Facial Plastic Surgery Questions and Answers: Part 07

Question: Nasal wall is very high. Can this be fixed and how?
Answer: Your nasal sidewalls are very wide, especially on your right side. Low lateral osteotomies should be able to accomplish improvement in this area. Since it’s a revision rhinoplasty, an in-person examination is usually required because this is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery.

Question: Will this help my turkey neck?
Answer: Congratulations on your 130 pound weight loss once you get to your goal weight. Since you are 55 years old, and having had a significant deflation in your neck, you’re going to need a lower face and neck lift procedure to properly rejuvenate this area.

Question: Unhappy with side profile after rhinoplasty – will I need a revision?
Answer: It’s important to wait at least a year before contemplating undergoing a revision surgery To allow full healing to occur before embarking on a another procedure. If you were talking about this very small Residual dorsal hump, that would involve shaving down a millimeter of extra bone and cartilage.

Question: Alternatives to quinolone antibiotic for post facelift prophylaxis?
Answer: In our practice, there’s no reason to do post facelift prophylaxis, since we give antibiotics during the procedure itself. It’s very rare to have an infection after a facelift procedure list or some underlying immune issue or you’re a smoker.

Question: Why did one doctor tell me my nose was too thin to perform a rhinoplasty and another say it’s okay?
Answer: It is best to go on consultations with at least 3 very experienced rhinoplasty surgeons to get 3 expert opinion on your nose, since rhinoplasty is the most difficult operation to perform correctly in the entire field of cosmetic surgery. Digital computer imaging would also be helpful to understand what can be accomplished with your nose upon your facial features.

Question: Considering rhinoplasty for broken nose?
Answer: A rhinoplasty is performed to straighten the crooked nose and is done for cosmetic purposes. A septoplasty is performed in the back of the nose to improve airflow dynamics only. Both procedures can be performed simultaneously under one anesthesia with one recovery period. In our practice, we performed this surgery in a Medicare certified outpatient surgery center under general anesthesia administered by board certified physician anesthesiologists for patient safety and comfort.

Question: Is a platysmaplasty necessary? 34 years old, 5’7″, 160 lbs
Answer: The Photographs demonstrate fat deposits located above AND below the platysma muscle. Liposuction will be only minimally effective, since it is only removing the fat above the platysma muscle. A surgical neck lift with a platysma plasty is required when fat is removed from underneath the platysma muscle.

Question: What kind of rhinoplasty would be best suited for my nose?
Answer: The photographs demonstrate anoverly projecting nose and an under projecting chin. A closed rhinoplasty approach can accomplish shaving down the hump decreasing the overall projection and reducing the bulbous nasal tip with all the incisions placed on the inside of the nose. Consider placement of a chin implant to augment the chin forward for better facial balance and proportions, especially from the side profile. Augmenting your chin forward will make her nose looks smaller.

Question: Follow-up question: Regarding first consult for lower eye blepharoplasty. Thoughts?
Answer: In our practice, we definitely do not perform fat injections to cheeks for a variety of reasons. If you are trying to augment the cheeks, use fillers placed in the office setting, or cheek implants for permanent augmentation. A simple transconjunctival lower blepharoplasty can accomplish improvement to rejuvenate your lower eyelids.

Question: Recovery Comparison. How would you rate recovery of a neck lift and any other procedure to address the jowls?
Answer: The 1 very limited photograph demonstrates jowls, and significant fat deposits in the neck. A lower face and neck lift is going to be required. In our practice, we place drains underneath the skin in the neck for the first 48 hours. Most patients take a few medium strength Vicodin pain pills first few nights to help them get to sleep. Anticipate 2 weeks of visible bruising and swelling. Full healing takes 4-6 months.

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    The Seattle Rhinoplasty Center

    Seattle Nose Surgeon ®
    William Portuese MD
    Joseph Shvidler MD

    Seattle, Washington 98104

    (206) 624-6200

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