Facial Plastic Surgery Questions and Answers: Part 4

Question: Is it possible to fix my nose or do a preservation rhinoplasty?
Answer: Revision rhinoplasty is more difficult than a primary rhinoplasty, and one of the most difficult procedures to perform in the entire field of cosmetic surgery. You need to be very specific on what your goals are trying to improve your nose. It is important to know how much cartilage is left over on the inside of your nose for potential grafting purposes if you’re trying to build up the bridge. Preservation rhinoplasty is not applicable in your case.

Question: Should I seek treatment for my under eye bags? 
Answer: To make any determination about being a candidate for lower eyelid surgery requires posting of photographs of your eyelids from all angles. In our practice, the fat bags are removed through a trans conjunctival approach on the inside of the lower lid.

Question: Support garment for neck lift/chin lipo?
Answer: A full set of facial and neck photographs from all angles are required to make a determination, since a surgical neck lift and chin liposuction or two completely different procedures. A neck lift is performed when there are fat deposits located above and below the platysma muscle, which also includes a platysma plasty. In that case, we place two surgical drains in the neck for two days after the procedure, no garment is necessary. Simple liposuction can only accomplish removal of the fat deposits above the muscle in the neck, and a garment would be acceptable in that case.

Question: Would a mini facelift be appropriate for me as a 31 year old?
Answer: You do not need a mini lift at age 31. You do not have jowls, but you have a hollow pre-Jowl sulcus and a mild recessive chin A a pre-jowl implant, or a pre-jowl chin implant could accomplish augmenting the width of your chin. These implants are manufactured by Implantech This procedure can be done under local anesthesia as an outpatient procedure, which takes about 30 minutes.

Question: How to get rid of neck bands?
Answer: To get rid of dynamic platysma muscle bands requires placement of Botox in the bands first, and then clipping those bands called a myotomy. This is done as part of a neck lift procedure.

Question: Deep Plane Neck Lift at 32 Inquiry?
Answer: From the photographs presented, you do have significant fat deposits, located both above, and below the platysma muscle in the neck, which will require a deep plane neck lift. This involves liposuction to remove the fat deposits above the muscle, surgical extraction of the fat below the platysma muscle, and then a platysma plasty to significantly improve the jawline. You also appear to have a recessive chin, so small chin implant may be beneficial as well. 

Question: Does every facelift need to be done under general anesthesia?
Answer: In our practice, we perform a comprehensive lower face and neck lift procedure which many times involves a deep neck lift to remove fat underneath the platysma muscle. For this, general anesthesia is mandatory. We also use board-certified physician anesthesiologists who use very short acting anesthetics which minimizes the hangover from the anesthesia itself.

Question: Would a brow lift fix divot between brows?
Answer: A full set of facial and forehead pictures of your eyebrows are required to make a determination. A brow lift is only performed when there’s low set eyebrows. If there is a divot present, the corrugator muscles are usually softened surgically in addition to placement of a fascia graft in that area.

Question: Chin implant, lipo, or rhinoplasty?
Answer: The photographs demonstrate an overly projecting nose, and an under projecting chin. The Under projection of your chin makes your nose look bigger than it really is, especially from the side profile. If you’re only going to do one procedure, consider the chin implant procedure. Liposuction can accomplish removal of fat deposits in the neck. A Closed rhinoplasty procedure can accomplish decreasing the overall projection of the nose, shaving down the dorsal hump, narrowing the bridge line and refining the nasal tip. The rhinoplasty procedure must be performed under general anesthesia, while a chin implant and the neck liposuction can be accomplished under local anesthesia.

Question: Am I a good candidate for Kybella or would it prematurely age me?
Answer: The photographs from the side profile demonstrate a recessive chin profile and fat deposits in your neck. Consider placement of a chin implant to augment your chin forward for better structural support for the soft tissues in your neck. If the fat deposits in your neck are located above the platysma muscle, then simple liposuction can improve your jawline. If the fat deposits are located both above, and below the muscle, you’ll need a neck lift procedure to surgically extract the fat deposits below the platysma muscle, which also includes a platysma plasty to significantly improve your jawline. Noninvasive treatments simply cannot accomplish improvement of all your issues.

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