Facial Plastic Surgery Questions and Answers: Part 03

Question: Why is my double chin still present after chin lipo?
Answer: It’s very important to understand that there are two compartments of fat in the neck, and they’re located both above and below the platysma muscle in the neck. Liposuction can only accomplish a partial removal of the fat deposits above the muscle. You probably have fat deposits located below the platysma muscle which is going to require a necklift procedure as an outpatient procedure. 

Question: What is the best procedure to lift face and get rid of wrinkles and 11s?
Answer: Your eyebrows are in excellent position, so brow lift is not necessary, therefore placement of Botox Will be all that’s required for the 11s between your eyebrows. A full set of facial photographs from all angles are required to make a determination about lower face and neck lift procedure.

Question: Is there any way I can have the tip of my nose lifted non surgically?
Answer: There’s a large dorsal hump present in addition to a Droopy nasal tip which requires a surgical closed rhinoplasty in order to lift the nasal tip. Also important to release the depressor septi Ligament which dynamically pulls the tip down when smiling.

Question: Minor Revision Rhinopalsty. Would shaving it down 2-3 mm make a visual difference?
Answer: Revision rhinoplasty is more difficult than a primary rhinoplasty, and this procedure is performed under general anesthesia in a surgery center, not under local anesthesia in the office. Shaving down your bridge to 3 mm will cause an open roof, flattop nasal deformity which will require osteotomies to be placed in the nasal bones to close the open roof, and to straighten the crooked nose shown in the photograph. 

Question: Is my photoshopping of my nose realistic?
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.

Question: At 53 wanting to look refreshed. Recommendations?
Answer: The photographs demonstrate low eyebrow position, especially your left eyebrow. Consider a brow lift procedure which can also soften the scowling (corrugator) muscles between your eyebrows as well. You may or may not require upper blepharoplasty a few months down the road if there is still residual excess skin in the upper lids after the brow lift procedure. Regarding the excess skin in your neck, you will require a lower face and neck lift. The goal of a lower face and neck lift is to tighten loose facial and neck skin, tighten loose facial and neck muscles, lift the jowls, and remove any fat deposits in the neck which also includes a platysma-plasty.

Question: Do I have a weak chin? If so, would fillers or an implant be the best solution?
Answer: The Photographs are rather limited, but it does appear there is a slight recessive chin profile for which a chin implant can improve. A chin implant can be performed under local anesthesia as an outpatient procedure.

Question: Would I be a good candidate for closed rhinoplasty?
Answer: A closed approach can accomplish narrowing the bulbous tip, shaving down the dorsal hump, and narrowing the bridgeline with all of the incisions placed on the inside of the nose. No external incisions are required.

Question: Morning Puffiness Under Eye. What can I do to prevent this?
Answer: Much more information is needed, such is a set up pictures of your lower lids, and your age. Try a low salt diet, and make sure your thyroid levels are normal. If you failed medical management, then consider a trans conjunctival lower blepharoplasty to remove the fat bags creating the puffy look.

Question: Please Help, Revision Rhinoplasty Needed, Bossae/Cartilage Knot in Left Tip
Answer: From the photographs presented, you have multiple issues that need to be addressed with A full revision rhinoplasty surgery. A closed rhinoplasty approach can accomplish narrowing your wide nasal bones and making them more symmetric, adding ha spreader graft to the midportion of your nose on your left side where it is collapsed, placement of a composite graft to the left nostril which has alar retraction, shaving down the small dorsal hump which is present, in addition to reducing the hanging columella. Revision rhinoplasty is very difficult, so choose your rhinoplasty specialist based on extensive experience producing natural results. 


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