Facial Plastic Surgery Questions and Answers: Part 09

Facial Plastic Surgery Questions and Answers: Part 09

Question: Can my nasal tip be corrected for better symmetry?
Answer: From the photos presented, there appears to be a very crooked nose including the nasal tip. Osteotomy’s placed in the nasal bone to accomplish straightening the bridge line. Spreader graft placement accomplishes improvement on the concave side to make the midportion of the nose more symmetrical. The columella and tip can be improved, but it may not be completely perfect.

Question: Would I be a good candidate for a chin implant?
Answer: The Side profile photograph demonstrates a recessive chin profile, and a chin implant would be beneficial. The digitally altered photographs do appear realistic. In our practice, Chin implants are placed through a submental incision under local anesthesia as an outpatient procedure. We have used Implantech brand of solid silicone chin implants for over 25 years with an excellent success rate.

Question: Spreader grafts for valve collapse?
Answer: Spreader grafts widen the mid vault of the nose when there is a inverted upper lateral cartilages in the mid portion. They help prevent the hourglass affect. It does not raise the bridge or make the nose larger.

Question: What rhinoplasty procedures would I need to achieve this result? Natural, ethnic rhinoplasty
Answer: A closed rhinoplasty approach can accomplish your goals with all incisions placed on the inside of the nose. No external incisions are required. The morphed photographs do appear realistic. To obtain these results, the dorsal hump must be shaved down, a small amount of cephalic trim removed from the nasal tip cartilages, and osteotomy’s placed in the nasal bones to narrow them. You may also need spreader graphs to prevent the upper lateral cartilages from collapsing inward. Very important to release the depressor septi ligament which dynamically pulls the tip down when smiling. Rhinoplasty is a very difficult endeavor, so it’s important to choose your plastic surgeon wisely based on extensive experience.

Question: How much would a rhinoplasty be for a very small hump on my nose?
Answer: The photographs demonstrate an overly projecting nose with a dorsal hump, and wide nasal bones and inverted upper lateral cartilages in the midportion of the nose. A full and closed rhinoplasty is going to be required. The price of rhinoplasty includes the operating room, surgeon’s fees, and the anesthesiologist fee. For more information and our current price list, please see link below.

Question: I am thinking about getting a Alar Reduction. What techniques would I use to narrow my nose?
Answer: An alar plasty is performed to narrow wide nostrils. This procedure involves removal of a wedge of skin at the base of the nostrils under local anesthesia.

Question: Why do opinions vary from doctor to doctor regarding the best treatment for loose neck skin and jowls?
Answer: In our practice, a lower face and neck lift accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, removing fat deposits in the neck located above and below the muscle lifting the jowls and performing a platysma-plasty. This is the procedure that you need based upon the photographs presented which demonstrate loose skin, neck cords, and residual fat deposits in the neck and addition to jowls.

Question: Is it possible to reduce projection but keep a slim nose? Am I a viable candidate for nose job or chin augmentation?
Answer: The Side profile photographs demonstrate an overly projecting nose and under projecting chin. A closed rhinoplasty approach can accomplish shaving down the dorsal hump and decreasing the overall projection of the nose in addition to straightening it and refining the nasal tip and bridge line with all of the incisions placed on the inside of the nose. Consider placement of a chin implant to augment the recessive Chin forward for better facial balance and proportions, especially with respect to the overly projecting nose from the side profile.

Question: What would the surgical plan of action be to achieve a nose shorter in length and closer to face?
Answer: A closed rhinoplasty approach approach can accomplish shortening the nose, decreasing the overall projection, and reducing the hanging columella with all the incisions placed on the inside of the nose. This is a major rhinoplasty. Only a very small amount of change will occur from the frontal view.

Question: Do I need chin implants and a rhinoplasty?
Answer: A chin implant and a rhinoplasty can be performed together or separately. Chin implants if done separately can be done under local anesthesia as an outpatient procedure, while rhinoplasty must be performed under general anesthesia. You would get more of an improvement from a chin implant itself, since your nose looks pretty good already.

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