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Question: Nose too big and excess nostril show, plus asymmetry – Options? Answer: You do have a hanging columella which can be reduced by excision of extra skin and cartilage on the inside of the nose. It’s very important have realistic expectations moving forward with a revision rhinoplasty, since there is no perfect nose And your nostrils will never be symmetrical. Just like there is facial asymmetry, There’s also nasal asymmetry which is genetic.  Question: Neck lift or thread lift? What do you think is my best option? Answer: More information is needed, such as your age and a full set of facial photographs from all angles. From the limited photograph, you do have fat deposits in the neck located both above and below your platysma muscle. A surgical neck lift is required to remove both compartments of fat. There’s no skin removal with a neck lift. If you’re have inelastic skin in the neck, then you’re going to need a lower face and neck lift procedure which involves tightening loose facial and neck skin, tightening loose facial and neck and muscles, removal of both compartments fat in the neck which also includes a platysma plastic to significantly improve your jaw line. Thread lifts Will be ineffective. Question: Does bromelain supplement taken before surgery help with swelling after rhinoplasty? Answer: Bromelain taken before surgery probably does not help the swelling and bruising after rhinoplasty surgery. It doesn’t hurt to take it either. Probably little to no benefit. Always check with your operative surgeon. Much more important is to choose your surgeon based on extensive rhinoplasty experience. Question: When can you wear contacts after a transconjuctival blepharoplasty?  Answer: In our practice, as long as there’s not too much swelling present, most patients are able to go back to wearing soft contacts at 2 to 3 weeks after their surgery. Question: Can drooping cartilage in right side of nasal tip be improved without taking apart left side of nasal tip? Answer: When performing a revision rhinoplasty, there’s always risk versus reward versus complication risks. Revision rhinoplasty is more difficult than a primary rhinoplasty. From the very limited photographs presented, the only thing appears to be wrong with your nose is a hanging columella. Question: Can a septoplasty be done without the need for a rhinoplasty when the nose is visually crooked? Answer: To straighten the visually crooked nose requires a rhinoplasty. A septoplasty is only performed when there is a breathing difficulty, and the deviation is blocking airflow back inside the nose. A septoplasty will not change the shape of the nose. Both procedures can be done together or separately when needed. Question: Lower facelift include double chin removal? Answer: In our practice, a lower face and neck lift does include rejuvenation of the neck. It’s very important to ask that question with your prospective surgeon. You also have significant fat deposits located below the platysma muscle, so it’s you’re going to need Neck specialist to address that issue. 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 fat deposits located both above and below the platysma muscle in your neck which also includes a platysma plasty to significantly improve the jawline. Liposuction alone in the neck will be ineffective, since the majority of your fat deposits are located below the platysma muscle which requires surgical removal.  Question: What type of facelift is recommended? Answer: A full set of facial photographs from all angles including your face and neck are required to make a determination about how best to proceed. In our practice, the goal of a facelift to tighten loose facial and neck skin, tighten loose facial and neck muscles, lift the jowls, and remove fat deposits in the neck located above and below the platysma muscle in addition to a platysma-plasty to significantly improve the jawline. Marionette lines are not improved with a facelift, otherwise your face will look too stretched. Question: My eyelids are beginning to droop and create hooded eyes. What are signs that it’s appropriate to have a blepharoplasty? Answer: From the one very limited photograph, it appears that the eyebrow position is normal, and a brow lift is unnecessary. An upper blepharoplasty procedure can accomplish removal of the excess skin in your upper lids creating the hooded look. This can be performed under local or general anesthesia. Question: Am I a candidate for lower eyelid surgery? Answer: The primary goal for lower eyelid surgery is to remove the fat bags through trans conjunctival approach on the inside of the lower lids. At age 33 you do not have inelastic skin, and therefore no skin removal is required.
Question: Best option for my double chin and more jaw definition? Answer: The photographs are rather limited, but there does appear to be a slight recessive chin profile present for which a small chin implant can improve. The fat deposits in your neck are located above AND below the platysma muscle, therefore a neck lift with a platysma plasty will be required to remove both compartments of fat in addition to significantly improving the jawline. This procedure does not remove any excess skin. Three small incisions located underneath the chin and behind each ear.  Question: I have a bit of a double chin from the side. Is this a skin laxity or fat problem? What’s the most effective treatment? Answer: A full set of facial photographs from all angles in a chin neutral position without smiling or going to be required to make a determination about how best to proceed. Simple liposuction can accomplish removal of fat deposits in that area. At age 34, your skin tone is totally acceptable. Question: Any recommendation for rhinoplasty to fix hump and narrow my tip? Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, narrowing the bridge line and refining the nasal tip with all the incisions placed on the inside of the nose. No external incisions are required. Digital computer imaging would also be helpful to understand what can be accomplished with your nose upon your facial features.  Question: What approach should I take with rhinoplasty and what kind of nose would benefit my face? Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, and straightening the nose with all the incisions placed on the inside of the nose it itself. No external incisions are required. No painful packing is required. To straighten the nose from the frontal profile requires osteotomy’s placed in the nasal bones, and a spreader graft composed of the patient’s own cartilage placed underneath the concave upper lateral cartilage on your right side. If there is a deviated septum present on the inside of the nose creating nasal obstruction, then a septoplasty will be required. Both procedures can be performed together under one general anesthesia with which allows one recovery.  Question: How do I ask my ENT doctor about getting a rhinoplasty at the same time as my septoplasty? Answer:  Rhinoplasty is the hardest operation to do properly in all of cosmetic surgery, so it is very important to make sure your ENT doctor has lots of experience producing natural results. Ask to look at his/her before and after rhinoplasty photo gallery to make sure that it is extensive with the results that you like. Look for a double board certified ENT /facial plastic surgeon with extensive experience. Digital computer imaging of your nose upon your facial features would also be helpful to understand what can be accomplished with the procedure. Question: Do I need a neck lift or lipo? Answer: Liposuction will only remove the fat deposits above the platysma muscle, while a neck lift removes fat above and below the muscle. A necklift also includes a platysma-plasty which will significantly improve your jawline. Also consider placement of a chin implant to augment the chin forward for better facial balance and proportions, since there’s a recessive chin present.  Question: Advice on Rhinoplasty during COVID? Answer: It is very difficult to predict the future regarding COVID 19. In our practice, patients who fly in for surgery are coming a few days early prior to the surgery and get tested. Question: Detroit area: What kind of neck and face lift? Answer: In our practice, we perform a high SMAS lower face and neck lift procedure. This accomplishes tightening loose facial and neck skin, lifting the jowls, tightening loose facial and neck muscles, and removing the fat deposits in the neck with liposuction. Best to lose 50 pounds first, since you will get a better result. Question: Is one has LASIK surgery for near or far sightedness, can you still have an upper bleph? Answer: Yes, it is certainly possible to undergo blepharoplasty procedure after LASIK surgery. Probably best wait at least three months to allow full healing between procedures. Question: Nose bridge changing. Can anything be done to make it appear better? Answer: Trauma to the nose can cause a variety of issues such as a displaced nasal fracture, dislocation of the upper lateral cartilages, and a deviated septum. A thorough internal and external examination of the nose going be required to make a determination about how best to proceed. A closed rhinoplasty can accomplish changing the external shape to the nose such as straightening it, and shaving down the dorsal hump, and narrowing the tip and the bridge line. 
Question: Do Nose exercises work? Can you really change the nose with facial exercises, pinching, pulling, or by blowing it? Answer: No, nose exercises do not work. Below the skin of the nose, there is cartilage and bone which must be surgically altered in order to change the shape. In our practice, we perform closed rhinoplasty with all the incisions placed on the inside of the nose. Question: Maintenance for Brow Lift w/ Botox – how many times a year should I get it? Answer: In our practice, we do not perform an endoscopic brow lift, just the coronal approach which can accomplish softening of the corrugator muscles which create the vertical lines in the forehead and soften the frontalis muscle which creates the horizontal lines in the forehead. As long as those muscles have been softened, no maintenance is required. Much more information is needed such as a full set of facial photographs to determine if your candidate from brow lift procedure. Question: 72F, 5’2, 97lbs, deep plane face & neck lift & upper & lower bleph is lack of surgeon a risk? Answer: Yes indeed, lack of experience is a risk for many different complications. The deep plane facelift has a higher incidence of facial nerve branch paralysis than her traditional smas facelift. You also need to consider getting a letter of clearance from your primary care physician before undergoing elective cosmetic surgery under general anesthesia.  Question: Bulbous tip revision after septoplasty – revision or Tip Plasty? Answer: A full revision rhinoplasty is going to be required in order to reduce the bulbous nasal tip, narrow the bridge line, and reduce the hanging columella that’s present. Ear cartilage might need to be used if grafting is necessary, since you probably don’t have any cartilage leftover inside the nose after the septoplasty. Also consider placement of a chin implant for the recessive chin present on your side profile photograph. Placement of a chin implant will help with facial balance and proportions, especially from the side View with respect to your nose. Revision rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, so choose your rhinoplasty specialist wisely based on extensive experience. Question: Can a facelift and a rhinoplasty be performed at the same time? Answer: Yes, a facelift and a rhinoplasty can be performed simultaneously under one anesthesia with one recovery period. Choose your surgeon wisely based on extensive experience producing natural results, especially with both of these two procedures. Question: Would I be an ideal candidate for a nonsurgical rhinoplasty and brow lift? Answer: To lift the Central Part of your eyebrows will require a surgical brow lift, and Botox cannot accomplish that. We do not recommend nonsurgical rhinoplasty because of the potential for vascular occlusion and skin necrosis. A Closed rhinoplasty is required to be able to shave down dorsal hump, refine the nasal tip, lift the tip of the nose and narrow your bridge line. Also important to release the depressor septi ligament which dynamically pulls the tip of your nose down when smiling. Choose your surgeon wisely based on extensive experience, since rhinoplasty is the most difficult procedure to performed correctly in the entire field of cosmetic surgery.  Question: Would Morpheus8 help minimize the appearance of my double chin? Answer: No morphious eight will not help your situation. You have significant fat deposits located in the neck both above and below the platysma muscle in your neck. It also appears that most of the deposits are located below the muscle. Once you’re at your ideal body weight with a BMI less than 32, then you can consider surgical alternatives. Liposuction can only accomplish removal of the fat deposits above the muscle which will be minimally effective. A surgical neck lift will remove the fat deposits both above and below the platysma muscle which also includes a platysma plasty to significantly improve the jawline. At age 37, no skin removal is required. Question: Age 52, what areas of the face will a lower facelift address & how long does a neck lift last? Answer: In our practice, a lower face and neck lift addresses tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and removal of fat deposits above and below the platysma muscle in the neck in addition to a platysma-plasty to significantly improve the jawline. Most facelifts last 10 to 15 years. For our current price list, please see the link below. Question: Male – Full facelift/deep plane or mini facelift + fat injections is sufficient? Answer: Mini facelift can you give mini results and we rarely ever performe them.A lower face and neck lift is going to be required to remove the deep neck fat deposits that you have in your neck in addition to the fat deposits above the platysma muscle. A platysma plasty is also performed significantly improve the jawline. Question: Is this polly beak deformity? Answer: Yes, you do have a poly beak deformity. The poly beak can be created from either thick skin or excess cartilage. Thick skin is treated with steroid shots, while residual cartilage is treated with a revision rhinoplasty. Revision rhinoplasty is more difficult than primary rhinoplasty, so choose your rhinoplasty specialist very wisely based on extensive experience.
