Facial Plastic Surgery Questions and Answers: Part 9

Facial Plastic Surgery Questions and Answers: Part 9

Question: How much would a rhinoplasty be for a very small hump on my nose?
Answer: The photographs demonstrate an overly projecting nose with a dorsal hump, and wide nasal bones and inverted upper lateral cartilages in the midportion of the nose. A full and closed rhinoplasty is going to be required. The price of rhinoplasty includes the operating room, surgeon’s fees, and the anesthesiologist fee. For more information and our current price list, please see link below.

Question: I am thinking about getting a Alar Reduction. What techniques would I use to narrow my nose?
Answer: An alar plasty is performed to narrow wide nostrils. This procedure involves removal of a wedge of skin at the base of the nostrils under local anesthesia.

Question: Spreader grafts for valve collapse?
Answer: Spreader grafts widen the mid vault of the nose when there is a inverted upper lateral cartilages in the mid portion. They help prevent the hourglass affect. It does not raise the bridge or make the nose larger.

Question: What rhinoplasty procedures would I need to achieve this result? Natural, ethnic rhinoplasty.
Answer: A closed rhinoplasty approach can accomplish your goals with all incisions placed on the inside of the nose. No external incisions are required. The morphed photographs do appear realistic. To obtain these results, the dorsal hump must be shaved down, a small amount of cephalic trim removed from the nasal tip cartilages, and osteotomy’s placed in the nasal bones to narrow them. You may also need spreader graphs to prevent the upper lateral cartilages from collapsing inward. Very important to release the depressor septi ligament which dynamically pulls the tip down when smiling. Rhinoplasty is a very difficult endeavor, so it’s important to choose your surgeon wisely based on extensive experience.

Question: Why do opinions vary from doctor to doctor regarding the best treatment for loose neck skin and jowls?
Answer: In our practice, a lower face and neck lift accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, removing fat deposits in the neck located above and below the muscle lifting the jowls and performing a platysma-plasty. This is the procedure that you need based upon the photographs presented which demonstrate loose skin, neck cords, and residual fat deposits in the neck and addition to jowls.

Question: Is it possible to reduce projection but keep a slim nose? 
Answer: The Side profile photographs demonstrate an overly projecting nose and under projecting chin. A closed rhinoplasty approach can accomplish shaving down the dorsal hump and decreasing the overall projection of the nose in addition to straightening it and refining the nasal tip and bridge line with all of the incisions placed on the inside of the nose. Consider placement of a chin implant to augment the recessive Chin forward for better facial balance and proportions, especially with respect to the overly projecting nose from the side profile.

Question: What would the surgical plan of action be to achieve a nose shorter in length and closer to face?
Answer: A closed rhinoplasty approach approach can accomplish shortening the nose, decreasing the overall projection, and reducing the hanging columella with all the incisions placed on the inside of the nose. This is a major rhinoplasty. Only a very small amount of change will occur from the frontal view.

Question: Do I need chin implants and a rhinoplasty?
Answer: A chin implant and a rhinoplasty can be performed together or separately. Chin implants if done separately can be done under local anesthesia as an outpatient procedure, while rhinoplasty must be performed under general anesthesia. You would get more of an improvement from a chin implant itself, since your nose looks pretty good already.

Question: Would a mini facelift help define my jaw better?
Answer: A mini facelift does not address your neck. You need a neck lift procedure, which includes removal of the fat deposits located both above and below your platysma muscle, in addition to a platysma plasty to significantly improve the jawline. At age 32, your skin tone is fine, and no skin removal is necessary. You also have a recessive chin profile, so give some consideration to placement of a small chin implant to augment your chin forward, which will also help improve your jawline and be complementary to the neck lift procedure.

Question: After 1st Rhinoplasty everyone thinks I have cheek filler now. What should my next steps be?
Answer: From the photographs presented, it does appear from the frontal profile that you had a nice conservative improvement to your nose that looks very natural. Revision rhinoplasty is more difficult than a primary rhinoplasty, so it’s important to have realistic expectations. You should be able to get another conservator improvement by narrowing your bridge line and performing an alar plasty to narrow your nostrils. The thick skin and the tip of your nose is going to prevent refinement in that area.

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