my nose ? 
Answer: No, the best results will require a full rhinoplasty. If you were to do digital imaging of your tip in the front view alone, you would realize that your bridge line and nasal bones will be excessively wide based on the new and more narrow tip. When performing closed rhinoplasty, all the components of the nose must be balanced with themselves into three-dimensional fashion, and the new nose must balance with patient’s facial features. In our practice, we perform the tip component of the rhinoplasty surgery first, and then build the rest of the nose around the new nasal tip.

Question: Can I have my upturned nose straightened with injectables? 
Answer: In our practice we do not recommend injectables placed in the nose since it is not FDA approved for that application, is only temporary, and can have significant complications such as skin necrosis, especially in the tip of the nose. A revision rhinoplasty procedure can accomplish improvement of your nose on a permanent basis. Revision rhinoplasty is more difficult than a primary rhinoplasty, so it’s important to choose your surgeon wisely based on extensive experience.

Question: 21 years old, what procedure would be best to help my side profile?
Answer: The photograph demonstrates a recessive chin profile, and fatty deposits in the neck. Consider placement of a chin implant and neck liposuction to give you significant improvement. Both procedures can be performed separately or together under local anesthesia as an outpatient surgical procedure.

Question: Would I benefit from rhinoplasty?
Answer: Only you can make the decision as to whether not you should undergo elective cosmetic surgery on your nose. If the issues with your nose bother you a lot, then strongly consider undergoing the procedure. Digital computer imaging would be helpful to understand what can be accomplished with your nose upon your facial features. A closed rhinoplasty approach can accomplish shaving down the hump and narrowing the bridge line. All the incisions replaced on the inside of the nose. No external incisions are required, and no painful packing is required. Rhinoplasty is a very difficult endeavor, so choose your surgeon wisely based on extensive experience.

Question: 1 year post-op- what needs to be done to correct depression on the bridge of my nose? 
Answer: Revision rhinoplasty is more difficult than primary rhinoplasty, so what’s important to have a full set of facial photographs from all angles since the nose is a three-dimensional structure. Also important have very realistic expectations. One option would be to shave down residual dorsal hump present, or add a cartilage graft to the depression, or a combination of both. It’s also important to know how much Cartilage is left over on the inside of the nose for potential grafting purposes. That information will be located on your Operative report.

Question: Is it possible to have the dorsal hump removed while keeping the general appearance of my face the same? 
Answer: The photographs demonstrate an overly projecting nose with a dorsal hump, and a recessive chin profile. A closed rhinoplasty approach can accomplish shaving down the dorsal hump on the nose itself with all the incisions placed on the inside of the nose. Consider placement of a chin implant to augment the recessive Chin forward for better facial balance and proportions. Placement of a chin implant will give you better facial balance and proportions.

Question: Is it safe to have an infected baby tooth pulled 1 week before rhinoplasty?
Answer: If you have an infected/ abscess tooth close to the nose, it’s probably best get that dealt with first and wait approximately a month for full healing on the abscess before undergoing your elective rhinoplasty procedure.

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