Facial Plastic Surgery Questions and Answers: Part 03

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.

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