The Seattle

Plastic Surgery Center

William A. Portuese, M.D.

Facial Plastic Surgery Questions and Answers: Part 02

Question: Rhinoplasty with nostril tuck – Will this help me achieve my goal of a smaller, narrower nose with nostril symmetry?
Answer: A closed rhinoplasty approach can accomplish improvement of your nose and an alar-plast can accomplish narrowing wide nostrils. Your nostrils are asymmetrical now, and will still be asymmetrical after the surgery. You also appear to have thick skin in the tip of the nose which is going to prevent refinement in that area. Steroid shot Will Most likely be needed to the first few months after the surgery to reduce the swelling in the tip of your nose when patient have thick skin.

Question: 18 months post chin liposuction – Would I benefit from a revision and what are my options?
Answer: Much more information is needed, such as a full set of facial and neck photographs from all angles, and a copy of the operative report to find out what was accomplished in your neck during that procedure. You may have additional fat, your platysmal bands may have separated, large digastric muscles, or hypertrophy of the submandibular glands.

Question: Will face and neck liposuction damage the SMAS layer, making a future facelift less effective?
Answer: In our practice, we never remove fat from the face, only in the neck. Much more information is needed, such as your age and A full set of facial and neck photographs to make a determination about the correct procedure for you. It’s also important to understand there are two compartments of fat in the neck, above and below the platysma muscle. Liposuction can only accomplish removal of the fat deposits above the muscle, while a neck lift procedure is required to surgically extract the fat deposits below the platysma muscle when present.

Question:  Wide nostrils and asymmetry 6 months post op revision rhino?
Answer: An alar-plasty accomplishes narrowing wide nostrils. It’s important to know whether or not you had this maneuver performed in the last two rhinoplasty surgeries. The procedure involves removing a small wedge of skin at the base of the nostrils and narrowing the base itself. This can be done as a standalone procedure under local anesthesia, or as a component of a full rhinoplasty.

Question:  36 y/o Interested in tightening the face – Should I reach my weight goal before moving forward with a procedure?
Answer: Yes indeed, it’s always best to be at your ideal weight before undergoing any elective facial surgery including a facelift. At age 36, your skin tone should be acceptable and you should not need a facelift. You have a prominent pre-Jowl sulcus on both sides of your chin just in front of the your jowls. Consider a ” pre-jowl” style chin implant to augment that area a which would help build out the depression in that area. You should not require a facelift at age 36. Chin implants Can be placed under local anesthesia as an outpatient procedure which takes about 30 minutes.

Question: What will happen if I get a DCF rhinoplasty without undergoing dorsal hump reduction? 
Answer: Much more information is needed, such as a full set of facial and nasal photographs from all angles to make a determination about which techniques are required. A DCF rhinoplasty augments the bridge, but if you have a dorsal hump that’s shaved down during rhinoplasty. Not sure why you would need both procedures.

Question:  Unattached earlobes post facelift – can they be reattached?
Answer: Pictures of your love with been important to make a determination about how best to proceed. As long as your earlobes are normal size, they can simply be reattached. If your earlobes are enlarged, then a reduction is necessary in addition to reattaching them.

Question:  Non-functional and crooked nostril after primary rhinoplasty – Can this be corrected?
Answer: What you’re seeing up your nostril is a prominent foot the lower lateral cartilage which is pushing into your airway. A thorough internal examination of your nose also required to make a determination if there’s any other issues such as valve collapse, deviated septum, or turbinate hypertrophy. That obstructing piece of cartilage can be trimmed back at any point, but it’s best to wait at least a year to undergo a revision rhinoplasty for cosmetic purposes. As long as your primary surgeon has lots of rhinoplasty experience, they should to Be able to address that issue.

Question:  If I get a facelift and fat transfer with two different doctors, which one should I do first?
Answer: Much more information is needed, such as a full set of facial photographs from all angles to make a determination about being a candidate for 2 separate surgical procedures. In our practice, we do not recommend fat injections to the face for variety of reasons. The goal of a facelift is to tighten loose facial and neck skin, tighten loose facial and neck muscles, remove fat deposits in the neck, and lift the jowls.

Question:  Does nose tip refining via suture technique have less swelling time the the average 1 year?
Answer: Much more information is needed, such as a full set of facial photographs from all angles to make a determination about requiring full rhinoplasty, and to evaluate your nasal tip cartilages. Suture techniques create additional swelling than simply conservative removal of cartilage. After undergoing a rhinoplasty, full healing is 1 year. These suture techniques can be performed through a closed rhinoplasty approach.

The Seattle

Plastic Surgery Center


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