Question: Is it normal to have endoscopic midface lift and deep plane full face lift together? Answer: In our practice, we do not perform a mid-face lift because the mid face does not descend vertically with aging process. The midface looses volume, therefore we insert cheek implants to improve the lost volume in the mid face. A lower face and neck lift procedure accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, removing fat deposits in the neck and lifting the jowls.  Question: What type of fat is this called and what are the best options for removal to define my jawline? Answer: A full set of facial photographs from all angles in a chin neutral position are going to be required to make a determination about how best to proceed. Also best to be at your ideal body weight before undergoing neck liposuction. The Fat in your neck is most likely located above the platysma muscle which can be removed with Liposuction under local anesthesia. Question: Rhinoplasty without disrupting facial harmony? Answer: The limited photographs demonstrate hanging Columella, alar retraction, and wide nostrils. All is can be addressed with the rhinoplasty procedure. Digital computer imaging would be helpful to understand what can be a conference with your nose on your facial features. To prevent the tip of the nose from drooping when. Question: Does endoscopic septoplasty involve less side effects than non-endoscopic septoplasty? Answer: The endoscope only provides visualization on the inside of those, and has nothing to do the surgery itself. Septoplasty still requires a knife to be able to remove the blockage which is composed of both bone and cartilage. Question: Skin care before rhinoplasty to treat my thick skin? Answer: No skincare regimen is going to be able to treat thick skin. It’s impossible to change the thickness of the skin in the tip of the nose. Follow-up care after your rhinoplasty procedure will be very important, since you’ll probably need some steroid shots to reduce swelling in that supra-tip area of the nose after the procedure. Question: Did I break my nose? I have a big hump on my bridge and a droopy tip. How much will it cost to fix? Answer: Trauma to the nose can cause a variety of issues such as a displaced nasal fracture, a nondisplaced nasal fracture, dislocation of the upper lateral cartilages off the nasal bones, and a deviated septum. A thorough internal and next generation the nose is going to be required. Question: Is it better to combine multiple procedures at once, or complete them gradually? Answer: A full set of facial photographs are required to make a determination as to whether not you are a candidate for four different surgical procedures. Those procedures can be performed together or separately, so is more of a personal choice. If you are to perform all them together, you would have about two weeks of visible bruising and swelling after the procedures. If you were to perform them individually, you would have two weeks of visible bruising and swelling four times.  Question: What procedure(s) would make my face more attractive? Answer: A full set of facial photographs from all angles are required to make a determination to best answer your question. It’s also best to be more specific about what’s bothering you, (the patient) rather than asking open-ended questions. For example, if the width of your nose from the frontal profile bothers you, then consider a rhinoplasty procedure. For some Rhinoplasty patients only the side profile dorsal hump bothers them. Digital computer imaging would also be helpful in education process to understand what can be accomplished with your facial features. Question: Confused about all the options: which procedures should I consider for lower face work? Answer: The limited photographs demonstrate significant fat deposits in the neck, jowls, and loose facial and neck skin. In order to address all of your issues, a lower face and neck lift is going to be required. In our practice, this procedure involves tightening loose facial and neck skin, tightening loose facial and neck muscles, removing the fat deposits above and below the platysma muscle which also includes a platysma plasty, and lifting the jowls. Noninvasive treatments would be a waste of time and money. Question: I want to get my lips lifted and I’m also considering having a facelift revision – which one should I do first? Answer: In order to make a determination about being a candidate for a revision facelift procedure, a full set of facial photographs are going to be required to make a determination about how best to proceed.
Question: What are the chances of having another callus develop after a revision rhinoplasty to correct it? Answer: Much more information is needed, such as a full set of facial photographs and an in-person examination to make a determination about what’s causing the callous formation. If there’s a small bony or cartilaginous hump, this can be simply filed down with the revision rhinoplasty procedure. Question: If my nose is narrow in the front, will hump removal with nothing else done make the front view wider? Answer: Yes, when there’s a narrow nose present when the hump is removed, the remaining nasal bones are too wide relative to the rest of the nose. Osteotomy’s are then required to close the open roof deformity created from the hump removal itself. In addition, spreader grafts are placed underneath the concave upper-lateral cartilages which will also add additional width, and are very important to prevent further collapsing inward of those narrow nasal cartilages.  Question: Revision rhinoplasty on a fractured nose? Answer: A revision rhinoplasty can certainly straighten the crooked nose after it’s been fractured. Much more information is needed such as a copy of your previous operative report and the x-ray or CAT scan that you had performed to make the diagnosis of the nasal fracture. Question: Would a revision help nose tip, as it seems a little full & columella hangs? Answer: The fullness in your nasal tip can be improved with steroid shots when there’s thick skin and scar tissue present. The hanging columella must be surgically improved the remove redundant skin and cartilage in that area. Question: Thick under eye folds when smiling – what can I do to correct this? Answer: The primary goal for lower eyelid surgery is to remove the fat bags creating the puffy look which is evident only in your third photograph. When there’s excess skin at rest (not when smiling), then the excess skin can be removed with a pinch technique. In our practice, we close that incision with tissue glue. Question: Botox before or after endoscopic brow lift – which order is more beneficial for healing and results? Answer: In our practice, we do not perform an endoscopic brow lift for a variety of reasons. The coronal approach gives much better, and long-lasting results. With the coronal approach, you can adjust the hairline upwards or downwards, improve asymmetry of the eyebrows, and soften both the corrugator and frontalis muscles which helps with both horizontal and vertical expression lines in the forehead. Botox is usually not required after the surgery if the muscles have been correctly softened during the surgical procedure.  Question: F, 24, 5’1”, 105lbs, what can I do to fix my uneven eyelid? Answer: A very conservative skin only pinch removal of excess skin can get rid of the excess pleat on your right eyelid. This can be performed under local anesthesia. Question: Does it matter what day of the week or time to schedule plastic surgery? Answer: In our practice, we perform facelift procedures earlier in the week, and not on a Friday afternoon. There’s lots of follow-up care for the first four days after the procedure. Question: Can I achieve a more natural nose with fat injections alone or should I consider other options? Answer: Fat injections don’t work very well in the nose. The photos are rather limited, but it appears that you have wide nasal bones and a hanging columella, along with a few irregularities your tip. Those issues can be improved with a closed revision rhinoplasty procedure. Question: Not happy with my rhinoplasty results 2 years post op. What needs to be done? Answer: A revision rhinoplasty can accomplished lifting your nasal tip, narrowing the bridge line and dependent upon how thick your skin is, you may get some improvement in the nasal tip. It’s also important to release the depressor septi ligament which dynamically pulls your tip downward when smiling. When you check in with your operative surgeon, ask about steroid shots to reduce the thickness and swelling in your nasal tip.  Question: Would a rhinoplasty help me achieve a more feminine nose and minimize the appearance of bumps on the side? Answer: From the front profile,What you’re seeing is wide nasal bones, narrow upper lateral cartilages, and wide tip cartilages. A closed rhinoplasty approach can accomplish getting rid of your “bumps” by narrowing the nasal bones, placement of spreader grafts to widen the Concave upper lateral cartilages, and refinement of the bulbous nasal tip. All of the incisions are placed on the inside of the nose. No external incisions are required, and no painful packing is required either. Choose your rhinoplasty specialist very widely based on extensive experience. Question: Which procedure would help minimize the appearance of wrinkles in the general eye area? Answer: Consider an upper blepharoplasty procedure to get rid of the extra Hooded skin on the upper eyelids. With respect to the lower lids, you could have a conservative “pinch” performed for the extra skin. In our practice, that might be approximately one eighth of an inch skin excision. You may require laser treatment to get rid of all the fine lines. Botox is performed for crows feet.
Question: Brow bone reduction, rhinoplasty, mini facelift/cheek lift – are these edits achievable? Answer: You’re not a candidate for a facelift or a brow lift, since you’re still very young. The amount of change or trying to obtain with a brow bone reduction is not worth it. Regarding your nose, it is possible to improve your side profile, however the nose is a three dimensional structure, therefore a full set of current pictures are required to make a determination about how best to proceed. A closed revision rhinoplasty can accomplish your goals with all the incisions placed on the inside of the nose. Digital computer imaging done by a rhinoplasty specialist would also be helpful to understand what can be accomplished with your nose upon your facial features. Question: What can I do to correct asymmetry, shadowing and a slight bump on my nose? Answer: From the photographs presented, your best off leaving well enough alone. There is no perfect nose, so it’s important to have realistic expectations. You would only consider performing a fourth rhinoplasty if there were very significant issues going on, which there is not. It would be too risky to perform a fourth rhinoplasty. Question: Considering procedures to alter my chin – Would filler, liposuction, or an implant deliver the best results? Answer: Your photos demonstrate several issues going on. You have a recessive Chin profile, so consider placement of the small chin implant to augment your chin forward for better facial balance and proportions, and for better structural support for all the soft tissues in your neck. Liposuction can only accomplish removal of the fat deposits above the platysma muscle, which will only give you minimal results. A surgical neck lift is required to remove the significant fat deposits below the muscle which also includes a platysma plasty to improve the jawline. No skin removal is required. A one inch incision underneath your chin is required for placement of the chin implant and the necklift procedure. The procedures performed under general anesthesia as an outpatient procedure. Question: Would liposuction be effective for my double chin? Answer: It’s difficult to tell from the limited photographs, however if the fat deposits are located above the platysma muscle, simple liposuction can accomplish improvement of your jawline and double chin. If the fat is located below the platysma muscle, then a neck lift with the platysma plasty will be required. No skin removal is required at age 30.  Question: Should I get an open rhinoplasty, closed rhinoplasty or non surgical rhinoplasty for my dorsal hump? Answer: A closed rhinoplasty approach can accomplish achieving 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. This will offer permanent reduction to the hump itself. We do not recommend fillers placed in the nose for a variety of reasons. Question: Are there alternative ways to reduce the cartilage at the tip of my nose? Answer: A closed rhinoplasty approach can accomplish reduction of the nasal tip cartilages with suture techniques and a conservative cartilage removal. All the incisions are placed on the inside of the nose. No external incisions are required and no painful packing is required either. Anticipate A cast applied across the bridge of the nose for one week, and two weeks of visible bruising and swelling.  Question: Difference between platysmaplasty with 1 incision under chin v/s necklift with (3 incisions over ears and chin)? Answer: A full set of facial photographs are required to make a determination if your candidate for a neck lift procedure. In our practice, a neck lift procedure usually involves three small incisions which allow access into the neck. The two incisions behind the ears are only about half an inch which allow liposuction of the jawline. A 1 inch incision underneath the chin allows for open liposuction of the neck, and surgical removal of fat deposits underneath the platysma muscle in addition to a platysma plasty. No skin removal is needed.  Question: I’d like a second opinion: My nose shape appears has changed since my primary, is this permanent, and can it be fixed? Answer: Revision rhinoplasty is more difficult than a primary rhinoplasty, therefore an in-person examination is going to be required. The fullness along the bridge line can be caused from residual cartilage, or thick skin. Steroid shots will only be effective for thick skin with scar tissue and edema, while a revision rhinoplasty is required if there’s excess cartilage left behind. Question: Revision rhinoplasty: are my expectations realistic? Answer: Much more information is needed, such as a full set of facial photographs, and a copy of the operative report to find out what you have done in the past. Do you need a revision septoplasty, some other functional breathing surgery, and is this a primary rhinoplasty or a revision rhinoplasty? Look for a double board certified ENT/facial plastic surgeon with extensive experience with rhinoplasty, since this procedure is one of the most difficult operations to perform correctly in the entire field of cosmetic surgery. Is also important know how much cartilage is left over on the inside of your nose for grafting purposes, since you will need to spreader grafts placed in the mid-portion of your nose where your upper lateral cartilages are concave. Question: Can Botox be used for non-surgical rhinoplasty? Answer: Botox is used to treat wrinkles in the forehead and crows feet. Fillers are used for nonsurgical rhinoplasty, which we do not recommend for a variety of reasons. If you have a dorsal hump, it must be removed with a surgical rhinoplasty, since the hump itself is composed of both bone and cartilage.
