The Seattle

Plastic Surgery Center

William A. Portuese, M.D.

Facial Plastic Surgery Questions and Answers: Part 6

Question: Would I benefit from a rhinoplasty?
Answer: Yes indeed, you could benefit from a rhinoplasty, since you have a very prominent nose. A closed rhinoplasty approach can accomplish shaving down the dorsal hump, decreasing the overall projection of the nose, straightening the nose, and reducing the hanging columella present. All of the incisions are placed on the inside of the nose. No external incisions are required, and no painful packing is required either. Digital computer imaging would also be helpful to understand what can be accomplished with your nose upon your facial features. Rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, so choose your plastic surgeon very wisely based on extensive experience. Study your perspective surgeon’s rhinoplasty photo gallery to make sure that it’s full of results that look natural.

Question: I am researching facelifts and I came across a 3 day facelift , less invasive & downtime. What can you tell me about results?
Answer: A full set of facial and neck photographs from all angles are required to make a determination about which type of facelift you are a candidate for. A mini facelift will give you mini results, and we rarely ever perform them. In our practice, 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 with liposuction, which also includes a platysma plasty to significantly improve your jawline. Most patients have some degree of visible bruising and swelling for 10 days after the surgery, and are then able to return to their normal activities.

Question: What procedure should I do about my double chin?
Answer: The photograph is rather limited, but it appears there’s fat deposits below the platysma muscle which requires a surgical necklift to remove that fat deposit below the muscle itself. Liposuction can only remove the fat deposits above the muscle. A platysma-plasty is also performed. No skin removal is necessary.. When patients have a recessive chin profile, consider placement of a chin implant to augment the chin forward for better structural support for the soft tissues in the neck.

Question: What are the possibilities for fixing my hanging columella (least invasively) while keeping my Italian looking self?
Answer: The Limited photographs demonstrate ad overly projecting nose with a dorsal hump,a hanging columella and a recessive chin profile. Consider a closed rhinoplasty approach to accomplish decreasing the overall projection of the nose, shaving down the dorsal hump, and reducing the hanging columella with all the inscisions placed on the inside of the nose.Consider placement of a chin implant simultaneously to augment the chin forward for better facial balance and portions from the side profile. Performing just a columella-plasty we’ll leave the nose more unbalanced than it already is, and make the dorsal hump more prominent due to the decrease in projection of the nasal tip that ccurs with the columella-plasty.

Question: Wrinkley eyelids at age 44, interested in a blepharoplasty. Should I be worried about looking like someone else?
Answer: An upper blepharoplasty procedure can accomplish removal of the Hooded and excess skin in the upper eyelids. A properly performed upper blepharoplasty procedure can accomplish rejuvenation, and not making you look like someone else.

Question: Would chin surgery be sufficient to balance my facial features or is jaw surgery the better option?
Answer: The side profile photographs demonstrate a recessive chin profile. Placement of a chin implant Is much less invasive and can be performed under local anesthesia as an outpatient procedure which takes approximately 30 minutes. Jaw surgery is performed by an oral surgeon under general anesthesia in a hospital setting with an overnight stay at the hospital, and is much more invasive. Jaw surgery is usually performed when the teeth are significantly out of alignment.

Question: Would another procedure make this worse?
Answer: A full set of facial photographs from all angles are required to make a determination about undergoing your third rhinoplasty procedure. Copies of the operative reports would also be helpful. It’s important understand that bone is living tissue and can grow back, usually about 10% of the time.

Question: Can you advise on pollybeak deformity from my rhinoplasty over a year ago?
Answer: The photographs do not demonstrate to Polybeak deformity, you have a hanging columella. If you’re looking to get more of a supratip break, then follow up with your operative surgeon for a steroid shot.

Question: Is it possible to get a my bump reduced without affecting my tip or front view of my nose?
Answer: It’s important to remember that the nose three-dimensional structure, and rhinoplasty is performed in all three dimensions. A closed rhinoplasty approach can accomplish shaving down the dorsal hump, narrowing the bridge line, and it is possible to just leave the tip alone as long as it’s balanced with the remainder of the new nose. All of the incisions are placed on the inside of the nose. No external incisions are required, and no painful packing is required either.

Question: Am I a non-surgical nose job candidate?
Answer: In our practice we do not recommend fillers placed in the nose for a variety of reasons. A closed rhinoplasty procedure can accomplish making the overall nose smaller, shaving down the dorsal hump, and narrowing the bridge line. All incisions are placed on the inside of the nose. No external incisions are required and no painful packing is required either.

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