Facial Plastic Surgery Questions and Answers: Part 2

Question: Time for a lower face and neck lift (42)?
Answer: From the photographs presented, you look fantastic for age 42, and a facelift is not needed. Only a very limited benefit would be accomplished performing the procedure at your age. Probably best to wait 7-10 years.

Question: Could a nose job help reduce eye circles?
Answer: A nose job will not reduce eyelid circles. The goal of a rhinoplasty to shave down the dorsal hump, and narrow the bridge line.

Question: Would chin liposuction minimize the appearance of my genetic double chin?
Answer: You have extensive fat deposits in the neck, located both above and below the platysma muscle. Liposuction can only accomplish removal of the fat deposits above the muscle, which will be only partially effective. A surgical neck lift procedure accomplishes removal of the fat deposits below the muscle, which also includes a platysma plasty to significantly improve the jawline in addition to liposuction above the fat above the muscle. For best results, your BMI needs to be below 32 in order to proceed.

Question: Upper eyelid surgery to repair heavy eyelids?
Answer: Cosmetic upper eyelid surgery is performed to reduce heavy eyelids by removing excess skin and fat. Occasionally a strip of muscle can be removed to help as well. The pictures presented are in adequate in order to make a determination. Levator resection is performed when there’s ptosis present.

Question: Blepharoplasty before pregnancy? Is there a minimum time interval between surgery and pregnancy?
Answer: It is certainly acceptable to undergo a blepharoplasty before any type of planned pregnancy. Probably best to give yourself a month or two after the surgery before becoming pregnant.

Question: Is making nose wider possible with revision rhinoplasty? 
Answer: Much more information is needed, such as a full set of facial photographs from all angles, and a copy of the operative report to find out what was accomplished in the first procedure. It’s also important to know if there’s any cartilage left over on the inside of your nose for grafting purposes.

Question: Should I get a neck lift or are there fillers that can fix the loose skin?
Answer: From the limited photographs, it appears that you have platysma muscle cords, loose and inelastic skin, and small amount of fat deposits in the submental area. A neck lift with skin removal is going to be required, not fillers.

Question: Best procedure to remove minimal fat below chin?
Answer: Liposuction can accomplish removal of fat deposits in the neck. This procedure can be performed under local anesthesia as an outpatient procedure.

Question: Eye bags or malar fat pads?
Answer: From the very limited photograph, it appears that you have fat bags in the lower lids creating the puffy look. A trans-conjunctival approach lower blepharoplasty can accomplish improvement with the incision located completely on the inside of the eyelid. No external insertion is required. This is performed under a brief general anesthesia as an outpatient procedure.

Question: What are my options with a revision rhinoplasty, could I narrow my bridge?
Answer: A Closed revision rhinoplasty can accomplish narrowing and straightening your nasal bones with osteotomies to try to help with the inverted V deformity. In addition to osteotomies, we usually place spreader grafts, composed of the patient’s own cartilage underneath the upper lateral cartilage in the mid vault of the nose, which also helps to widen those cartilages to match the nasal bones. It’s important to know if you have any further cartilage left over on the inside of your nose, and whether or not, you’ve had spreader graphs in the past. You also have a small residual dorsal hump, which can be filed down as well.


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