Question: Is a nose job worth it? Answer: Only the patient can answer that question. If your nose bothers you enough, then consider having it done. A closed rhinoplasty approach to accomplish shaving down the dorsal hump, decreasing the overall projection of the nose, lifting the tip and narrowing the bridge line. To Prevent the tip of the nose from drooping when smiling requires releasing of the depressor septi ligament. Question: Wondering if I’m a good candidate for rhinoplasty with my bulbous tip nose? Answer: A closed rhinoplasty approach can accomplish improvement of your nose including your bulbous nasal tip. All the incisions placed on the inside of the nose. Thick skin and the tip of the nose will prevent refinement in that area, so is important to have realistic expectations. Question: How difficult would it be for surgeon to narrow my nose? Answer: Rhinoplasty is the most difficult operation to perform in all cosmetic surgery, so it’s important to choose your surgeon based on extensive experience. For a very experienced rhinoplasty surgeon this would be a straightforward operation. A closed Rhinoplasty approach can accomplish your goals with all the incisions placed on the inside of the nose. No external incisions are required. Thick skin and the tip of the nose will prevent refinement in that area, so this must be determined at the time of the consultation.  Question: Do I need nose job or jaw Botox? Answer: The side profile photographs demonstrate an overly projecting nose, and an under projecting chin. The under projection of your chin make your nose look bigger than it really is. For better facial balance and proportions, consider placement of a chin implant augment your chin forward, which will help with your side profile. A standalone chin implant procedure can be performed under local anesthesia. If your nose bothers you, then consider a closed rhinoplasty approach to accomplish decreasing the overall projection of the nose, shaving down this dorsal hump, straightening it and refinement of the nasal tip with all incisions based on the inside of the nose. Rhinoplasty is performed under general anesthesia. Both procedures can be performed together under one anesthesia with one recovery.  Question: Raising bridge with thin skin? Answer: Revision rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, therefore a full set of facial photographs are required to make a determination about how best to proceed. Trying to make nostrils symmetrical is impossible due to the fact that there’s a left half of the nose and right half of the nose. There are multiple options upon how to build up a bridge, if necessary. It’s important know how much cartilage is left over on the inside of your nose for grafting purposes in addition to a copy of the operative report defined out what maneuvers were performed in the first procedure. Question: How do I decided on a rhinoplasty surgeon when every surgeon has at least a couple bad reviews? Answer: Choose your rhinoplasty specialist based on extensive experience, since rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery. Looking at reviews is only one metric to evaluate your surgeon, not the end all. Study your prospective surgeon’s before and after rhinoplasty photo Gallery and make sure that it is extensive with results that you like. Negative reviews are very common with rhinoplasty due to multiple factors which include unrealistic expectations, obsessive-compulsive disorder and body dysmorphia. We have even received negative reviews from patients who have allowed us to post their pictures on our before after Photo Gallery. Question: Supratip deformity after rhinoplasty? Answer: From the photographs presented, you have what’s called a poly beak deformity which is caused by residual cartilage in the lower part of your nasal dorsum. Rasping only works for bone, while the cartilage must be cut with a knife or scissors to give you a better profile. Question: Can I have a mini neck lift performed without making any changes to my face? Answer: Yes, a mini necklift would involve performing a platysma-plasty to help improve those two platysma muscle cords located in your neck. To accomplish this, there’s a small incision located underneath the chin crease. Alternatively you can also try Botox in the muscle cords first, and then if that doesn’t suffice, then try the Surgical option. Question: Can I have a facelift at the same time as cheek implant removal? Answer: Yes, it is certainly possible to undergo cheek implant removal at the same time as a facelift. Facelift incisions are in front and behind the ears, while the cheek implant removal incisions are placed inside the mouth above the upper teeth. A full set of facial photographs from all angles are required to make a determination about whether or not you’re a candidate for a lower face and neck lift procedure. Question: If my surgeon shortened the tip but forgot to trim the excess skin in the columella would that translate to a longer philtrum? Answer: Revision rhinoplasty is more difficult than her primary rhinoplasty, therefore a full set of facial photographs from all angles are required to make a determination about how best to proceed. A closed rhinoplasty approach can accomplish reduction of the hanging columella with all the incisions placed on the inside of my nose.
Question: Can I refuse HIV test before facelift even tho surgeon is requesting it? Answer: It is best to have a frank discussion with your operative surgeon that you’re planning on having the facelift procedure with. Some offices do require pre-surgical bloodwork prior to elective cosmetic surgery, to ensure the safety of that all the staff and the surgeon during the the perioperative period. More important is to Study your prospective surgeon’s before and after facelift photo Gallery to make sure that they have lots of before-and-after’s that look very natural. Question: Jaw surgery or chin implant? Answer: Jaw surgery is performed by oral surgeon under general anesthesia in the hospital setting with an overnight stay, and is much more invasive. It is usually performed when the teeth are significantly out of alignment. Placement of a small chin implant can be performed under local anesthesia the office setting which takes about 30 minutes. A small silastic chin implant can cosmetically augment your chin forward for better facial balance and proportions.  Question: One side of my nose is extremely different from the other. Should I ask for a revision? Answer: Revision rhinoplasty is more difficult than a primary rhinoplasty, so make sure your surgeon is well-versed with the procedure and produces lots of natural results. You also appear to have thick skin in the tip of the nose which is going to require multiple steroid shots during your follow-up visits for the first several months after the procedure. This will help prevent what’s called a poly beak. Make appointments for three busy rhinoplasty surgeons in your area and get three opinions about how best to proceed. It’s also important have realistic expectations because there is no perfect nose, just improvements. Question: Am I a good candidate for a neck/facelift @ almost 36? Answer: From your photographs and your Weight loss history, the only way to tighten that loose and inelastic skin in the neck is by performing lower face and neck lift procedure. The reason liposuction may not have been very effective is because you probably have fat deposits located underneath the platysma muscle which would have to be surgically removed with a face and neck lift. Choose your facelift surgeon wisely based upon extensive experience producing natural results, since you’re very young for this procedure. Study your prospective surgeon’s before and after facelift photo Gallery. Question: What’s the likelihood of a callus forming during my revision rhinoplasty? Answer: Callus formation on the top of the bridge line of the nose is caused from bone growth after the surgery itself. A small callous can be just filed down without breaking the nasal bones. If there’s a large dorsal hump/callus present, then osteotomies are going to be mandatory to close the open roof created from the hump removal itself. Question: Is there a limit to how much you can narrow the bridge in an osteotomy? Answer: Yes, there are limitations to as to how much the nose bridge can be narrowed with osteotomy’s during a rhinoplasty procedure. The thickness of the nasal bones and skin is usually the determining factor. Also depends on what type of osteotomy is performed. Our practice, we perform both medial osteotomy’s and low lateral osteotomy’s to effectively narrow the nasal bones. Question: Am I a good candidate for a rhinoplasty for bulbous tip with thick skin? Answer: When patients have thick skin in the bulbous nasal tip, it’s important to have realistic expectations. Thick skin in that the nose prevents refinement in that area, and steroid shots will be required to reduce swelling in the tip of the nose for several months after the surgical procedure itself. Question: Is brow lift, blepharoplasty, or a combination the best solution to my droopy look? Answer: More photos are going to be needed to make that determination, however from the one limited photo it appears of the brow position is acceptable. An upper blepharoplasty procedure can accomplish removal of the hooded and extra skin and the upper lids. When performing a brow lift procedure, it’s possible to raise the airline, or lower the hairline depending on placement of the incision.  Question: Would another revision be possible due to thin skin? Answer: Much more information is needed, such as a full set of facial photographs from all angles to make a determination about how best to proceed. In addition, it is important to know if there is any cartilage left over on the inside of your notes for grafting purposes. When patients have thin skin, small and very slight irregularities can occur along the bridge line. It is possible to undergo a revision as long as there’s been at least a year since your last procedure. Question: I had a rhinoplasty 3 years ago which I now have a very lopsided tip/columella. What are my options to correct it? Answer: A full set of facial photographs, especially from the side profile going to be required to make a determination about how best to proceed. It appears that you have a crooked and hanging columella for which a revision rhinoplasty can improve. This can be accomplished with a closed rhinoplasty to avoid the visible external incision again.
Question: Should I consider a revision rhinoplasty because I am not happy with how big and outwards my nose is? Answer: A revision rhinoplasty can accomplish shaving down the residual cartilaginous dorsal hump, decreasing the overall projection of the nose, and lifting the nasal tip. It’s important to release the depressor septi ligament which dynamically pulls the tip downward when smiling. The skin in the super tip area of the nose will require steroid shots after the procedure to prevent further swelling in that area and to prevent a polly- peak deformity.  Question: I would like to know what kind of lift I can get for the area under the chin and jowls? Answer: A mini lift will only give you mini results, and would be an inappropriate procedure to address rejuvenation of your face and neck. A comprehensive lower face and neck lift can accomplish listing the jowls, tightening loose facial and neck skin, tightening loose facial muscles, and removal of the fat deposits in the neck which also includes a platysma-plasty. Consider placement of a chin implant for the recessive chin profile which will also give improvement to the jawline. Question: Would rhinoplasty fix my profile/hump? Answer: Yes, a closed rhinoplasty approach can accomplish shaving down the dorsal hump, refining the nasal tip cartilages, and narrowing the bridge line with all the incisions placed on the inside of the nose. No external Incisions are required. Rhinoplasty is a very difficult endeavor, so choose your surgeon wisely based on extensive experience producing natural results. Question: Is getting a rhinoplasty during the pandemic too risky? Answer: In our practice, performing only virtual consultations, and then patients are Covid 19 tested just prior to the plastic surgery itself. Question: Was offered a submaxillary gland reduction. Will I get a good result? Answer: In some patients, some patients have sub maxillary glands that are very enlarged and ptotic. When the Neck becomes de-fatted, the Glands become more prominent. In certain instances, a portion of the gland can be removed to get better neck contouring. If you have large glands, then you’ll have visible neck bulges after your facelift if they’re not reduced. Question: Facetite risks? Does it remove the fat or just tighten the face? Answer: It would be best to submit a full set of facial and neck photographs to make inappropriate determination upon what procedure you’re going to need accomplish your goals. Minimally invasive procedures give minimal results, if any. If you’re fat deposits are located above the platysma muscle in the neck, liposuction is a Great alternative. If you’re fat deposits are located below the platysma muscle in your neck, then a surgical neck lift with a platysma plasty is going to be required.  Question: Chin implant vs sliding genioplasty – which procedure would be right for me? Answer: Your side profile photograph demonstrates an overly projecting nose with a dorsal hump, and an under projecting chin. In our practice, we perform many chin implants in combination with a closed rhinoplasty. If you’re only wanting to perform a chin implant, that can be performed under local anesthesia which takes about 30 minutes. The implant is inserted through a small incision underneath the Chin. A sliding genioplasty is performed by an oral surgeon in a hospital setting under general anesthesia it with an overnight stay at the hospital and is much more invasive. It’s usually performed when the teeth are significantly out of alignment. Digital computer imaging of both your nose and your chin would be helpful to understand what can be accomplished with both procedures upon your facial features. Choose your surgeon wisely based on extensive experience. Question: Primary rhinoplasty – can I accomplish everything and do I need grafting? Answer: A closed rhinoplasty approach can accomplish refinement of the bulbous nasal tip, shaving down the dorsal hump, lifting the tip slightly and narrowing the bridge line with all the incisions placed on the inside of the nose. No external incisions are required, and no painful packing is required either. Also important to release the depressor septi ligament which dynamically pulls your tip downward when smiling. Rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, so choose your rhinoplasty specialist wisely based on extensive experience. Digital computer imaging of your nose upon your facial features would also helpful. The only cartilage graft needed would be a graft called a spreader graft placed underneath your upper lateral cartilages to prevent them from collapsing after the hump removal.  Question: Revision brow lift after endoscopic brow lift failed? Answer: A full set of facial photographs are required to make a determination about being a candidate for a brow lift procedure. In our practice, we perform a coronal brow lift which can accomplish lifting and adjusting the asymmetry in the eyebrows, raising or lowering the hairline, and adjusting the muscles of the forehead to improve the vertical and horizontal lines. It’s also important to wait at least a year after your first surgery before embarking on another forehead lift.  Question: Is it a bad idea to get a rhinoplasty and facelift in one procedure? Answer: In our practice, we performed the combination a facelift and rhinoplasty frequently. The reason we do this because patients undergo one anesthesia with one recovery period and are back to work at two weeks. A full set of facial and nasal photographs are required make a determination about being a candidate for both procedures.
