Facial Plastic Surgery Questions and Answers: Part 1

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.


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