Facial Plastic Surgery Questions and Answers: Part 02

Question: Can I make changes to my nose?
Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, refining the nasal tip, and straightening the nose with all of the incisions placed on the inside of the nose itself. No external incisions are required, and no painful packing is required either. Digital computer imaging would be helpful to understand what can be accomplished with your nose upon your facial features. Due to the thick skin you appear to have in the tip of your nose, you may need a couple of steroid shots after the surgery to make sure the nose is balanced.

Question: Mini facelift with a chronic illness?
Answer: You are not a candidate for a facelift at this time based on the photographs, you presented, and you’re only 35 years old. More importantly, is to see if you’re even a candidate for elective cosmetic surgery with your chronic illness. That will need to be addressed by the surgeon and the anesthesiologist prior to any type of surgery you’re going to have.

Question: Does this look like a broken nose that will require surgery?
Answer: I there are many issues that can occur from trauma to the nose, such as a broken nose, a dislocation of the nasal cartilages, and a deviated nasal septum. Best to re-evaluate once the swelling has subsided in about two weeks. If it’s crooked at that point, then you can consider surgery.

Question: Tear trough deformity? Or fat?
Answer: You have herniated fat in the lower eyelids which can be removed through a trans conjunctival approach with two small incisions made on the inside of the lower lids. Since you’re only 27, a conservative amount of fat would be removed.

Question: Am I a good candidate for a rhinoplasty? Is what I want feasible?
Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, adjusting the radix, and reducing the hanging columella, and refinement of the nasal tip, along with lifting the tip itself. All of the incisions are placed on the inside of the nose. There’s no external incision and no painful packing placed on the inside of the nose, digital computer imaging of your nose upon your facial features from different angles to also be helpful. Releasing the depressor septi ligament will prevent the tip of the nose from drooping dynamically.

Question: Would you recommend canthoplasty or just a blepharoplasty?
Answer: You’re an excellent candidate for both upper and lower blepharoplasty. Your left eye could certainly use a canthoplasty since you have a downed turned outer corner. These procedures are usually performed under a brief general anesthetic as an outpatient procedure. Anticipate about two weeks of visible bruising and swelling.

Question: What kind of facelift is best for a proactive 35yr old wanting to prevent nasolabial wrinkles?
Answer: Based upon your photographs, you do not need any type of facelift procedure. You do have a mild recessive chin, so consider placement of a chin implant under local anesthesia as an outpatient procedure, which takes about 30 minutes. That would give you more facial balance and proportions.

Question: Can I thin out and shorten my columella strut?
Answer: Much more information is needed such as a full set of facial photographs from all angles and a copy of the operative report. Revision rhinoplasty is more difficult than a primary rhinoplasty, so you must weigh the risks versus the rewards of what you’re trying to accomplish.

Question: Would a lower blepharoplasty help my bags?
Answer: Yes, a lower blepharoplasty performed through a trans-conjunctival approach can accomplish removal of the fat bags creating the puffy look. Two very small incisions are made on the inside of the eyelid, and those fat bags are removed. At age 40, you should not need any tightening of the skin from the outside. Choose your surgeon wisely based on extensive experience producing natural results.

Question: How much de-projection can be made for my nose? Make nostrils shorter in length.
Answer: The side profile photograph demonstrates an overly projecting nose, and an under projecting chin. A rhinoplasty can only de-project the nose approximately 3 mm. Consider placement of a chin implant which can augment the chin forward as much as 10 mm.

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