Question: Would alarplasty and ear cartilage reshaping the nasal tip help to narrow my nose? Approx cost in CA? Answer: Nasal cartilage is always the primary grafting source for an alar-plasty, not ear cartilage. An alar-plasty accomplishes narrowing wide nostrils. A closed rhinoplasty approach can accomplish shaving down the hump, and narrowing the tip and the bridge line. Question: Is change possible with a revision rhinoplasty? Answer: Much more information is needed, such as a full set of facial and nasal photographs from all angles. A copy of the operative report would also be helpful as well to understand what maneuvers were performed during your last rhinoplasty. The nose is a three-dimensional structure, and rhinoplasty is performed in all three dimensions. It appears that there’s thick skin in the tip of the nose which is going to prevent refinement in that area, so it’s important to have realistic expectations. Revision rhinoplasty is more difficult than a primary Rhinoplasty due to the fact that the previous alterations to the normal anatomy and scar tissue present. Question: Addressing signs of aging around the eyes: Non-surgical methods or straight to brow lift and blepharoplasty? Answer: From the photographs presented, you do not need a brow lift procedure, since the height of your eyebrows is acceptable. You do have asymmetrical eyelids, so just a conservative upper blepharoplasty procedure would be all that is recommended. An upper blepharoplasty procedure can be performed under local anesthesia as an outpatient procedure. Botox is the best treatment for crows feet.  Question: Is it possible for a facelift to make my fibromyalgia worse? Answer: There’s no direct association between a surgical facelift and a chronic medical condition like fibromyalgia. If you have a questions, get Clarence from your primary care physician. Question: Will a non-surgical nose job realistically address asymmetry? Answer: A non-surgical rhinoplasty only make your nose bigger, not smaller and more symmetrical. Consider a closed rhinoplasty to accomplish shaving Down the dorsal hump, and straightening and narrowing your nose with all the incisions placed on the inside of the nose itself. Question: Around how much does an alar rim graft cost?  Answer: Much more information is needed, such as a full set of facial photographs from all angles, and any operative reports from previous nasal surgery, to make a determination about how best to proceed. The cost of a rhinoplasty is determined by three factors which includes operating room costs, anesthesia costs, and the surgeon’s fee for performing the procedure. For many examples and our current price list, please see the link in the bio. Question: I was suggested a fat transfer to address the hollowness beneath my eyes. Should I also go for a brow lift? Answer: From the one very limited photograph, there appears to be low set eyebrows in addition to scleral show on the lower lids. Consider a brow lift procedure to raise the eyebrows, and A canthoplasty procedure to reduce the scleral show in the lower lids. Question: Should I continue with filler and Botox or save my money and get a mini/mid facelift and neck lift? Answer: Much more information is needed, such as your age, and a full set of facial photographs from all angles in a chin neutral position to make a determination about how best to proceed. The goal of a lower facelift is to Tighten loose facial skin, tighten loose facial and neck muscles, lift the jowls, and remove fatty deposits to the neck which also includes a platysma-plasty. Anticipate two weeks of visible bruising and swelling after the procedure.  Question: Could rhinoplasty straighten my nose? Answer: A Closed rhinoplasty procedure can improve the asymmetry of your nose, so it’s important to understand there is no perfect nose. Everyone has some degree of facial asymmetry and nasal asymmetry. A closed rhinoplasty approach can accomplish straightening and narrowing in addition to placement of a spreader graft placed under your concave upper- lateral cartilage on the right side in the midportion of the nose. Question: What surgery or treatment do I need to improve the shape of my chin? Answer: The limited photograph demonstrates a recessive chin profile for which a chin implant can improve. This can be performed under a local anesthesia as an outpatient procedure to augment your chin forward.
Question: Will I need to see a doctor for check ups after getting a facelift? How will I be able to ask for my medical report?  Answer: It is imperative to have follow ups with your plastic surgeon for the first 10 days after the surgery, not some other doctor. This is especially important, since you’re flying in from out of the country. If your surgeon is unavailable, reschedule with him/her when they is available to be in town for 10 days with you, or find another surgeon. In our practice, patients follow up with us and a minimum of four- five times in the first 10 days after the surgery. Question: Will a rhinoplasty make my face more proportionate? Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, decreasing the overall projection of the nose, narrowing the bridge line, and refining the bulbous nasal tip with all incisions placed on the inside of the nose. No external incisions are required, no painful packing is required.To prevent the tip of the nose from drooping when smiling requires releasing of the depressor septi ligament. An alar-plasty accomplishes narrowing wide nostrils. Digital computer imaging would be helpful in the communication process as well. Choose your surgeon wisely based on extensive experience, since rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery. Question: What would balance out my face in a natural and feminine way? Answer: A closed rhinoplasty approach can accomplish decreasing the overall projection of the nose, shaving down the dorsal hump and refining the nasal tip. All of the incisions are placed on the inside of the nose. No external incisions are required, and no painful packing as required either. Digital computer imaging would be helpful in the education process see what you’re new nose would look like upon your facial features. Rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, so choose your surgeon wisely based on extensive experience. Question: Will a gliding brow lift work for me & will it affect my forehead? Answer: Much more information is needed, such as a full set of facial photographs, especially of your forehead from all different directions. From the limited photograph, it appears that the height of your brows appears adequate And it does not appear that you even need a brow lift. You have significant asymmetry of your upper eyelids what can be addressed with an upper blepharoplasty under local anesthesia to make them more symmetrical. Question: Septoplasty – will it help breathing and straighten my nose? Answer: A septoplasty is performed in the back of the nose to improve air flow dynamics, and does not change the shape of the nose whatsoever from the outside. You’re going to require a cosmetic rhinoplasty procedure to change the outside of your nose. From the limited photograph it appears that you’re also going to need spreader graft composed of your own cartilage placed underneath the concave upper lateral cartilage in the mid portion of the nose to help straighten it. Choose your surgeon wisely based on extensive experience, since rhinoplasty is the most difficult operation to perform correctly in the entire field of cosmetic surgery. Both a septoplasty and a rhinoplasty are routinely performed together under one anesthesia with one recovery.  Question: How long should I wait between Accutane and a facelift?  Answer: One option would be to undergo the facelift first ,and then get on the Accutane later. If you’re going to go on the Accutane first, then it’s probably best to be off of it for 3 to 6 months before undergoing a facelift procedure. Study your surgeon’s before and after facelift photo Gallery, and make sure that it is expensive with lots of natural results that you like.  Question: Chin implant options – Are there different types besides rounded? Answer: Chin implants are manufactured in a large array of sizes, thicknesses, and shapes which is best determined that time of the consultation and examination. They can also be custom carved when necessary for patients unique asymmetric anatomy. X-rays are of no benefit. In our practice, we use Implantech brand of solid silicone implants for over 25 years with an excellent success rate.  Question: Am I good candidate for upper eyelid surgery? Answer: You can certainly do the more hooded upper eyelid surgery side with a conservative skin removal upper blepharoplasty to match the opposite side. This can be done under local anesthesia. A brow lift is not necessary, since the height of your eyebrows is acceptable. Question: Can my dorsal hump be shaved down without breaking my nose? Answer: From the limited photograph presented, you have a moderate hump composed of both bone and cartilage. Removal of the dorsal hump creates an Open roof, flat top nasal deformity. Osteotomy’s are going to be mandatory. You’ll probably also need bilateral spreader grafts to prevent collapse of the upper lateral cartilages in the mid portion of the nose. Question: Would I benefit from a rhinoplasty? Concerned about asymmetrical nose bridge. Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, and making your nose more symmetrical and straight. There is no perfect nose, just improvement. Rhinoplasty is a very difficult endeavor, so choose your surgeon wisely based on extensive experience. Digital computer imaging would be helpful to understand what can and cannot be accomplished with your nose upon your facial features.
Question: What doctor should I chose, I am debating between a new or old surgeon? Answer: Rhinoplasty is the most difficult operation to perform correctly in the entire field of cosmetic surgery, so it’s imperative to choose a plastic surgeon based on extensive experience. It takes a decade of experience and over 1000 noses to become very consistent with this operation. A closed rhinoplasty approach can accomplish shaving down the dorsal hump, refinement of the nasal tip cartilages, narrowing the nasal bones and placement of spreader graphs in the mid-portion of the nose where the bridge line is pinched. The spreader grafts will be a very important component to prevent further collapse in that area after the hump removal. Digital computer imaging would be helpful to understand what can be accomplished with your nose upon your facial features. Question: Do I need alar base reduction? Answer: Alar base reduction is performed to narrow wide nostrils. This can be performed as part of the rhinoplasty procedure under general anesthesia, or as a standalone procedure under local anesthesia. A closed rhinoplasty approach can accomplish reduction of the bulbous nasal tip, narrowing the bridge line, and shaving down the dorsal hump with all of the incisions placed on the inside of the nose. Digital computer imaging would be helpful to understand what can be accomplished with your nose upon your facial features. Rhinoplasty is a very difficult endeavor, so choose your surgeon wisely based on extensive experience. Question: Can my tip be lifted up under local anesthesia? Answer: In our practice, we perform all rhinoplasty procedures under general anesthesia for patient safety and comfort. Board-certified physician anesthesiologists perform the anesthesia. There way too many nerve endings in nose to try to accomplish this under local anesthesia. It will be extremely painful to try to get your nose numbed up in order to do the surgery. A full set of facial photographs from all angles are going to be required to make a determination about how best to proceed. At a minimum, going to want to reduce the overall projection of the nose, reduce the hanging columella, and slightly lift the tip. A full closed rhinoplasty is going to be required. Question: I would like to get a Rhinoplasty revision and a face lift. Should I do the rhinoplasty first? Answer: A revision rhinoplasty and a facelift can be performed together under one anesthesia which allows for one recovery period. There’s no reason to have two separate surgeries with two separate recovery periods. A full set of facial photographs from all angles are going to be required to make a determination about being a candidate for both procedures. Revision rhinoplasty is one of the most difficult operations to perform correctly in the entire cosmetic surgery, so it is very important to choose your surgeon based on extensive experience. Question: I had open rhinoplasty two years ago and overall very happy with result. Revision needed? Answer: The photographs demonstrate a hanging columella. The caudal nasal septum behind the columella appears crooked as well. A revision closed rhinoplasty can accomplish reduction of the hanging columella and straightening the caudal septum. This is performed under general anesthesia for patient safety and comfort, not in the office. Question: Is there limits to how small you can make your nose? And will I have a piggy nose if I correct my droopy tip? Answer: Yes, there are limits to how small you make a nose based on your current nasal anatomy. It is very important that all of the components of the nose balance with themselves, and the entire new nose balances with the patient’s facial features in a three-dimensional fashion. Revision Rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery, so it’s important to choose your surgeon based on extensive experience. A Closed rhinoplasty approach can accomplish lifting the droopy tip, and narrowing the bridge line. Releasing the depressor septi ligament will prevent the tip from drooping dynamically when smiling. An alar-plasty can accomplish narrowing wide nostrils. A full set of facial photographs from all angles are going to be required to make a determination about how best to proceed. Digital computer imaging would also be helpful in the communication process to see visually what you’re trying to accomplish.  Question: What procedure do I need to achieve slimmer jawline? Liposuction? Answer: A full set of facial photographs from all angles are required to make a determination about how best to proceed. Liposuction can accomplish permanent removal of fat deposits above the platysma muscle.A Surgical necklift is going to be required remove fat deposits underneath the platysma muscle, which also includes a platysma plastic procedure. No skin removal is required in patients less than 50 years of age.  Question: Can someone with keloid prone skin get a nose job and cheek bone implants? Tattoos? Answer: Yes, it is certainly possible to undergo a closed rhinoplasty procedure whereby all the incisions are placed on the inside of the nose which prevents keloid formation. Look for someone who specializes in closed rhinoplasty, not open rhinoplasty. In our Practice, we place cheek implants through an intraoral approach above the teeth in the gum line, which also completely eliminates keloid formation.  Question: Multiple surgeries: rhinoplasty, nuss procedure and umbilicoplasty. When should I do them and in what order? Answer: Rhinoplasty is 1 of the most difficult operations to perform in the entire field of cosmetic surgery, so it is very important to find someone who specializes in that procedure. Digital computer imaging of your nose upon your facial features would also be helpful in the communication process as to what we are trying to accomplish. It does not matter which order these 3 surgeries are done, but it is very important finding the right surgeon for each procedure. Question: Do you ever have patients who go back and forth with the decision to undergo rhinoplasty? Answer: Yes, occasionally we do have patient see go back and forth about making their decision to undergo a rhinoplasty procedure. We usually offer those patients an additional consultation to sort through the indecisive issues so that they understand they are making the right decision at the right time to undergo a rhinoplasty procedure.
