Facial Plastic Surgery Questions and Answers: Part 7

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.


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