Facial Plastic Surgery Questions and Answers: Part 05

Question: Will a 3rd Rhinoplasty achieve my goals?
Answer: A full set of facial photographs from all angles of your current nose are going to be required to make a determination about proceeding. Probably best to wait at least a year after your year second rhinoplasty before embarking on another procedure. Also important to look at a sidee profile photograph at repose and smiling to determine if there’s an active Depressor septi ligament.

Question: Revision rhinoplasty after 10 years. My tip is crooked and scar is very visible. Are my expectations unreasonable?
Answer: A closed revision rhinoplasty can accomplish straightening the crooked nose, and reducing the hanging columella which will reduce the appearance of the previous open rhinoplasty incision. Spreader graft placed in the middle portion of your nose on the left-hand side where the upper lateral cartilage is concave will be needed. It’s important know if there’s any cartilage left over on the inside of the nose for grafting purposes, so your operative report would be helpful from your previous surgery.

Question: Is neck surgery my only option?
Answer: Is difficult to tell from photographs if there is loose and inelastic skin, or neck bands present. Botox can address softening the bands on a temporary basis, while a platysma plasty can address the neck bands a permanent basis. You will need a neck lift with skin removal if there is loose and elastic skin in the neck.

Question: Can you get an upper blepharoplasty if you have had Restylene in the upper eyelid area?
Answer: Yes it is possible to get an upper blepharoplasty after you have had fillers placed in the eyelids. A full set of facial / eyelid photographs are required to make a determination about being a candidate for the procedure.

Question: Transgender woman looking for nose job. I had a rhinoplasty and my nose is still too large. Would you do surgery on me?
Answer: Revision rhinoplasty is always more difficult than a primary rhinoplasty, therefore a full set of facial photographs and an in-person examination are going to be required to make a determination about how best to proceed. Previous alterations to the normal anatomy and scar tissue formation make revision rhinoplasty surgery more challenging.

Question: Could I get these results through a rhinoplasty or tip plasty?
Answer: The nose is a 3-dimensional structure, and Rhinoplasty is performed in all 3 dimensions, therefore a full set of facial photographs of your nose from all angles are required to make a determination about how best to proceed. Consider digital computer imaging of your nose to understand what can be accomplished with your current anatomy.

Question: Which treatment would be best for my jowl and jawline to slim and lift my lower face?
Answer: When jowls are present at 35 years of age, consider a mini-facelift. The photographs also demonstrate a recessive chin profile for which a small chin implant can improve as well. Both procedures to be performed together under one anesthesia with one recovery period.

Question: Mini neck lift, chin implant and chin liposuction. Is this too aggressive?
Answer: More information is going to be needed, such as your age, and the status of the skin tone in your neck. The limited photographs demonstrate fat deposits in the neck and what appears to be loose and inelastic skin in the neck as well. While fat can be removed with liposuction, that may exacerbate the excess and loose skin. If that is the case, a lower face and neck lift is going to be required to tighten loose facial and neck skin. The photographs also demonstrate recessive chin profile for which a small chin implant can improve.

Question: Age 23, is it possible to change the shape of an Asian nose?
Answer: First of all it’s very important to have realistic expectations about what can and cannot be accomplished with your nose. You also have very thick skin in the tip of your nose which is going to prevent refinement in that area. From the front view you can undergo rhinoplasty with osteotomies to narrow your current nasal bones. You also have to understand that they are very short in Asian nose. Many Asians also build up the bridge which gives the illusion of height and more narrow of a nose. Digital computer imaging of your nose would be helpful in the education process.

Question: Am I a good candidate for upper blepharoplasty?
Answer: Yes indeed, your left upper eyelid is more hooded then you’re right side, so a conservative skin only upper blepharoplasty would be helpful to rejuvenate your upper eyelids. You also have low eyebrows, so give some consideration to a brow lift.


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