Question: Love a slightly droopy nose – would a supratip break during surgery be the best option? Answer: A full set of facial photographs are required to make a determination about how best to proceed. Digital computer imaging would be helpful in the education process for you to understand what can and cannot be accomplished with the procedure. In our practice, we usually give it a supratip break, and we release the depressor septi ligament which dynamically pulls the tip downward when smiling.  Question: 10 years post op. breathing issues, scar tissue, and deviation – Should I consider revision or am I risking asymmetry? Answer: From the photographs presented, your nose looks very natural so be very careful about undergoing another cosmetic procedure on your nose. We perform all septoplasty, primary and revision rhinoplasty procedures with the closed rhinoplasty approach with all the incisions placed on the inside of the nose. Question: Would a chin implant or jaw contouring help me achieve a more heart shaped face? Answer: A full set of facial photographs of you from all different angles are required, since the Chin is a three-dimensional structure, and the augmentation occurs in three dimensions. Placement of a chin implant is performed mostly to augment the chin forward, but it also gives additional width from the frontal view and a small amount of vertical height. Question: Can double chin be minimized with weight loss or would will I need surgery to target this? Answer: A full set of facial and neck photographs in neutral position are required to make a determination about how best to proceed. It’s also best to have your BMI less than 32 before undergoing any fat reduction surgery. From the limited photographs, it appears that you have fat deposits located above and below the platysma muscle in the neck. liposuction can only remove fat deposits above the platysma muscle, while a surgical neck lift with a platysma plasty is required to remove the fat deposits below the muscle.  Question: Which procedures would help balance out my facial features, with respect to the nose and chin/jaw? Answer: A closed rhinoplasty approach can accomplish narrowing your nasal bones with osteotomy’s and building up your bridge line with either your own cartilage, or a synthetic implant. An alar plasty can accomplish and narrowing wide nostrils. No Chin worker is needed. Question: Catheter ablation done in 2019. Is elective surgery still possible? Considering a rhinoplasty. Answer: As long as you’re not having any symptoms when exercising, have normal sinus rhythm, and clearance from your cardiologist, you should be a good candidate for elective rhinoplasty surgery. Question: Would I be a good candidate for a chin implant? Answer: The photographs demonstrate a recessive chin profile, and a chin implant can certainly argument your mandible forward for better projection. If your teeth are significantly out of alignment, then consider performing a sliding genioplasty by an oral surgeon. Question: Can a facelift reposition grafted fat successfully? Answer: Fat that has been grafted is going to be encased in scar tissue, and much more damage is going to be done to try to reposition it or remove it. 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 fat deposits in the neck located both above and below the platysma muscle in the neck itself.  Question: Age 49 & concerned about jowls & stringy neck – mini, midi or full face lift? Answer: The limited photographs demonstrate hooded upper eyelids, and jowls and laxity of the skin in your face and neck. An upper blepharoplasty procedure can accomplish removal of excess skin on the upper eyelids, and removal of the fat pocket on the inner corner of your upper eyelids as well. A lower face and neck lift can accomplish lifting the jowls, removing fat deposits in the neck, tightening the neck muscles in three locations,Lifting the SMAS, and tightening loose and inelastic facial and neck skin. Choose your plastic surgeon very wisely based on extensive experience producing natural results. Question: 32F, Are my facial features ‘bad’ enough to be a good candidate for plastic surgery? Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, refining your nasal tip, narrowing the bridge line and giving more symmetry to your nose. Also important to release the depressor septi ligament which dynamically pulls your tip downward when smiling. If you’re having breathing difficulties out of your nose, that’s considered functional nasal surgery such as a septoplasty, turbinate surgery, or valve collapse surgery which is usually billed to your medical insurance. If you’re having chronic sinus infections, then you’re going to need a CAT scan of your sinuses to determine whether or not you need endoscopic sinus surgery. Any type of Functional nasal surgery can be performed at the same time as cosmetic nasal surgery. All functional surgery is billed to patient’s medical insurance, while the cosmetic component patients must pay for. Best to leave your chin alone. 
Question: What can I do to fix uneven nostrils and would it be considered a secondary rhinoplasty? Answer: A revision rhinoplasty procedure will be required to reduce the significant hanging columella present and a composite skin/cartilage graft from the ear will have to address the alar retraction in your left nostril. Addressing the hanging columella also help camouflage the open rhinoplasty scar present across your columella. A closed rhinoplasty approach with all incisions placed on the inside of the nose accomplish significant improvement in your nose. No painful packing is required, and all incisions are placed on the inside of the nose. Revision rhinoplasty for this nose is a very difficult procedure, so it is imperative that you choose your second surgeon widely based on extensive experience. Question: Would I need a radix graft? Answer: You do NOT need a radix graft to your bridge line, since it would make your nose look odd. A closed rhinoplasty approach can accomplish shaving down the dorsal hump to the slope that you desire.All of the incisions are located onthe inside of the nose. Digital computer imaging would be helpful to see what your new nose would look like upon your facial features. Question: Would you recommend a chin filler or chin implant for a more balanced facial structure from the side view? Answer: Chin fillers only offer a soft tissue temporary augmentation, while chin implants offer a permanent bony augmentation. Chin implants accomplish an improvement of the recessive mandible bone, and can be placed under local anesthesia as an outpatient procedure. Question: Am I a good candidate for a rhinoplasty – I’m half-Asian? Answer: From the limited photos,your nose looks pretty good already, so there would not be a whole lot of changes needed. A full set of pics from all angles would be required to make a determination if you are a good candidate. Digital computer imaging would also be helpful. Question: Hi, I was wondering if I would be a good candidate for a chin implant after weight loss? Answer: The limited photos demonstrate a recessive chin, fat deposits in the neck and what appears to be loose skin. All 3 of these issues are treated with 3 different procedures. To augment the chin forward requires a chin implant. To remove diet resistant fat in the neck requires liposuction. To tighten loose skin will require a neck lift. Additional photos and an in-person exam are required to evaluate the skin tone in your neck. Question: What would be a better option for my receding chin? Kybella/CoolSculpting or genioplasty? Answer: From the one limited photograph, there appears to be recessive chin profile due to lack of development of the mandibular bone. Placement of the chin implant directly over the bone can accomplish augmenting the chin forward for better facial balance and proportions. The fat deposits in your neck appear to be located above and below the platysma muscle which is going to require surgical neck lift in order to remove those fat deposits. Liposuction can only accomplish removal of fat deposits above the platysma muscle, while a surgical neck is going to be required to remove fat deposits below the muscle which also includes a platysma-plasty. No skin removal is required. This can be accomplished through a one-inch incision underneath the chin, under general anesthesia as an outpatient procedure. Question: I had a rhinoplasty and am thinking of getting a revision. What do you think of my nose and would you recommend a revision? Answer: From the very limited photographs, there appears to be very nicely shaped nose with the exception of a hanging columella. The hanging columella can be reduced by removal of excess skin and cartilage in that area which accomplishes tucking the columella upwards and inwards. All the incisions are placed completely on the inside of the nose, no external incisions are required to reduce the hanging columella.  Question: Double chin and jawline fat. What is the best option at 40? Answer: The photos show a recessive chin profile and sub-platysmal fat. Consider a chin implant to augment the mandible forward and a neck lift. In our practice a neck lift accomplishes removal of fat above the platysma muscle with liposuction, surgical removal of the fat below the muscle and a platysma-plasty. No skin removal is needed. Question: I’m looking to improve my jaw line and side profile. Would liposuction or fillers be the best option? Answer: The photos demonstrate a recessive mandible and fat deposits in the neck. Consider a neck lift with platysma-plasty and a chin implant. No skin removal is needed. Question: My nose tip is larger and lowered and nose seems overall bigger. Should I consider a revision? Answer: A closed revision rhinoplasty can accomplish your goals of hump removal and possibly making the tip smaller,but that will depend upon the thickness of the skin in the tip of the nose.
Question: What’s the best technique for Asian Rhinoplasty DCF, DCGG or Diced Cartilage Injections? Answer: The techniques that you’re asking about can leave irregularities along the bridgeline. Best to use Flowers nasal dorsal implant which is made of silastic. Question: How much can my nose be de-projected? Answer: Your side profile photographs demonstrate an overly projecting nose and an under projecting Chin. The under projection of your chin makes your nose look bigger than it really is. A closed rhinoplasty approach can accomplish shaving down the dorsal hump, lifting your tip slightly, refining the nasal tip cartilages and narrowing the bridge line with all incisions placed on the inside of the nose. No external incisions are required, no painful packing is required either. Your entire nose can be made smaller and be de-projected about 3 to 4 mm at the most. It’s important to remember that the nose is a three-dimensional structure, and surgery is performed in three dimensions. Strongly consider placement of a small chin implant to augment your chin forward for better facial balance and proportions, especially with respect to the projection of your nose. Your chin can be projected further outwards than your nose can be de-projected. Digital computer imaging of your nose and chin would be helpful in the consultation process to understand what you might look like. Rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, should choose your plastic surgeon very wisely based on extensive experience producing natural results.  Question: Would I benefit from a sliding genioplasty or chin implant? Answer: A sliding and genioplasty is performed by an oral surgeon under general anesthesia in a hospital setting with an overnight stay, and is much more invasive. Placement of the chin implant is done under local anesthesia which takes approximately 30 minutes in the office setting. if your teeth are significantly out of alignment, then consider the sliding genioplasty. If you’re just looking for cosmetic improvement, then do a chin implant. Question: 19 years post rhinoplasty – would a revision help with dropping columella / bulbous tip? Can this also improve my smile? Answer: A full set of facial photographs from all angles are going to be required to make a determination about how best to proceed, since revision rhinoplasty is more difficult than a primary rhinoplasty. If you have a hanging columella, that can be Addressed with skin and cartilage removal in that area through a closed revision rhinoplasty approach. If you have a droopy tip, then releasing the depressor septi ligament would be helpful to prevent your nose from dripping dynamically when you smile. Don’t expect your smile itself to change. Thick skin in the tip of the nose prevents refinement in the bulbous nasal tip, so it’s important to have realistic expectations. Question: Why do some doctors do laser treatment with lower facelifts & others don’t, and does profhilo impact the surgery? Answer: The goal of a lower face and neck lift based on your photographs it Is to tighten the jowls, tighten the platysma neck muscle cords, and tighten loose facial skin. Your Upper lip wrinkles can be smooth out with either a laser or dermabrasion. Dermabrasion tends to give less hypopigmentation. The lines on your forehead best be treated with Botox.  Question: Timing of lower face lift (deep plane) – is it too close to Christmas & when can I be in the sun? Answer: Anticipate two weeks of visible bruising and swelling after a lower face and neck lift procedure. We also ask patients refrain from exercising for two weeks after the procedure, And it’s best that you and your surgeon are both in town for two weeks for follow-up appointments. Getting out in the sun is okay, just limit your exposure and put sun screen on and a hat. Choose your surgeon wisely based on extensive experience producing natural results. Study you’re prospective surgeon’s before and after facelift photo Gallery and make sure that it is extensive with results that you like. Question: Revision rhinoplasty for nostrils, notching & nose tip? Answer: Much more information is needed, such as a full set of facial photographs from all angles, since the nose is a three-dimensional structure. You also Have thick skin in the tip of the nose which is going to prevent refinement in that area. Revision rhinoplasty is more difficult than of primary rhinoplasty, so it’s imperative to have realistic expectations. There is no perfect nose, just improvements A copy of the operative report would also be helpful to understand what maneuvers were performed in the first surgery.  Question: What type of procedure would benefit me with my nose shape? Answer: A full set of pictures from all angles would be more helpful, since the nose is a three-dimensional structure. From the one limited photograph, osteotomy’s would be required to narrow your bony bridge line, nasal tip surgery is required to narrow the nasal tip cartilages, and an alar-plasty is required to narrow wide nostrils. Question: How to improve my profile view, chin and jawline? Answer: Liposuction can accomplish removal of fat deposits above the muscle, while a surgical neck lift is required to remove the fat deposits below the platysma muscle in the neck. A platysma-Plasty is also performed as a component of the neck lift Chin implants are placed for patients when they have a recessive chin profile. Both procedures can be performed simultaneously. For best results, make sure that you’re BMI is less than 32 before undergoing elective cosmetic surgery in your neck.   Question: Can a chin implant give me a more feminine chin?  Answer: Chin implants simply augment a recessive and weak chin when your mandible has not grown far enough forward. Chin implants augment mostly in the forward direction, but also give improved width, and a small amount of vertical height. The implants are placed through a small incision underneath the chin under local anesthesia.  
