The Seattle

Plastic Surgery Center

William A. Portuese, M.D.

Facial Plastic Surgery Questions and Answers: Part 06

Question: Do cheek implants change the shape of the nose?
Answer: No, cheek implants do not change the shape of the nose, they simply augment your existing maxilla and midface. Revision rhinoplasty is one of the most difficult procedures to perform in the entire field of cosmetic surgery, so make sure you choose a rhinoplasty specialist. Both rhinoplasty and cheek implants can be performed together under one anesthesia with one recovery period.

Question: Can nasal deprojection be achieved without changing anything else about the nose?
Answer: No, when deprojecting the nose, it will affect other components of the nose, and therefore a full rhinoplasty is required. The nose is a three dimensional structure, and rhinoplasty is performed in all three dimensions.

Question: How long after BBL/breast implants can I safely undergo mid-face lift and brow lift?
Answer: It’s probably best to separate out your body procedures and your facial procedures under two general anesthesias at least a month apart. Does not matter which one goes first.

Question: Deep plane facelift and Invisalign? 
Answer: It is certainly acceptable undergo a lower face and neck lift while undergoing invisiline treatment. Just need to leave the invisiline braces out for the first couple of days after the surgery

Question:  How long do I have to wait for a revision facelift/necklift?
Answer: As long as it’s been one year it is acceptable to undergo a revision lower face and neck left to address all of your concerns. In addition to redefining your tragus, also important to shorten your ear lobes, address the dog ears under your chin, and remove additional fat deposits located below the platysma muscle in your neck. Choose your second surgeon very wisely based on extensive experience producing natural results. Study Your prospective surgeon’s before and after facelift photo Gallery and specifically look at the after results.

Question: Is this Cobra neck? What can be done to fix this?
Answer: Much more information is needed, such as what procedure you had done in the past, your age, height and weight. There appears to be residual fat deposits or prominent digastric muscles present. And neck lift procedure with a platysma plasty is going to be required to correct these issues.

Question:  68 y/o interested in eyelid surgery – would transcutaneous or transconjunctival blepharoplasty deliver best results?
Answer: For over 30 years, we have performed all fat removal through a trans- conjunctival approach with the incision placed on the inside of the lower lid to remove the fat deposits. If and when there’s excess skin located on the outside, then a very small incision is placed directly below the eyelash line and a very conservative small pinch of skin is performed. We close that incision with tissue glue. No stitches. Transcutaneous lower blepharoplasty can create with scleral show and ectopion at your age. The transcutaneous approach weakens the lower eyelid muscle and is not advisable.

Question:  Would a chin implant improve my jawline? Should I consider other procedures?
Answer: In the first photo, you do have a recessive chin profile and for which a small chin implant can improve. In our practice, we place chin implants through a small incision underneath the chin under local anesthesia as an outpatient procedure. We have used Implantech brand of solid silicone chin implants for over 25 years with excellent success rate.

Question:  How can I achieve facial symmetry? What procedures would most likely achieve a balanced symmetrical face?
Answer: Everyone has some degree of facial asymmetry which makes your face Unique. The side profile photographs demonstrate a recessive chin profile, so consider placement of a chin implant to augment the chin forward for better facial balance and proportions.

Question: What surgeries would give me these results?
Answer: The digitally altered photograph do appear realistic, however there will not be any change to the your upper lip. The hanging columella can be reduced and a small amount of deprojection of the tip of the nose to be accomplished. Placement of a chin implant can augment the chin forward.

The Seattle

Plastic Surgery Center

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