Facial Plastic Surgery Questions and Answers: Part–10

Question: Do I have to dissolve filler in my nose before rhinoplasty?
Answer: Placement of filler in the nose distorts the anatomy of the nose itself, so it’s best to dissolve the filler several weeks ahead of time. Rhinoplasty is a procedure that is performed in millimeters, so it’s best to go in to the procedure with your normal anatomy, not an artificial anatomy.

Question: Why don’t doctors recommend a cheek or mid face lift?
Answer: It’s because the Face does not descend vertically with the aging process, like the lateral face does. The mid face shrinks with volume loss, therefore we place cheek implants in the cheeks to restore that lost volume. There are many different complications can occur with a midface lift, that’s why we never recommend them.

Question: Recessive chin and fat cheeks – SMAS face/necklift and/or genioplasty?
Answer: Even though you’ve had a chin implant, you still have a recessive chin, so consider placement of a larger chin implant. You also have significant fat deposits in your neck, located both above and below the platysma muscle. You will also require a neck lift procedure to remove both fat compartments in the neck, in addition to a platysma – plasty. At age 35, your skin tone should be acceptable, and skin removal should not be required. You should also have a BMI of less than 32 before undergoing any of these facial and neck procedures.

Question: Badly botched 8 years ago. Is this fixable?
Answer: Much more information is needed, such as a full set of facial photographs of your nose from all angles, and even a copy of the operative report. The nose is a three-dimensional structure, and rhinoplasty is performed in all three dimensions. Revision rhinoplasty is more difficult than a primary rhinoplasty, so it’s imperative to have realistic expectations. It appears from the one very limited photograph that you had anosteotomy placed too high on the left nasal bone resulting in that line. Low lateral osteotomy’s should be able to improve your issue, but that will be determined at the time of a physical examination. 

Question: Am I candidate for bleph or ptosis surgery? I’ve always been like that I’m 33.
Answer: The Photographs are rather limited, but it does appear that you have excess skin on the upper lids for which a cosmetic upper blepharoplasty can improve. There does not appear to be ptosis from these photographs, but that may need to be determined at the time of examination.

Question: Looking at lower face and sunspots – Best procedure for me?
Answer: To rejuvenate the lower face, consider a lower face and neck lift. In our practice, this procedure accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and removing fat deposits in the neck which also includes a platysma- plasty to significantly improve the jawline. We no longer perform Chemical peels since there are much better alternatives today. The wrinkles on your upper and lower lips can be treated with dermabrasion or laser resurfacing. The sunspots are treated by dermatologists in the office setting.

Question: Is it safe to combine a facelift and brow lift with liposuction? 43 year old healthy male who is fit physically.
Answer: In our practice, a male facelift and brow lift would take approximately 5 hours of surgery/ anesthesia time. Adding body liposuction would add additional hours depending upon what you’re try to accomplish. It’s probably best to separate your facial work from the body work and have them done separately, since this is done as an outpatient surgical procedure, not inpatient at a hospital. Please post full set of facial photograph to make a determination about being a candidate for both the facelift and brow lift procedures.

Question: Lipodissolve before surgery?
Answer: Probably best to undergo the functional surgery first, heal up from that, and then consider undergoing any type of cosmetic procedure. A full set of facial and neck photographs are required to make a bet the best determination for what is the appropriate procedure for you. It’s also very important to understand that there are two compartments of fat in the neck, and they are located both above and below the platysma muscle in your neck. Liposuction can only remove the fat compartment above the muscle, while a surgical neck lift is required to remove the compartment fat below the muscle. This also includes a platysma plasty to significantly improve the jawline.

Question: I’m 5’6, 34 and 143lbs. I have some jowling and a double chin. Chin/jaw lipo?
Answer: From the photographs presented, you do not have any jowls. It’s also very important to understand there are two compartments of fat in the neck, and they are located both above and below the platysma muscle in your neck. Liposuction can only accomplish removal of the fat deposits above the platysma muscle, which will be ineffective for you. You have a significant fat compartment below the platysma muscle, which is going to require a neck lift procedure with a platysma-plasty to significantly improve your jawline. This can be performed under a brief general anesthesia with one incision underneath the chin. Your skin tone should be just fine at age 34, so no skin removal is required and you’re not a candidate for a mini- facelift.

Question: What is the best scarless option for lifting the cheeks? 37 y/o
Answer: Consider placement of cheek implants placed through the mouth to augment your flat cheeks and maxilla. No external incisions are required.

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