Question: Should I wait to consult a physician? Answer: A full set of facial photographs from all angles of both the face and neck are going to be required to make a determination about whether or not you are candidate for a mini lift, or a lower face and neck lift at age 58. Placement of fillers in the midface will not have any effect on performing a facelift procedure since the facelift is tightening the lateral face, not the midface.  Question: I am wanting to thin the tip of my nose, what options do I have? Will it be less expensive than a traditional rhinoplasty? Answer: A wide nasal tip can be caused by thick skin or wide nasal tip cartilages. Rhinoplasty will only help with wide nasal tip cartilages. If there is thick skin present in the tip of the nose, this is going to prevent refinement in that area. The thickness of the skin must be determined at the time of an in-person examination. Most patients must undergo full rhinoplasty to ensure that all the components of the nose balance with themselves, and the entire new Nose balances with the patient’s facial features in all 3 dimensions.  Question: Do I have thin or thick skin? Answer: The thickness of the skin must be determined at the time of the examination. From the limited photo, it appears there is thick skin present. If you are contemplating undergoing a rhinoplasty procedure, you most likely require a few steroid shots in the tip of the nose after the procedure. Question: Is rhinoplasty worth it? Images attached. I would like to have a more slope to my nose. Answer: Its certainly possible to shave down the dorsal hump and give more of an slope to your side profile. Very important not to over-rotate your tip upwards anymore than it already is when trying to reduce the dorsal hump. Digital computer imaging would be helpful to understand what can be accomplished with your nose upon your facial features Question: Am I still a candidate for cheek implant surgery if I have already had injectibles in my cheeks? Answer: yes, it is certainly possible to undergo cheek augmentation even though you had previous Fillers placed in the cheeks. Cheek implants are placed for patients who have a flat midface and a flat maxilla and desire a permanent augmentation. The implants themselves are composed of solid silicone, and are Manufactured in a large array of thicknesses, sizes, and shapes. For over 25 years, we have used Implantech Brand of solid silicone cheek implants with an excellent success rate. The implants are placed through intraoral oral incision under a brief general anesthesia outpatient procedure. The implants are placed directly over the bone and any filler material is located above the implants themselves.  Question: Should I get sliding genioplasty or something else? Answer: A sliding genioplasty is performed by an oral surgeon under general anesthesia in a hospital setting with an overnight stay at the hospital, and is much more invasive. It usually performed with the teeth are significantly out alignment. For cosmetic purposes only, consider placement of a chin implant to augment the chin forward. Chin implants are placed under local anesthesia as an outpatient procedure which takes approximately 30 minutes. Question: Sliding genioplasty or chin implant? I want to improve my side profile. Answer: A sliding genioplasty is performed by an oral surgeon under general anesthesia in the hospital setting with an overnight stay, and is much more invasive. It is usually performed when the teeth are significantly out alignment. Placement of a chin implant can be done under local anesthesia as an outpatient procedure which takes approximately 30 minutes. Liposuction can accomplish removal of the fat deposits in the neck which will also help with improvement of the jawline. Question: Rhinoplasty 5 years ago, like everything except uneven nostrils. Are they easy to fix? Answer: Revision rhinoplasty is more difficult than a primary rhinoplasty, sewn in-person examination, a full set of pictures and a copy of the operative report of going to the needed in order to make a determination. He most likely have a hanging columella or a corrected caudal septum. Question: Is my rhinoplasty botched and can my uneven bridge be fixed? Answer: To straighten the crooked nose would require a revision rhinoplasty to reset the nasal bones straight, and possibly add a spreader graft of cartilage on the concave side. Revision rhinoplasty is more difficult than a primary rhinoplasty, therefore an In-person examination is going to be required. Copies of the operative reports would also be helpful to know how much cartilage left over on the inside of the nose for potential grafting purposes.  Question: Is Kybella right for me as I find my profile disappointing as I age? Answer: Kybella is not very effective, must be repeated multiple sessions, and patient’s become very swollen for an extended period of time after each injection. Consider liposuction to remove the fat possible of the platysma muscle. If there is fat deposits below the muscle, a neck lift will be required with a platysma plasty.
Question: How long are internal dissolvable facelift sutures noticeable on your skin? Answer: In our practice for over25 years, we have never used dissolvable sutures underneath the skin. We use permanent nylon sutures to tighten The SMAS, and the muscles in the neck. In our practice, we perform a high-SMAS lower face and neck lift which tightens loose facial and neck skin, tightens loose facial and neck muscles, lifts the SMAS which is the facial muscle structure, lift the jowls, and remove any fat deposits located both above and below the platysma muscle in the neck which also includes a platysma-plasty. Choose your plastic surgeon wisely based on extensive experience producing natural results. Study your prospective surgeon’s facelift photo Gallery and make sure that hair is pulled back behind the ears on the postoperative photos so that you can see are the incisions are. In our practice we don’t post photos to our photo Gallery for at least 4 to 6 months. Question: Surgeon said he’ll remove nose filler during rhinoplasty – is this normal? Shouldn’t the filler be dissolved before? Answer: Much more information is needed, such as type of filler have you had placed, exactly where was placed, and how long ago it was placed. If you think there’s a significant amount of H/A filler still present, then it’s probably best to have it reversed. More importantly is to choose your surgeon wisely based on extensive experience ,since rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery and you have artificially inflated the anatomy of your nose going into this procedure with placement of fillers for many years.  Question: Would I be a good candidate for a Tip Plasty? Answer: No, you are not a candidate for just a standalone tip – plasty for a variety of anatomical reasons. The nose is a three-dimensional structure in the nose must look good in all three dimensions. The nose has lots of sensory nerve endings in it, and it would be extremely painful to try to accomplish any type of nasal procedure under local anesthesia. In our practice, we use board-certified physician anesthesiologists who put patients completely asleep under general anesthesia for patient safety and comfort.  Question: What should I do before my facelift for the best outcome? Nutrition, vitamins, lotions? Answer: You should always communicate with your surgeon upon what their suggestions are. Most important is to make sure that year not take any blood thinners like aspirin, ibuprofen, herbal supplements and vitamins E. Make sure you’re in excellent height /weight proportion and don’t have any other health issues. Study your prospective surgeon’s facelift photo Gallery make sure it’s extensive with natural results that you like. Question: Is it possible to have a septorhinoplasty done after turbinate reduction? Answer: A septoplasty and turbinate reduction are performed when there is significant decreased airflow out of the nose. That can because by and large turbinates, or a deviated septum. They’re both are frequently performed together when necessary. Rhinoplasty is the most difficult operation to perform correctly in the entire field of cosmetic surgery, so choose your rhinoplasty surgeon wisely based on extensive experience. Both functional and cosmetic nasal surgery can be performed under one anesthesia with one Recovery period.  Question: Do you prefer silicone or ePTFE for facial implants?  Answer: For Chin and cheek implants, we prefer silicone. The tissue ingrowth is a real problem on ePTFE implants when they have to be removed due infection. Question: Is it possible for me to go from the first two pictures to last two with plastic surgery? Answer: A closed rhinoplasty procedure can accomplish shaving down the dorsal hump narrowing the bridge line and refinement of the nasal tip and reduction of the hanging columella with all the incisions placed on the inside of the nose. Your “after” side profile demonstrates too much upward rotation and A persistent hanging columella. Question: Would chin liposuction or jaw surgery be more beneficial? Answer: The limited photographs demonstrate a recessive chin and fat deposits in the neck. Consider placement of a chin implant to augment your chin forward, and liposuction under the jaw line to Remove some of the fat in that location. Both procedures can be performed together and actually complement each other. Question: How far up can an osteotomy go to fix a nose fracture? Answer: Medial and lateral osteotomy’s Are performed up into the frontal recess bone in order to manually reset the nasal fracture. When the upper lateral cartilages have been fractured off the nasal bones, a placement of a cartilage spreader graft is necessary on the concave side. Most significant nasal fractures also have a deviated septum component blocking airflow, so make sure you don’t need a septoplasty. Straightening the crooked nose is a very difficult endeavor, so choose your surgeon wisely based on extensive experience. Question: Which type of chin implant would help me achieve my desired look? Answer: In our practice for most women, we use size small pre-jowl chin implants with an excellent success rate for over 25 years. It’s important to remember that most of the augmentation occurs in the forward projection, but there’s a small amount of augmentation giving width and a small amount of vertical height as well. Your chin is three-dimensional, and the augmentation is three-dimensional. We also placed chin implants under local anesthesia as an outpatient procedure which takes approximately 30 minutes.  
Question: What kind of changes to my nose would flatter my face? Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, refinement of the nasal tip, and narrowing the bridge line. An alar-plasty accomplishes narrowing wide nostrils, but that does not appear to be needed based on the limited photographs. Thick skin in the tip of the nose is going to prevent refinement in that area, so it is important to have realistic expectations. Rhinoplasty is a very difficult endeavor, so choose your plastic surgeon wisely based on extensive experience. Question: Chin Implant: Should it be sutured to the chin? Answer: In our practice, we place chin implants directly over the bone and into pocket underneath the periosteum. We also placed one dissolvable suture centrally to hold the implant in place. Once the pocket heals around the implant, it is very rare for the implant to ever shift or move. Question: Would an eyebrow lift help my tired eyes? Answer: Much more information is needed, such as a full set of facial photographs looking directly into the camera to make a determination about the need for an upper blepharoplasty, ptosis repair, or browlift. From the two limited photographs, it does not appear that a browlift would be necessary. Question: What method provides more predictability and precision in revision rhinoplasty: external or internal osteonomies? Answer: In our practice for over 25 years, we have performed endonasal closed rhinoplasty with all incisions placed on the inside of the nose. This also includes both medial and lateral osteotomies. This totally prevents an external incision and offers a very predictable result. Most important is what is accomplished with placement of the cuts in the nasal bones, not where the incision is made to do it. With either technique, the procedure is done by feel, not by sight since the surgeon cannot actually see the nasal bones themselves directly. Question: Does someone with high nostrils always have a hanging columella? Answer: Alar retraction and hanging columella are 2 completely separate issues. They are most commonly associated with a previous rhinoplasty. Each 1 is treated differently. Question: Is it possible to have a secondary facelift under local anesthesia? Answer: In our practice, we perform most face/necklift procedures under general anesthesia for patient safety and comfort. Board certified physician anesthesiologist administer the anesthesia. Trying to perform the entire face and neck lift under local anesthesia can be very difficult and painful for 3 hour procedure. Question: How complex would a rhinoplasty for my nose be? I attached pictures of my nose now and the desired result. Answer: Rhinoplasty is 1 of the most difficult operations to perform correctly in the entire field of cosmetic surgery, so it is imperative to choose your surgeon wisely based on extensive experience. A full set of facial photographs from all angles are going to be required to make a determination about how best to proceed. The dorsal hump can certainly be shaved down, and the tip lifted very slightly. Osteotomies placed in the nasal bones will be required to close the open roof deformity created from the hump removal, and spreader grafts will probably need to be placed in the midportion of the nose to prevent the upper lateral cartilages from collapsing inward. Digital computer imaging would be helpful to understand what can and cannot be accomplished with your nose upon your facial features. This would be a routine rhinoplasty, not a complex rhinoplasty for an experienced surgeon. Question: Is it worth it to get a revision rhinoplasty? My nose is severely deviated. Answer: Your Nose is not severely deviated, but there is a small area of fullness in the supra tip area which can be related to thick skin or excess cartilage. Thick skin is best reduced with steroid shots, while a revision rhinoplasty can accomplish removal of residual cartilage in that area in addition to reduction of the hanging columella. A septoplasty is performed in the back of the nose only to improve air flow dynamics, and will have no bearing on the look of the nose. Both procedures can be performed together when necessary. Question: Crooked tip – Should I get a 2nd opinion for revision rhinoplasty? Answer: A full set of unadulterated photographs are going be required to make a determination about straightening the Crooked nose. To straighten crooked nasal bones require osteotomies placed in the nasal bones to straighten them, a spreader graft composed of the patient’s own cartilage in the midportion of the concave upper lateral cartilage, and cartilage removal and cartilage grafting techniques in the nasal tip cartilages to straighten the nasal tip. Revision rhinoplasty for the crooked nose deformity is a difficult procedure to perform correctly in the entire field of cosmetic surgery, so it is important to choose a surgeon based on extensive experience.  Question: How can I correct a droopy nose tip? Answer: A closed rhinoplasty approach can accomplish correcting the drooping nasal tip by lifting the nasal tip cartilages, and shaving down the dorsal hump. It is also important to release the depressor septi ligament which pulls the tip down dynamically when smiling.
