Facial Plastic Surgery Questions and Answers: Part 9

Facial Plastic Surgery Questions and Answers: Part 9

Question: Do I need a neck lift? 33 years old?
Answer: A full set of facial and neck photographs from all angles are required to make a determination about how best to proceed. A necklift procedure involves removal of fat deposits in the neck and a platysmaplasty. In addition, have you had a massive weight loss, which may change the Procedure necessary to address your issues.? The skin tone in your neck Will need to be evaluated in-person to determine your best procedure.

Question: Can nasal bridge rasping/shaving be done under local anesthesia instead of a full blown rhinoplasty?
Answer: A Full set of facial photographs from all angles are required to make a determination about how best to proceed. Once you have removed 3 mm of cartilage and bony dorsal hump on the bridge line, that will create a flat top, open roof deformity. Medial and lateral osteotomies of the nasal bones are then mandatory to close the open roof created from the hump removal itself. This requires general anesthesia. The depressor septi ligament can also be released in the tip elevated as well. All this can be accomplished with a closed rhinoplasty approach with all the incisions placed on the inside of the nose. No external incisions are required, no painful packing is required either. Digital computer imaging of your nose will be helpful to understand what can and cannot be accomplished with the procedure.

Question: Chin implant or sliding genioplasty?
Answer: The photographs demonstrate a recessive chin, and extensive fat deposits in your neck, located both above and below the platysma muscle in your neck. Placement of a chin implant can accomplish giving you more chin projection. A surgical neck lift with liposuction is going to be required to remove both compartments fat.

Question: 48yo female. I had VSG 06/20/20. Lost 100lbs. Best options for neck skin sag and forehead wrinkles from weight loss?
Answer: As far as your forehead goes you do not have low eyebrows, therefore a brow lift is not required. Consider Botox for forehead wrinkles. With respect to your neck, the inelastic skin in the neck is due to the deflation of your face and neck from the hundred pound weight loss. The loose and an elastic skin is going to require a lower face and neck lift procedure at age 48. This procedure involves tightening loose facial and neck skin, tightening loose facial and neck muscles, removing any residual fat in the neck, and lifting the jowls.

Question: What should I do to fix my weak chin?
Answer: From the photographs presented, you have a significant recessive chin profile. For cosmetic purposes only, consider placement of a chin implant to augment the Chin forward for better facial balance and proportions. Placement of the chin implant is less invasive, and can be performed under local anesthesia as an outpatient procedure which takes approximately 30 minutes.If your teeth are significantly out of alignment, then consider a sliding genioplasty performed by an oral surgeon under general anesthesia In a hospital setting with an overnight stay.

Question: Is Septorhinoplasty safe if you have a heart condition?
Answer: If you have any heart condition, you need to have medical clearance by your cardiologist, and make sure not on any blood thinners. Almost all elective cosmetic surgery is performed as an outpatient procedure in a surgery center. Trying to perform cosmetic surgery in a hospital setting would be unaffordable and really expensive.

Question: What procedures and cost will I have to do to get this type of side profile?
Answer: Placement of a chin implant can augment the Chin forward for better facial balance and proportions. Chin implants coming a variety of sizes and shapes, and we place them thru a small incision underneath the chin. To get a significant improvement in your jawline as in the Computer imaging, A neck lift procedure with removal of fat above and below the platysma muscle will be required in addition to a platysma plasty. Both procedures can be done together under general anesthesia as an outpatient procedure. 

Question: Is outside incision the best/only way for my lower lids?
Answer: In our practice, we take the fat bags out from and incision on the inside of the lower lids, known as a trans conjunctival approach. That addresses the fat bag of removal which is significant based on the photographs. The minor goal is to tighten a little bit of extra skin with a small incision on the outside of the lower lid at the eyelash line. In our practice, that incision is closed with tissue glue, and there are no sutures needed on the lower lids.

Question: Will my deviated septum continue to get worse over time if the septum isn’t straightened?
Answer: A septoplasty is performed in the back of the nose to improve air flow dynamics and has nothing to do with the shape of the external portion of the nose. A cosmetic rhinoplasty is performed to change the shape of the nose. A cosmetic rhinoplasty can accomplish straightening the crooked nose and narrowing a wide nose. electrocautery is used to cauterize blood vessels that are present in the skin. A septoplasty and a rhinoplasty can be performed together under one anesthesia with one recovery period, how ever expect to pay for the cosmetic component yourself, while the septoplasty is usually billed to medical insurance once medical necessity has been documented and preauthorization has occurred with your medical insurance. Anticipate co-pays and deductibles with your medical Insurance company.

Question: How old is too old for a mini facelift?
Answer: A full set of facial and neck photographs from all angles with your hair pulled back behind your ears are required to make a determination about how best to proceed. Mini lifts tend to give mini results, and are not very effective, therefore we rarely ever perform them. At age 72, you are going to most likely require a face and neck left procedure which accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and removing any fat deposits in the neck which also includes a platysma plasty. Choose your plastic surgeon very wisely based on extensive experience producing natural results.

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