Facial Plastic Surgery Questions and Answers: Part 04

Question: Is it possible to get an ethnic/closed rhinoplasty without raising my bridge?
Answer: yes, a closed rhinoplasty approach can accomplish refinement of the nasal tip and narrowing the entire bridge line. To narrow wide nostrils going to require an alar-plasty.

Question: Do I need a revision rhinoplasty?
Answer: Since it is only been 4 months since her rhinoplasty procedure, its best to wait at least a year before embarking on another procedure to allow full healing before revising your nose. Rhinoplasty and revision rhinoplasty or the most difficult operations to perform correctly in the entire field of cosmetic surgery.

Question: I would like tips for an improved jaw line/chin. What are my options?
Answer: The Photographs are rather limited, and more information is needed such as your age, and this status of the skin tone in your neck. From the photographs, there is fat deposits located both above and below the platysma muscle in the neck so at a minimum, you are going to need a neck lift with a platysma plasty to significantly improve the jawline. If your skin tone is poor, then you will need a lower face and neck lift to tighten loose and inelastic skin in the neck itself.

Question: I just want the loose skin removed due to my 50 pound weight loss. Can the skin just be trimmed for a tighter look?
Answer: First of all, congratulations on the weight loss. Since the face and the neck had been deflated with the significant weight loss, you are going to have significant loose skin and muscles. A lower face and neck lift is going to be required to tighten loose facial and neck skin, tighten the 2 muscle cords in your neck, and remove any residual fatty deposits with liposuction in the neck as well. A skin only face neck would not last very long, so it is important to tighten the muscles and fascia underneath the loose skin.

Question: Would Morpheus8 be a good option for my turkey neck?
Answer: Since you lost a significant amount of weight, you have deflated the skin in your neck and have significant skin laxity. In addition, you also have residual fat deposits in the neck which can be located both above and below the platysma muscle in your neck. A surgical neck lift with skin tightening most likely going to be required to address all of your issues. Noninvasive treatments are not going to accomplish very much at this point.

Question: What are my options for minimizing the appearance of double chin and dent when smiling?
Answer: From the photographs presented, you have a recessive chin and fat deposits in the neck. Consider placement of a small chin implant and liposuction to remove the fat deposits above your platysma muscle. If the fat deposits are located below the platysma muscle, you’ll need a neck lift procedure with a platysma -plasty to significantly improve the jawline.

Question: Stage IV vs V Deep Plane Facelift?
Answer: From the photographs presented, you’re good candidate for a lower face and neck lift procedure. In our practice that accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the Jowls, and removing residual fat deposits in the neck which also includes a platysma plasty. You also have a recessive chin present, so Consider placement of a chin implant to augment your chin for better facial balance and proportions, and a better jawline.

Question: Ocularplastic surgeon versus general plastic surgeon for upper & lower blepharoplasty?
Answer: In our practice for over 30 years, we’ve never heard of a blepharoplasty causing decreased vision. If anything, a functional blepharoplasty increases a peripheral vision by removal of excess hooded skin. It’s very important to go to A surgeon who has lots of experience performing blepharoplasty. Study your perspective surgeon’s before and after eyelid photo gallery to make sure that it is extensive with Lots of results that you like and they look natural.

Question: Is my hyoid bone too low for chin liposuction?
Answer: Your hyoid bone is irrelevant. It’s very important to understand if there are two compartments of fat, and they’re located both above and below the platysma muscle in your neck. The majority of your fat deposits are located below the muscle, which will require a neck lift procedure with a platysma plasty to significantly improve the jawline. Liposuction alone will only remove the fat deposits above the muscle, which will be an incomplete removal.

Question: Why cheek implants vs. fat grafting or fillers? Or why not?
Answer: Cheek implants offer very predictable augmentation which is permanent. The implants can be placed thru an intra oral approach under either local or general anesthesia. Fillers are all temporary, and fat grafting is very inconsistent, just like you’ve experienced.


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    William Portuese MD
    Joseph Shvidler MD

    Seattle, Washington 98104

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