Question: Non-invasive rhinoplasty – what options do I have to thin the bridge of my nose? Answer: A Closed rhinoplasty is less invasive than open rhinoplasty and is required to narrow your nasal bones. Osteotomies placed in the nasal bones themselves accomplish narrowing the wide bridge line. An alar plasty is required to narrow wide nostrils. Question: 18, female, should I consider a sliding genioplasty or v-shape surgery? Or other options? Answer: The photographs demonstrate a dorsal hump on your nose and a recessive chin profile. Consider placement of a chin implant to augment the chin forward for better facial balance and proportions. A closed rhinoplasty approach can accomplish shaving down the dorsal hump, narrowing the bridge line and refining the nasal tip. Both procedures can be performed together under one anesthesia with one recovery period. Question: How could rhinoplasty be done with minimal discomfort? Answer: First of all, it’s imperative that your plastic surgeon does not shove painful packing on the inside your nose after the surgery. Some surgeons still do pack noses. In our practice, we do not. We also perform closed rhinoplasty which is less invasive than open rhinoplasty. Choose your surgeon wisely based on extensive experience producing natural results, since rhinoplasty is the most difficult operation to perform correctly in the entire field of cosmetic surgery. Question: Facelift with upper / lower bleph? Or fat transfer? Answer: Much more information is needed, such as a full set of facial photographs from all angles including your neck. In our practice, 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 fat deposits in the neck located above and below the platysma muscle in addition to a platysma -plasty. Mini facelifts give mini results, and we rarely ever perform them. For a variety of reasons we also don’t perform fat injections and mid – facelift due to complications that can occur with these procedures. Question: Does the age of a patient who undergoes rhinoplasty affect the success and healing of the procedure? Answer: In our practice, we have performed rhinoplasty on patients from ages 17 through 85. You can perform rhinoplasty at any age, as long as you’re in excellent health. The procedure takes approximately an hour and a half under general anesthesia, monitored by a board certified physician anesthesiologist in our Medicare certified outpatient surgery Center. The procedure is also performed as a closed rhinoplasty approach with all the incisions placed on the inside of the nose. No external incisions are required, and no painful packing is required either.  Question: I’d like to know if it is safe to get subcision after a whole facelift? Answer: It’s probably best to wait at least 4 to 6 months after a facelift procedure before undergoing another procedure on your face involving the epidermis and dermis. Question: Will a scarless bleph not address skin laxity? Answer: More information is needed such as Pictures of your eyelids and your face from different angles. The primary goal of upper eyelid surgery is to remove extra skin and a little bit of fat at the inner corners on the upper eyelids. The Incision is placed directly in the upper eyelid crease. Regarding the lower lids, the primary goal is to get rid of the fat bags which are removed through trans- conjunctival approach on the lower lids on the inside of the lower lids. In our practice, we mark the upper and lower eyelids because of the asymmetry present in both upper and lower lids before undergoing surgery. We do not mark the patient for a facelift. For a variety of reasons we also do not do fat transfers in the face as well. Choose your surgeon wisely based on extensive experience. Study your prospective surgeon’s eyelid surgery and facelift photo Gallery to make sure that it is extensive with results that you like.  Question: Best for jowls and under chin/neck procedures? Answer: The photographs demonstrated recessive chin profile, jowls, sub mental fat deposits and significant laxity in your neck. Consider placement of a chin implant to augment your chin forward for better facial balance and proportions, which would also help with your pre-Jowl sulcus as well. A lower face and neck lift is going to be required to lift the jowls, remove the fat deposits in the neck, and tighten loose facial and neck skin in addition to tightening loose facial and Nick muscles which also includes a platysma plasty to significantly improve the jawline. Noninvasive procedures would be a waste of time, Since none of them can accomplish what’s a surgical facelift can. Question: Sliding genioplasty to open airway & improve side profile? Or deep plane? Answer: A sliding genioplasty is usually performed by an oral surgeon when your teeth are significantly out of alignment.This is done in hospital setting under general anesthesia with an overnight stay in the hospital and is much more invasive. A small chin implant can be placed through an incision underneath your chin under local anesthesia as an outpatient procedure which takes about 30 minutes. This is done for purely cosmetic purposes and has nothing to do with your airway or the way your teeth fit together. Regarding your neck, it appears to have fat deposits located below the platysma muscle in your neck that’s why you still have residual fat deposits. Liposuction can only remove the fat deposits above the muscle.A Surgical neck lift is required to remove the fat deposits below the muscle which also includes a platysma plasty to significantly improve the jawline.  Question: Is it safe to get a facelift after Bellafill? Answer: It’s always best check with your operative surgeon, but it should not be a problem having a facelift after filler injection.
Question: Rhinoplasty revision – Can a small alar rim graft be added? Answer: Revision rhinoplasty is more difficult than a primary rhinoplasty, and it is not just a little simple procedure done under local anesthesia. The cartilage must be harvested from inside the nose. Placement of an alar rim graft is usually done for collapsing of weak alar cartilage that may be present. A full set of facial photographs and in-person examination would be required. Most important to have very realistic expectations and understand the risk versus reward benefit from undergoing another revision.  Question: 36 with blunt jawline that lacks definition. What procedure could improve this? Answer: At age 36, your skin tone should be acceptable, therefore a face lift should not be necessary. A neck lift procedure involves removal of fat above and below the platysma muscle which also includes a platysma-plasty. No skin removal is performed with this procedure. This would significantly improve your jawline. Question: How can I get rid of scar tissue/mild polly beak deformity? Answer: Poly-beak deformity can be caused from 2 separate issues, thick skin with fluid retention, or residual cartilage. Steroid shots are effective for fluid retention and thick skin, however a touch-up rhinoplasty procedure is going to be required if there is extra cartilage present. Question: Can I get a mini neck lift while taking blood thinners for DVT? Answer: The position of your eyebrows is acceptable, therefore just an upper blepharoplasty can accomplish removal of the hooded skin on your upper eyelids to rejuvenate them. This procedure can be performed under local anesthesia as an outpatient procedure. Question: Would I be a better candidate for Kybella or jaw/chin filler for a more permanent solution? Answer: Liposuction of the fat deposits in the neck accomplishes a permanent removal and is usually a one-time treatment. Kybella requires multiple treatments with significant swelling after each treatment. Fillers are only temporary. Question: Could I have your opinions on the success of an alar trim to decrease my bulbous tip? Answer: A full set of unadulterated facial photographs will be required to make determination about how best to proceed. In addition, there appears to be thick skin present to the nose which is going to significantly prevent refinement in that area. The thickness of the skin must be determined time and in-person examination. Performing a tip-plasty may leave your nose unbalanced, and most patients must undergo full rhinoplasty to ensure that all of the components of the nose are balanced with themselves, and the entire new nose is balanced with the patient’s facial features in all the different angles. Question: Would you suggest a rhinoplasty revision to fix a septum that did heal properly? Answer: There are many issues on the inside of the nose can cause breathing difficulties, such as a deviated septum, turbinate hypertrophy, valve collapse, allergies, and chronic sinusitis. All these issues must be sorted out with in-person examination to make a determination about how best to proceed. A septoplasty procedure is performed to straighten a deviated nasal septum. Question: What can I do to fix mid face sagging? Answer: The midface usually does not tend to sag with aging process, but it loses volume in that area. In our practice, we place cheek implants which offer a permanent augmentation/ volume restoration to the midface. The implants are manufactured in a large array of thicknesses, shapes, and sizes. The implants are placed through an intraoral incision under brief general anesthesia as an outpatient procedure. Question: Is NeckTite a better option than having a submental lipectomy? Can I have both? Answer: Much more information is needed such as your age and a full set of facial photographs from all angles to make a determination about how best to proceed. It is important to understand that there are 2 compartments of fat in the neck, and they are located above AND below the platysma muscle. Liposuction can only remove the fat deposits above the muscle, while a neck lift procedure with platysma plasty is required to remove the fat below the muscle. No skin removal is required in patient’s less than 50 years of age. Question: Do you recommend I get Botox and fillers before or after a revision rhinoplasty? Answer: It does not really matter Botox and fillers are performed before or after Your revision rhinoplasty surgery. Probably best to separate them out in time by at least a month.

