Facial Plastic Surgery Questions and Answers: Part 03

Question: Can I reduce my hump and size of the nose?
Answer: The dorsal hump is composed of both bone and cartilage which must be surgically removed in order to make the required changes. The to the nose can also be listed as well when needed. Also important to release the depressor septi ligament which pulls the tip down dynamically when smiling. Osteotomies can accomplish narrowing the bridge line from the frontal profile.

Question: I’m wondering if the length of my nose could be improved. I don’t mind the front view but the side profile ?
Answer: A closed rhinoplasty approach can accomplish decreasing the overall projection of the nose, shaving down the dorsal hump, and reducing a little bit of the hanging columella with all incisions placed on the inside of the nose. No external incisions are required. This must be performed under general anesthesia. It’s impossible to tolerate a full rhinoplasty under local anesthesia, since there will be cartilage and bone work being performed. In our practice we use board-certified physician anesthesiologists for patient comfort and safety, and all rhinoplasty surgery is performed under general anesthesia.

Question: Will getting a nose job to reduce the overall size and length of my nose make my face look less long?
Answer: The nose is a three-dimensional structure and rhinoplasty is performed in all three 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 refining your nasal tip, shaving down the dorsal hump, and narrowing the bridge line. Digital computer imaging be helpful to understand what can be accomplished with your nose upon your facial features.

Question: I had a tip rhinoplasty 9 months ago and see some issues with symmetry. Can filler help make my tip symmetrical?
Answer: Much more information is needed, such as a full set of facial/nasal photographs from all angles to make a determination about how best to proceed. The limited photographs demonstrate asymmetrical tip cartilages, a hanging columella and alar retraction. A revision rhinoplasty is going to be required. We do not recommend fillers placed in the nose, especially in the nasal tip, since you can have significant complications that can occur. It would be important to know how much cartilage is left over on the inside of your nose for potential grafting purposes.

Question: Can I have a smaller nose bridge and make my nose seem more symmetrical?
Answer: A closed rhinoplasty approach can accomplish narrowing the nasal tip and the bridge line in addition to reducing the hanging columella. All incisions are placed on the inside of the nose.

Question: If I get a rhinoplasty, will my columella go back to being droopy or having a bump? Is this an easy fix or more complex?
Answer: A closed rhinoplasty approach can accomplish lifting the nasal tip, reducing the hanging columella, shaving down the dorsal hump, and narrowing the bridge line with all of the incisions placed on the inside of the nose. Once the hanging columella has been reduced, it does not return.

Question: What would be the best nose job for me that would look good on my face structure but not totally change my look?
Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, decreasing the overall projection of the nose, and narrowing the nasal tip with all incisions placed on the inside of the nose.

Question: I don’t like the outline of my nose from my first surgery. It looks “bony” to me. It is also crooked. Can this be fixed?
Answer: The photographs demonstrate a crooked nose which includes asymmetrical nasal bones, an asymmetrical nasal tip, and upper lateral cartilages in the midportion of the nose. To straighten the crooked nose requires osteotomies placed in the nasal bones, cartilage spreader graft placed underneath the concave upper lateral cartilage in the midportion of the nose, and asymmetrical tip surgery to adjust asymmetrical nasal cartilages themselves.

Question: Fat Removal or Fat Repositioning: which is better for my situation?
Answer: At age 25, your skin tone in your lower lids is just fine. No skin removal/ laser treatments are required. A trans-conjunctival approach lower blepharoplasty with conservative fat removal it’s all we would do in our practice. Two very small incisions are placed completely on the inside of the lower lid where the fat bags are removed. This is done under a brief general anesthesia as an outpatient procedure. We’ve seen too many complications from fat repositioning, and that procedure doesn’t work very well.

Question: Why do most before and after photos of facelifts not show improvement of marionette lines?
Answer: Marionette lines cannot be improved with a facelift due to the fact that they’re located too far away from the incisions for a facelift. Very unnatural results what occur if you tried to tighten marionette lines from incisions in front and behind the ear.


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    The Idaho Center for Facial Plastic Surgery ®

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    Ketchum, ID 83340

    (208) 481-9155

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