Facial Plastic Surgery Questions and Answers: Part 8

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. 


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