Facial Plastic Surgery Questions and Answers: Part 02

Question: Is finding a surgeon that will make minor adjustments to tip/nostrils under local plausible?
Answer: Trying to perform a rhinoplasty under local anesthesia is a bad idea, and will be very painful. A full set of facial photographs from all angles are going to be required to make a determination about which maneuvers may be needed to perform your rhinoplasty. Thick skin in the tip of the nose is going to prevent refinement as well, so it is important to have realistic expectations.

Question: What surgeries/implants should I get to correct my weak chin/wide jaw angle?
Answer: The limited photographs demonstrate a recessive chin profile for which a chin implant can improve. The implants themselves are manufactured in a large array of thicknesses, sizes, and shapes which can be custom carved when needed to match patient’s unique anatomy. The procedure can be performed under local anesthesia as an outpatient procedure. There’s not enough fat in your neck to consider liposuction. 

Question: Is a revision rhinoplasty to remove a small bump in-office a painful procedure?
Answer: Yes, trying to remove a bony and cartilaginous dorsal hump is going to be quite painful done under local anesthesia. We would recommend general anesthesia performed by a board certified physician anesthesiologist for patient safety and comfort. This is performed in a surgery center, not a clinic.

Question: 20 years post op and considering a revision – is my alar retraction fixable?
Answer: The Alar retraction that you have on one nostril can be repaired with a composite graft of skin and cartilage harvested from the ear. Removing any further cartilage out of a nasal tip might make the alar retraction worse, so probably best to leave your nasal tip cartilages alone. A Composite graft from the ear can be done under local and aesthesias an outpatient procedure. General anesthesia would only be required for a full revision rhinoplasty.

Question: Eye bags surgery and cornea ulcer
Answer: A trans conjunctival lower blepharoplasty can accomplish removal of the fat bags in the lower lids creating the puffiness look. The Incision is located on the inside of lower lid. Lower eyelid surgery should have no bearing on a healed corneal ulcer from years ago. Probably be a good idea to have your ophthalmologist take a look at your cornea prior to the surgery to make ensure there’s no issues going on. 

Question: 28 with dull skin, sagging cheeks, and nasolabial folds
Answer: The Photographs demonstrate a rather flat appearance of your maxilla. Consider placement of temporary fillers in that area to augment the volume loss in your cheeks. After you have tried fillers, then you can consider placing cheek implants to augment your cheeks a permanent basis.

Question: Is it possible to achieve a lower nose bridge?
Answer: A closed rhinoplasty approach can accomplish achievement of a lower nose bridge by shaving down the dorsal hump which is composed of both bone and cartilage. All the incisions are placed on the inside of the nose. No external incisions are required, and no painful packing is required either. Your bridge line will also need to be narrowed with osteotomy’s to prevent an open roof. Refinement of the nasal tip can also be accomplished to ensure that all the components of the Nose are balanced with each other in a three dimensional form. Digital computer imaging of your nose upon your facial features would also be helpful to understand what can be accomplished with a rhinoplasty.

Question: Nose is messed up looking after septoplasty. How can I get my nose back?
Answer: Much more information is needed, such as a full set of facial and nasal photographs from before and after your surgery, in addition, a copy of the operative report to find out what was accomplished in your procedure. A rhinoplasty procedure can accomplish shaving down the dorsal hump, narrowing the bridge line and making out any other required changes necessary.

Question: Rhinoplasty and fertility – should I wait until after having the baby?
Answer: Having a septoplasty and a rhinoplasty should not have any bearing on fertility three or four years later. It’s really a personal choice as to which procedure you have done first. Rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery, so choose your plastic surgeon wisely based on extensive experience.

Question: Rhinoplasty and chin lipo together?
Answer: A full set of facial/neck photographs from all angles are going to be required to make a determination about how best to proceed. Both procedures can certainly be performed together under one anesthesia with one recovery period.

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