Asian Rhinoplasty Bellevue WA

Posted on October 11, 2023
Asian Rhinoplasty Surgery Near Bellevue WA Asian Rhinoplasty: The Why Factor The desire for rhinoplasty can stem from various sources, such as the pursuit of enhanced aesthetics or the correction of functional issues like a deviated septum or other airway-related complications. Interestingly, many patients stumble upon the revelation post-surgery that a previously unnoticed breathing issue has been rectified. The Seattle Cosmetic Surgery Center frequently notes that individuals could effectively acclimate to restricted nasal passages, especially if they’ve had these limitations from a young age. Asian rhinoplasty, in particular, brings on an additional layer of complexity as the primary aim is usually to achieve greater nose projection and tip refinement. The inherently delicate structure of an Asian nose calls for a considerate, less aggressive sculpting approach. The Seattle Cosmetic Surgery Center often encounters Asian individuals contemplating Asian rhinoplasty in Seattle & Bellevue for the correction of unwanted features. Still, they firmly express their desire to steer clear from a ‘cookie cutter’ nose that diminishes their ethnic identity. Typical Asian Rhinoplasty Procedures Frequently, our patients express desires for specific changes, including: Narrowing of the nasal bridge Augmentation of the nasal dorsum Enhancement of the nose’s projection Reconfiguration of the nose tip for an appealing look Modification of the nostril shape Asian rhinoplasty ranks among the most complex ethnic rhinoplasty procedures that facial plastic surgeons contend with. This complexity mainly results from the unique combination of scant nasal dorsum, frail cartilaginous infrastructure, along with the presence of thick skin and a robust soft-tissue envelope. What Makes an Ideal Asian Rhinoplasty Candidate? The perfect candidates for Asian rhinoplasty in Seattle & Bellevue are those seeking a nuanced enhancement to their nose shape without undermining their cultural identity. Asian rhinoplasty can be an optimal procedure for individuals aiming to modify their nose or nostril width or to uplift the nasal tip or nasal bridge. The importance of a minimalist approach cannot be overstated when considering Asian rhinoplasty. It should foster balance and harmony without introducing any distractingly harsh or dramatic changes. Ideal candidates are also expected to: Maintain robust physical and emotional health Harbour realistic goals and expectations Be non-smokers, or if they do smoke, they should be prepared to quit for at least six weeks pre and post-surgery Refined Nasal Tip A recurring request among Asian rhinoplasty patients is the quest for a less rounded or jutting nasal tip. Historically, surgery designed to redefine the nasal tip would necessitate aggressive over-resection of the lower lateral cartilages. This method typically results in a loss of projection, a downturned, bulbous nasal tip, potential long-term contour irregularities, diminished support, and nasal blockage. At The Seattle Cosmetic Surgery Center, doctors abstain from aggressive cartilage removal, as it might inflict damage necessitating corrective rhinoplasty surgery later on. Our surgeons hold firm the belief that ‘less is more’ and that these structural techniques drastically reduce the likelihood of future rhinoplasty corrections, while still realizing the patient’s desired appearance. It is their profound understanding in this field that positions them among the premier surgeons executing Asian rhinoplasty in Seattle WA. Reducing the Alar Base In our Seattle Asian rhinoplasty procedure, we aim to restore a harmonious balance by narrowing the width of the alar base. This procedure can be carried out alongside other nose treatments or as a standalone operation. The Process of Rhinoplasty Recovery The majority of our patients, regardless of whether they’re Asian, Persian, or Caucasian, often find the recovery process smoother than expected. This can be attributed in large part to our surgical technique, which aims to achieve necessary modifications with minimal tissue manipulation. Every stage of the surgery and recovery is thoroughly reviewed and discussed during visits to our Seattle Plastic Surgery clinic. In this manner, patients are not taken by surprise post-surgery, as they are fully informed and ready for all aspects of the recovery process. Adhering to instructions both pre and post-surgery is crucial to attaining the optimal result. The path to recovery from rhinoplasty is simplified if preparations are handled before the surgery, covering everyday tasks like grocery shopping, prescription filling, childcare, bill payments, etc. In the initial few weeks, we recommend that patients sleep slightly elevated, refrain from lifting or any exercise beyond walking, and avoid bending down. These precautionary measures help maintain stable blood pressure, which facilitates the healing process. The Road to Recovery: A Timeline The initial days post-surgery can be the toughest, featuring symptoms like swelling and congestion akin to a head cold. A cast is applied to stabilize the tissues for the first week, and the nasal passages may be filled with absorbent material. Our surgeons remove the cast and any sutures within 5 to 7 days while ensuring the healing process is on track. During these first few weeks, some bruising under the eyes is normal and the face may appear swollen near the surgical site. Majority of these issues typically resolve within a 10-day to 2-week period, enabling patients to confidently resume work or school. The ultimate result of Asian rhinoplasty unfolds slowly. Swelling may intermittently appear and recede as tissues heal. Although initial results become visible mere weeks after the surgery, it may take up to a year for the final outcome to fully materialize. Are There Any Associated Risks? As with any surgical procedure, there are inherent risks involved, most common of which are bleeding, bruising, swelling, and potential infection. By diligently adhering to aftercare instructions, you can significantly reduce these risks and side effects. Crucial factors to consider are proper surgical execution and achieving results that align with your expectations. What is the Procedure Duration? The duration of Asian rhinoplasty can range between one to three hours, or potentially longer, depending on the intricacy of the surgery. How Does Asian Rhinoplasty Differ from Other Ethnic Rhinoplasty Surgeries? Asian rhinoplasty stands out from other ethnic rhinoplasty procedures due to the distinct cultural elements of nasal shape and structure it represents. The nose is among the most diverse facial features, mirroring your ethnic roots. An in-depth understanding of Asian aesthetics, the differences in skin type, and the optimal strategy for structure enhancement is crucial in performing successful Asian rhinoplasty. Will the Result Look Natural? The objective is always to achieve a result that appears as natural and unaltered as possible. For a naturally seamless result, it’s crucial to choose the right surgeon for your Asian rhinoplasty. Dr. Lee is dedicated to delivering an Asia-specific procedure that creates a captivating harmony of balance and beauty among your features while accentuating your appealing characteristics. Is Scarring Expected? Scarring should be minimal as incisions are strategically placed in concealed locations. Depending on the surgical approach applied, scars are typically hidden within nostrils. If an open rhinoplasty approach is chosen, the resulting scar will be virtually invisible, as it’s strategically located at the base of the column between the nostrils. Book a Consultation Now During the consultation phase, it’s imperative to articulate your aspirations and objectives clearly. We will then provide a realistic overview of what can be accomplished given your bone structure, without compromising, but rather enhancing, your nasal breathing functionalities. During your consultation’s physical examination, our surgeons can identify any underlying anatomic structures causing nasal airway obstruction that you might not be aware of. We ensure that you have a comprehensive understanding of the procedure and potential outcomes at every phase. Effective communication between physician and patient is paramount throughout the entire process, and The Seattle Cosmetic Surgery Center staff will be with you at every step. If you desire to learn more, don’t hesitate to reach out to us today and schedule a consultation for one of the best Asian rhinoplasty procedures that Seattle can offer.
Teenage Rhinoplasty Many teenagers struggle with self-consciousness due to the appearance of their nose, such as a prominent hump or disproportionate size. Teenage rhinoplasty, also known as a nose job, can offer a solution by reshaping and resizing the nose to enhance facial harmony and boost self-confidence. This article explores the various aspects of teenage rhinoplasty, including its benefits, risks, considerations, and the expertise of The Seattle Cosmetic Surgery Center. Understanding Teenage Rhinoplasty Rhinoplasty is a surgical procedure aimed at reshaping the nose and restoring its functionality. Teenage rhinoplasty specifically caters to teens who seek both aesthetic improvement and correction of structural defects causing breathing difficulties. Dr. William Portuese and Dr Joseph Shvidler, expert facial plastic and reconstructive surgeons, specialize in teenage rhinoplasty to help patients achieve their desired facial rejuvenation goals. Benefits of Teenage Rhinoplasty: Aesthetic Enhancement: Teen rhinoplasty can address concerns such as a large hump, drooping nasal tip, wide nostrils, and asymmetry, resulting in a more balanced facial appearance. Improved Confidence: Correcting nasal imperfections can significantly boost self-confidence, particularly during a pivotal stage of a teenager’s life. Functional Improvement: Teenage rhinoplasty can also correct structural issues responsible for breathing difficulties, contributing to better overall health and well-being. Risks Associated with Teenage Rhinoplasty While teen rhinoplasty is generally safe, it is important to be aware of potential risks, including nosebleeds, scarring, numbness, swelling, and rare cases of permanent nerve damage. The Seattle Cosmetic Surgery Center ensures candid discussions with patients and their parents, highlighting both the benefits and risks during the initial consultation. The Consultation Process for Teenage Rhinoplasty Prior to undergoing rhinoplasty, teenagers and their parents must consult with one of our facial plastic surgeons, who stress the importance of physical maturity before the surgery. We evaluate the patient’s unique nasal anatomy and provides customized treatment recommendations. The consultation involves comprehensive communication to ensure a full understanding of the procedure, recovery process, and expected outcomes. Rhinoplasty and Teens Considerations for Teenage Rhinoplasty Age and Physical Development: Teen rhinoplasty should only be performed once the patient has stopped growing physically. Our surgeons evaluate the anatomical readiness of each patient on an individual basis. Open Communication: Teenagers must fully comprehend the procedure, recovery timeline, and realistic results. Our surgeons encourage open communication between parents, teens, and himself, fostering a supportive environment to address any concerns. Self-Confidence: Teenage rhinoplasty can have a positive impact on self-confidence by addressing nasal imperfections that may affect a teen’s self-esteem. Teen Rhinoplasty Recovery The recovery period following a teenage rhinoplasty varies from patient to patient. Dr. William Portuese and Dr Joseph Shvidler, during the initial consultation, provide detailed information about the recovery process, assists patients in setting realistic expectations, and helps them plan accordingly. Teenage Rhinoplasty Recovery Timeline The duration of recovery after teenage rhinoplasty is individualized but here is a general timeline: First Week: Teenage rhinoplasty patients may experience bruising and swelling around the eyes during the initial week following the surgery. Some patients may also feel slight fatigue from the anesthesia. Resting is crucial during this period, and patients are advised to maintain an upright position as much as possible to minimize swelling and facilitate healing. First Few Weeks: Swelling and bruising start to subside gradually. Patients may still have some residual swelling, but it typically becomes less noticeable. Following the surgeon’s instructions diligently is important at this stage to promote proper healing. Two Years and Beyond: Teenagers can expect to see the final, permanent results of their rhinoplasty within approximately two years. It takes time for the nose to fully settle and for any residual swelling to completely dissipate. Our surgeons schedule regular follow-up appointments to monitor the progress and ensure the recovery process is smooth and successful. Postoperative Care for Teenage Rhinoplasty: Rest: Adequate rest during the initial recovery period is vital for the body to heal optimally. Patients should take it easy and avoid strenuous activities or exercise as advised by their surgeon. Medications: Pain medications and antibiotics prescribed by the surgeon should be taken as directed to manage discomfort and prevent infection. Nasal Care: Following the surgeon’s instructions regarding nasal care and hygiene is essential. This may include gentle cleansing of the nose and avoiding any activities that could harm the healing nasal tissues. Protective Measures: Teenagers should protect their nose from any accidental bumps or injuries by avoiding contact sports or other activities that could pose a risk during the healing phase. The Importance of Follow-Up Appointments: The Seattle Cosmetic Surgery Center emphasizes the significance of scheduled follow-up appointments after teenage rhinoplasty. These appointments allow the surgeon to monitor the progress of healing, address any concerns or complications promptly, and ensure that the desired results are achieved in the long run. Patients should attend these appointments as scheduled to optimize their recovery and obtain the best possible outcomes. The recovery process following teenage rhinoplasty is unique to each patient. While it generally involves swelling, bruising, and a gradual healing timeline, following proper postoperative care and attending scheduled follow-up appointments are crucial for successful outcomes. By prioritizing rest, adhering to medications, practicing nasal care, and protecting the nose, teenagers can optimize their healing process and enjoy the final, natural-looking results of their rhinoplasty within a span of approximately two years. How old should a candidate for teenage rhinoplasty be? The age at which teenage girls may be considered for rhinoplasty surgery is typically 15 or 16 years old. Similarly, teenage boys may become eligible for a rhinoplasty procedure at around 16 or 17 years old. However, it is crucial to ensure that the nose has fully developed before proceeding with the surgery. Is parental consent required for teen rhinoplasty surgery? If a teenager is below the age of 18, obtaining parental consent is necessary for rhinoplasty surgery. Irrespective of age, rhinoplasty is a significant surgical procedure. It is advantageous for teenagers to engage in a discussion with their parents about nose surgery, even if they are over 18 years old. This collaborative approach with The Seattle Cosmetic Surgery Center enables teenagers and their parents to work together towards achieving the most favorable treatment outcomes. Should a teen get a rhinoplasty? Undergoing a rhinoplasty procedure is a significant decision that can have a profound impact on one’s life. It is important for teenagers to carefully consider the potential short-term and long-term consequences before opting for nose surgery. By scheduling a consultation, both teenagers and their parents can thoroughly assess all aspects of teen rhinoplasty. Our board-certified facial plastic surgeons possess comprehensive knowledge and expertise in the field of teen rhinoplasty. During the consultation, he provides a detailed explanation of the treatment process to parents and teens alike. He also assists teenage patients in establishing realistic expectations for the procedure. Furthermore, our surgeons offer valuable insights to help teenagers and their parents make well-informed decisions about their treatment options. Why do teens have to wait until a certain age before they can undergo nose surgery? During adolescence, the sinuses experience growth, which contributes to the overall facial structure. This growth affects not only the sinuses themselves but also the jaw and nose, leading to changes in shape. Therefore, it is important for teenagers to avoid undergoing rhinoplasty at an early stage, as it could potentially interfere with proper facial development. teenage rhinoplasty

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