Facial Plastic Surgery Questions and Answers: Part 09

Question: Follow-up question: Are there stark differences between a Genioplasty and Chin Implant?
Answer: Yes there are certainly stark differences between a genioplasty and a chin implant. Chin implants are performed under local anesthesia which takes approximately 30 minutes to slip in the implant itself. A genioplasty is performed by an plastic surgeon under general anesthesia in hospital setting with an overnight stay and is much more invasive. A genioplasty is usually performed when the teeth are significantly out of alignment.

Question: What is the name of lower face lift or neck lift which doesn’t alter tragus? How is it done?
Answer: The Facelift incision involves placement of an incision in front and behind the ears. One option is to place the incision at the edge/behind the tragus, or in front of the tragus. In our practice, we prefer to camouflage the incision behind the tragus. It is very important not to put any tension on the tragal incision itself to avoid pulling the tragus outward.

Question: What is the difference between a short scar neck lift, direct excision of neck fat and a mini neck lift? Number of incisions?
Answer: At age 27, skin removal is not necessary anywhere in the neck, since your skin tone is acceptable. A full set of facial photographs are required to make a determination about how best to proceed. If there are fat deposits underneath the platysma muscle in the neck creating fullness, this needs to be surgically removed with a neck lift procedure followed up with a platysma-plasty to significantly improve the jawline. This usually involves 3 small incisions located behind both ears and underneath the chin.

Question: In chin and neck liposuction, apart from chin, when you say behind the ears, where exactly near the ears are sutures placed?
Answer: Much more information is needed, such as a full set of facial photographs from all angles to determine where in the neck your fat deposits are located. It is very important understand that can be significant fat deposits located below the platysma muscle and above the platysma muscle in the neck. A surgical neck lift with a platysma plasty is required to remove the fat deposits located below the muscle, while simple liposuction will only remove the fat deposits above the muscle. 3 small incisions are placed behind both ears and underneath the chin. If you are less than 50 years of age, no skin removal is required.

Question: What can be done to make my nose look more proportional?
Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, refining the bulbous nasal tip, and narrowing the bridge line with osteotomies. All the incisions are placed on the inside of the nose. No external incisions are required, and no painful packing is required either. Its also very important to release the depressor septi ligament which pulls the tip down dynamically when smiling.

Question: Would an alarplasty alone be enough for my nose?
Answer: An alar plasty simply narrows wide nostrils which are slightly out of balance with the rest of your nose. This procedure can be performed under local anesthesia as an outpatient procedure.

Question: What procedures can fix my extremely hooded and uneven eyes?
Answer: Much more information is needed such as a full set of eyelid photographs in a chin neutral position. A very conservative skin only upper blepharoplasty can accomplish lifting your upper eyelid crease to a higher position. It is also important to rule out ptosis on your left eye.

Question: What safe options exist to correct too much nostril show, frontal view? Alar base is not too wide. Rims are notched.
Answer: A full set of facial photographs and all angles are required to make a determination about how best to proceed. It sounds as though you have a hanging columella.

Question: Not a good candidate for Revision Rhinoplasty?
Answer: Revision rhinoplasty is more difficult than a primary rhinoplasty due to the fact there’s been previous alterations to the normal anatomy, and scar tissue. The reason that your nose appears crooked is that you’re right side has a convexity of cartilage just above the nasal tip, and you’re left upper lateral cartilage is collapsed. Shaving down small amount of cartilage on your right side, and adding a spreader graft composed of your own cartilage would give you some improvement. There is no perfect nose. Your nostrils Will still be asymmetrical. It’s very important to know how much cartilage is left over on the inside of your nose for grafting purposes.

Question: I’m planning to get an open rhinoplasty with dorsal augmentation and tip cartilage. Am I at risk for necrosis?
Answer: In our practice for over 30 years, we have only performed closed rhinoplasty with all the incisions placed on the inside of the nose. No external incisions are required, and no painful packing is required either. We have never seen skin necrosis from closed rhinoplasty.


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    The Idaho Center for Facial Plastic Surgery

    The Idaho Center for Facial Plastic Surgery ®

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    Ketchum, ID 83340

    (208) 481-9155

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