The Seattle

Plastic Surgery Center

William A. Portuese, M.D.

Facial Plastic Surgery Questions and Answers: Part 4

Question: How long is the lower facelift recovery & is there a type of person/skin that are more likely to have problems?
Answer: In our practice, we place drains underneath the skin and the neck for the first two days to minimize bruising swelling due to the fact that the blood is not trapped underneath the skin. The goal of a lower face and neck lift is to tighten loose facial and neck skin, tighten loose facial and neck muscles, lift the jowls, and remove fat deposits in the neck, which also includes a platysma plasty to significantly improve the jawline. Most patients are able to return to their social activities in about 10 days after the procedure. The incisions are placed in front and behind the ears. We also do not recommend any exercise for the first two weeks after the surgery. Carefully study your prospective surgeon’s facelift photo gallery, especially the after photos to see how well the incisions have healed in the sideburn area.

Question: Chin implants? Is there anything wrong with my chin?
Answer: From the one very limited photograph, it appears that there is recessive chin profile present. Consider placement of a chin implant to augment the chin forward for better facial balance and proportions. In our practice, we place chin implants under local anesthesia as an outpatient procedure which takes approximately 30 minutes.

Question: Would it be wise to get 2 surgeries a month apart?
Answer: From an anesthetic standpoint, it’s best to separate two general anesthetics about a month apart. If you’re going to perform both of these two procedures, it’s probably best to do the nose first and wait at least a month or two, and then undergo the brow bone reduction just due to the local swelling. When performing the rhinoplasty procedure, give some consideration to placement of a small chin implant to augment your chin, forward for a better facial balance and proportions, especially with respect to the projection of your nose. Digital computer, imaging of both your nose and chin from the side profile would be help on the education process.

Question: Does a Platysmaplasty with Lower Rhytidectomy meet my goals?
Answer: A lower face and neck lift with the platysma plasty can accomplish your goals. This procedure involves removal of fat deposits above and below the platysma muscle itself, a platysma plasty, tightening loose facial and neck skin and lifting the jowls. This procedure takes approximately 3 hours and is performed under general anesthesia. Anticipate two weeks of the visible bruising and swelling.

Question: Is it possible to get the outcome I desire?
Answer: The bulbous tip can be reduced, the dorsal hump shaved down, and the bridge line narrowed As well with all the the incisions placed on the inside of the nose. No external incisions are required and no painful packing is required.

Question: What procedure(s) would best improve my side profile?
Answer: The side-profile photographs demonstrate a recessive Chin profile for which a chin implant can improve. You also have fat deposits located above AND below the platysma muscle in the neck which will require a necklift procedure with a platysma plasty to remove both compartments of fat. Both procedures can be performed together. No skin removal is required.

Question: Would a revision help refine the tip more? Also make the nostrils a slightly more even?
Answer: Thick skin in the tip of the nose will prevent refinement in that area, so its very important have realistic expectations with a revision rhinoplasty. You can also try steroid shots applied to the tip of the nose from your original surgeon to see if that helps produce the bulbous nasal tip.

Question: What is wrong with my side profile as I can’t figure out what it is?
Answer: The side profile photographs demonstrate an overly projecting nose and an under projection of the chin. A closed rhinoplasty can accomplish it’s in the first round there decreasing the overall projection of the nose, lifting the tip, refinement of the nasal tip itself with all the incisions placed on the inside of the nose. No external incisions are required. Placement of a Chin implant could help augment the chin forward for better facial balance and proportions, especially with respect to the Nose from the side profile. Both procedures can be performed simultaneously.

Question: Do I have a tension nose and will a columelloplasty reduce the long tip and excess show seen in profile?
Answer: A closed rhinoplasty procedure can accomplish Reducing the hanging columella, lifting the nasal tip, shaving down the dorsal hump, and reducing the bulbous nasal tip with all incisions placed on the inside of the nose. Also important to release the depressor septi ligament which dynamically pulls the tip downward when smiling. No external incisions are required. An alar-plasty can accomplish narrowing wide nostrils.

Question: Is rhinoplasty at 66 years old risky?
Answer: As long as you’re an excellent health, you can certainly undergo a rhinoplasty procedure at age 66. Your age doesn’t dictate the cosmetic results. Choose your plastic surgeon wisely based on extensive experience producing natural results.

The Seattle

Plastic Surgery Center

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