Facial Plastic Surgery Questions and Answers: Part 04

Question: How invasive is the process of fixing an open roof deformity during a revision rhinoplasty?
Answer: First of all, a full set of facial photographs and an in person examination are going to be required to make the determination of having an open roof deformity present. If it is present, both medial and lateral osteotomies can accomplish closing the open roof through a closed rhinoplasty approach. Open rhinoplasty would not be unnecessary, which would allow a faster healing. All the incisions are placed on the inside of the nose, and no painful packing as required either.

Question: Crooked nose – how much might it cost to treat this?
Answer: In our practice, we perform a closed rhinoplasty approach with all the incisions placed on the inside of the nose. There are no external incisions, and no painful packing is required. Straightening the nose, making it more symmetrical and shaving down the dorsal hump can all be accomplished with closed rhinoplasty. For a current price list, please see the link below.

Question: 2 years after rhinoplasty. What is happening to my nose?
Answer: The tip of your nose has dropped after the original rhinoplasty, therefore you have what’s called a hanging columella, and a residual dorsal hump present. A closed revision rhinoplasty can accomplish shaving down the residual hump, and reducing the hanging columella with all of the incisions placed on the inside of the nose. No painful packing is required either.

Question: Would I benefit from upper eyelid surgery?
Answer: From the one limited frontal photograph, you have very mild extra skin on your upper lids. Your right eye is worse than your left because your right eyebrow is lower than your left eyebrow. A very conservative skin only upper blepharoplasty under local anesthesia could give you some improvement. If you’re complaining of eyelid droopiness, it’s important to make sure you don’t have any ptosis present. 

Question: How long for heavy face wear after rhinoplasty? 
Answer: After a septoplasty and rhinoplasty, you should not do any physical exercise for at least two weeks to prevent a nosebleed. Once you go back to work, you can use the cast that was placed on the bridge of your nose to rest your safety goggles on. Bending over should not be a problem.

Question: Am I a candidate for a revision rhinoplasty/columelloplasty?
Answer: The photographs demonstrate a hanging columella which is composed of both excess skin and cartilage. A columella-plasty can be performed to trim back the extra skin and cartilage in that area through a closed rhinoplasty approach. All incisions are placed on the inside of the nose.

Question: Rhinoplasty in Turkey. How are surgeons trained compared the the US? Are hospitals held to strict standards?
Answer: If you’re looking to travel to undergo rhinoplasty, you should travel within United States for sure. If anything goes wrong, you will have no recourse. You must also consider the follow-up care and touchup revision work which is needed from between 10 to 20% of the time, depending upon who’s doing the procedure. Rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, so choose your rhinoplasty specialist based on extensive experience. We perform closed rhinoplasty in a Medicare certified outpatient surgery center under general anesthesia by a board certified physician anesthesiologists for patient safety and comfort.

Question: Will I be able to get a more deprojected nose via revision rhinoplasty?
Answer: You’re not gonna be able to deproject the tip of your nose more than just a couple of millimeters. That said, it’s probably not worth redoing your whole nose for 2 mm. Since you have a recessive chin, strongly consider placement of a chin implant, which can bring your chin forward by 10 mm to make your nose look smaller. Your recessive chin Makes your nose look more projected than it really is. Digital computer imaging would be helpful to understand what can be accomplished with a chin implant procedure.

Question: Worried rhinoplasty could worsen the bulbous tip because I get keloid scarring, is it a good idea to get one?
Answer: The bulbous tip can be reduced with a closed rhinoplasty approach with all of the incisions placed on the inside of the nose. We have never seen a keloid in the nose in over 30 years. You most likely require some steroid shots placed in the nasal tip for the first few months to prevent swelling and that tip after the surgery to reduce fluid retention and scar tissue formation in that location.

Question: Do I need lower jaw surgery or would genioplasty alone suffice?
Answer: Lower jaw surgery is also known as at genioplasty, which is performed by an oral surgeon in a hospital setting under general anesthesia with an overnight stay at the hospital. This procedure is usually performed when the teeth are significantly out of alignment. For a purely cosmetic improvement of your chin area, consider placement of a chin implant under local anesthesia, which takes about 30 minutes, and it’s much less invasive. 

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