Facial Plastic Surgery Questions and Answers: Part 10

Question: I had a lip lift (with a face/neck lift). The corners of my mouth now slope downward. Am I a candidate for a revision?
Answer: The lip lift you have had raised the central part of your upper lip, but not the outer corners. If you try to lift the outer corners, you’re gonna have visible scars present.

Question: 1.73cm, 80kg, male, 28 years old, brown skin – I want to know if have ptosis or not?
Answer: Your photographs are rather limited, but it does appear that you may have ptosis on your upper eyelids, which is a weakness of the eyelid muscle. Ptosis repair is usually performed by a ocular plastic surgeon. A cosmetic blepharoplasty procedure will not help with this issue.

Question: Different nasal sides after 2 rhinoplasties, can this be fixed?
Answer: There’s no perfect nose, and rhinoplasty can give some improvement, usually in the 85 to 95% range. Never 100%. You can consider placement of either a cartilage graft or a fascia graft to that area to try to make it look more symmetrical. A third rhinoplasty procedure is going to be less predictable than your first, so it’s important to have realistic expectations.

Question: I’ve had a few neck fusions and someday down the road will possibly need more. Would I be able to get Kybella?
Answer: From the limited photographs, there appears to be recessive chin profile for which a chin implant can improve. There is also significant fat deposits located above AND below the platysma muscle in the neck. To remove those fat deposits will require a neck lift procedure with a platysma plasty. If you are over age 50 and have loose and inelastic skin in the neck, then a lower face and neck lift is going to be required.

Question: I don’t like how big my nostrils are and fat around it. What would be the best surgery?
Answer: A full set of facial and nasal photographs from all angles are going to be required to make a determination about how best to proceed, since the nose is a 3-dimensional structure, and rhinoplasty is performed in all 3 dimensions. An alar-plasty is performed to narrow wide nostrils. The bulbous nasal tip is reduced with a closed rhinoplasty approach.

Question: Is jowl/jawline liposuction safe?
Answer: In our practice, liposuction of the neck is only performed underneath the mandible and into the neck. Never above the jawline. A neck lift procedure is required if there is fat deposits located below the platysma muscle which also included a platysma-plasty.

Question: Fluid behind eardrum after rhinoplasty?
Answer: Fluid behind your eardrum is related to eustachian tube dysfunction, which does not allow adequate aeration and pressure equalization like when you go up/down in an airplane. A rhinoplasty itself will not cause eustachian tube dysfunction. If there’s some other swelling and edema in the back of your nasopharynx(Not the external portion of your nose) that can create issues, such as allergies, chronic, sinusitis, and large adenoids.

Question: Eyelids naturally heavy & sty may have left with with ptosis – best minimal procedure?
Answer: It’s difficult to tell from the photographs presented, but you do have a symmetrical creases on your upper lids. An – person examination is going to be required to make a determination about how best to proceed. The asymmetrical skin and creases can be improved with a cosmetic blepharoplasty, while ptosis repair requires tightening, one or both of the muscles that open the eyelids.

Question: Do I need eyelid surgery?
Answer: A very conservative upper eyelid lateral skin only blepharoplasty can accomplish your goals in the outer 1/3 of your upper lid. This procedure can be performed under local anesthesia as an outpatient procedure.

Question: Can lower eyelid fat repositioning damage the tear trough area?
Answer: In our practice, we only do fat repositioning for upper eyelid surgery when needed. We perform a transconjunctival conservative fat removal through the inside of the lower lids to rejuvenate them.

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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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