Facial Plastic Surgery Questions and Answers: Part 10

Question: Does having existing infraorbital rim-malar implants disqualify you from getting a rhinoplasty? 
Answer: No, infraorbital implants are acceptable, and you can have a rhinoplasty at any time whether or not you have cheek implants in place.

Question: Can I successfully have desired improvement with closed surgery?
Answer: In our practice for over 30 years, we have only performed closed rhinoplasty. All of the incisions are placed on the inside of the nose, and no painful packing as required either. Your desired results can certainly be performed with a closed technique. It’s very important to know how much cartilage is left over on the inside of the nose for placement of a spreader graft underneath the concave upper lateral cartilage on your left side, which is creating the twisted/crooked look. If there’s no cartilage left over from your previous septoplasty, then ear cartilage may be required. The dorsal hump can also be filed down.

Question: Am I a candidate for buccal fat removal?
Answer: From the limited photographs, it does not appear that you’re even a candidate for a buccal fat pad removal. You should lose the 40 pounds of weight first, and then reevaluate. Rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery, so choose your specialist very wisely based on extensive experience producing natural results. Study your prospective surgeon’s rhinoplasty photo gallery, which should be extensive with lots of very natural results.

Question: Is it best to wait until after weight loss to do submental liposuction and buccal fat removal?
Answer: You should absolutely lose the 40 pounds first, and then re-evaluate how much fat is located in your neck before contemplating the liposuction. It’s also important to remember that there are two compartments of fat in the neck, and they are located both above and below the platysma muscle in the neck. Submental liposuction can only accomplish removal of the fat deposits above the muscle, while a surgical neck lift procedure is required when there are significant deposits below the muscle.

Question: Neck lift, lipo, or chin augmentation?
Answer: Based on your side profile photographs and your age, you’re going to require a lower face and neck, lift procedure. This accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, removal of the fat deposits in your neck with liposuction, and lifting the jowls. A platysma plasty is also performed which significantly improves your jawline.

Question: Is a septorhinoplasty the best option for me?
Answer: If you have symptomatic nasal obstruction due to a deviated nasal septum, then a septoplasty is most likely required, but that must be determined at the time of a physical examination. A closed rinoplasty approach can accomplish shaving down the dorsal hump, narrowing your bridge line, refining the nasal tip, and decreasing the projection of the nose with all of the incisions placed on the inside of the nose. No external incisions are required, and no painful packing is required either. The digital imaging that you had performed looks very appropriate. Rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, so choose your surgeon wisely based on extensive experience producing natural results. Study your prospective surgeon’s before and after rhinoplasty photo gallery.

Question: No matter how much weight I lose, I still have this double chin! What procedure would be best for a defined jaw & neck?
Answer: Much more information is needed, such is your heightWeight and BMI in addition to a full set of facial photographs. From the one very limited photograph, you have extensive fat deposits in the neck located above AND below the platysma muscle in the neck. A surgical neck lift will be required to remove the fat deposits below the muscle which also includes a platysma plasty to significantly improve the jawline. Liposuction will only remove the fat deposits above the platysma muscle. Three small access incisions are placed underneath the chin and behind the ears to accomplish this procedure under general anesthesia as an outpatient surgical procedure. 

Question: In your opinion, do I need a chin implant, along w/ a rhinoplasty to correct my profile?
Answer: Your side profile photographs demonstrate an overly projecting nose, and an under projecting chin. Considered performing a closed rhinoplasty procedure which can accomplish shaving down the dorsal hump, decreasing the projection of the nose, and narrowing the bridge line. All the incisions are placed on the inside of the nose, and no painful packing is required. In addition, consider placement of a small chin implant to augment the chin forward for better facial balance and proportions, especially with respect to the nose from the side profile.

Question: Fat deposits or sagging eyelids?
Answer: The one photograph is rather limited, however you do have significant fat depositsOn the upper eyelids along with the extra skin as well. An upper blepharoplasty accomplishes removal of the extra skin and fat deposits. The incision is in the upper eyelid crease. The fat bags in the lower lids are removed through a trans-conjunctival approach on the inside of the lower lids. The procedure takes approximately one hour to perform under general anesthesia as an outpatient surgical procedure. Anticipate two weeks of visible bruising and swelling.

Question: Is open or closed rhinoplasty the better choice to make a long, droopy nose more feminine?
Answer: Open rhinoplasty versus closed rhinoplasty is ONLY about the approach on how the surgeon gets into the nose, not what is performed Inside the nose itself. A closed rhinoplasty approach can accomplish shaving down the dorsal hump, decreasing the overall projection of the nose, lifting the nasal tip, reducing the hanging columella, and preventing the tip of the nose from drooping down dynamically when you smile. All incisions are placed on the inside of the nose. No external incisions are required, and no painful packing is required. In our practice, we only perform closed rhinoplasty.

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