The Seattle

Plastic Surgery Center

William A. Portuese, M.D.

Facial Plastic Surgery Questions and Answers: Part 04

Question:  Is it safe to get a second nose job with permanent filler in the nose?
Answer: Much more information is needed, such as a full set of facial photographs from all angles, and a copy of your operative report find out what was accomplished in the first procedure.

Question:  Which procedure would help me achieve a more symmetrical nose and nostrils?
Answer: A closed a rhinoplasty procedure can accomplish improvement in your nose, but your nostrils will never be perfectly symmetrical. You have a significant hanging columella, and this can be addressed by removal of the excess skin and cartilage hanging down too far between your nostrils. All the incisions are placed on the inside of the nose. No external incisions are required, no painful packing is required either.

Question:  Can I achieve a shaved bridge and refined lifted tip with a rhinoplasty?
Answer: Yes indeed, the morphed pictures that you have presented are very realistic, and can be accomplished with a close rhinoplasty approach. All the incisions are placed on the inside of the nose. No external incisions are required, and no painful packing is required either. 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.

Question:  Would a rhinoplasty and jaw surgery help me achieve a more youthful and feminine look?
Answer: You absolutely do not need a rhinoplasty procedure since your nose looks fantastic already. You do have a bit of the recessive chin profile for which a small chin implant can augment your Chin forward for better facial balance and proportions. The Chin implant will also give you a small amount of width from the frontal view. In our practice, we place chin implants under local anesthesia is an outpatient procedure.

Question: Will having cheek implants make a deep plane facelift more challenging? Will I be at risk for complications?
Answer: As long as the implant is placed directly over the bone and are placed in the right position, and your surgeon is the right plane of dissection during the facelift procedure, there shouldn’t be any complications. Study your prospective surgeon’s before-and-after facelift photo Gallery to make sure that there are lots of results that look very natural.

Question: Which type of facelift scars are most noticeable to surgeons? 
Answer: It’s very important that you Study your prospective surgeon’s facelift Photo Gallery and look specifically at the incisions in front and behind the ears and look how well they’ve healed. Make sure that the after photos have the patient with her hair pulled back over the ears. In our practice, we place incision at the bottom of the sideburn so that we do not raise their hairline when doing the procedure. We also placed incision behind the tragus.

Question:  Pursuing a career flying in the military – wondering how much force can a chin implant handle?
Answer: A chin implant is placed underneath the periosteum directly over the bone and once healed, it is totally not gonna get dislodged from flying an airplane with high-G forces. In our practice, we insert chin implants under local anesthesia as an outpatient procedure which takes about 30 minutes.

Question:  Rhinoplasty after septoplasty turbinate reduction surgery – is a rib cartilage graft necessary?
Answer: In our practice, we always try to use nasal cartilage first, so it’s important to know if there’s any cartilage left over on the inside of your nose for grafting purposes. Some patients don’t even require cartilage grafting, while some do. If there’s a cartilage depleted nose, then we use ear cartilage.

Question: How can I reduce a constant double chin?
Answer: The Side profile photographs demonstrate an overly projecting those with a dorsal hump, and an under projecting chin. Consider a closed rhinoplasty approach to shave down dorsal hump, lift the tip, narrow bridge line with all the incisions placed on the inside of the nose. A chin implant procedure can accomplish augmenting the chin forward for better facial balance and proportions, especially with respect to the over projecting nose from the side profile. Both procedures can be performed together under one general anesthesia which allows one recovery period.

Question: Would I benefit from rhinoplasty?
Answer: The dorsal hump is composed of both bone and cartilage can be shaved down to give a much better sitde profile. Osteotomies placed in the nasal bones will be required to narrow the bridge line after the hump removal. A closed rhinoplasty approach can accomplish your goals by making all incisions on the inside of the nose. No external incisions are required, no painful packing is required either.

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Plastic Surgery Center

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