Facial Plastic Surgery Questions and Answers: Part 3

Question: Closed Rhinoplasty to deproject/ reduce length of a long ethnic nose?
Answer: In our practice for over 30 years, we have only performed closed rhinoplasty with excellent results. All of the incisions are placed on the inside of the nose. No external incisions are required, no painful packing is required either. Digital computer imaging of your nose upon your facial features would also be helpful in the education process to understand what can and cannot be accomplished. Study your perspective surgeon’s before and after closed rhinoplasty photo gallery to make sure that you see lots of natural results.

Question: Is the ‘after’ result possible on my nose?
Answer: No, that result is not possible to de-project your nose that amount. It’s important to understand that the nose is a three-dimensional structure, and plastic surgery is performed in three dimensions. The healing process also occurs in three dimensions. It’s important to do imaging from multiple different angles.

Question: Genioplasty or chin implant for chin recession?
Answer: A genioplasty is performed by an oral surgeon under general anesthesia in a hospital setting with an overnight stay at the hospital, and is usually performed when the teeth are significantly out of alignment. A chin implant is performed under local anesthesia in the office setting, which takes about 30 minutes and is much less invasive.

Question: Bossae, able to be fixed with a revision?
Answer: The bossa are the result of your tip cartilages that have had some type of procedure done to them with very thin skin. A revision rhinoplasty can reduce the appearance of those. An in person examination and a copy of the operative report would be very helpful to understand what was accomplished in the primary procedure.

Question: I had a facelift & neck lift in March of 2020. I’m not happy. Can a revision take care of this?
Answer: A full set of facial photographs from all angles in a chin neutral position are required to make a determination about how best to proceed. Another lower face and neck lift should be able to address tightening loose facial and neck skin.

Question: Septoplasty and turbinate reduction – local or general anesthesia?
Answer: It would be very painful and difficult to perform a septoplasty and turbinate reduction under local anesthesia. In our practice, we perform these two procedures under a brief general anesthesia as an outpatient procedure.

Question: How safe is giving a patient a shot of Demerol & 10mg of valium before a mini face lift? 
Answer: Mini facelifts tend to give mini results, and we rarely perform them for that reason.A Mini facelift can be performed under local anesthesia, with sedation, or by an anesthesiologist. Just depends on patient safety, and comfort.

Question: Under eye wrinkles/folding skin – what to do?
Answer: The determination about removing extra skin on the lower lids is made at rest, not one smiling. An in person consultation would be required for that. Try placement of some Botox in your crows feet, which may help.

Question: Would I be a good candidate for upper and lower blepharoplasty?
Answer: The pictures are rather limited, but it does appear that your possible candidate for a blepharoplasty on both your upper and lower lids. The primary goal for upper eyelid surgery is to get rid of the hooded and excess skin and a little bit of fat located in the upper eyelids. The incision is located directly in the upper eyelid crease. The primary goal for lower eyelid surgery is to remove the fat bags in the lower lids creating the puffy look. We remove that fat through an incision on the inside of the lower lid called a trans conjunctival approach. This procedure is performed under general anesthesia takes about one hour, and anticipate about two weeks of visible bruising and swelling.

Question: Is this due to a deviated septum or something with the nasal tip?
Answer: Are the diagnosis of a deviated septum must be made from a thorough internal examination of the nose. A rhinoplasty can accomplish refinement of the nasal tip cartilages, narrowing your nostrils, and narrowing the bridge line.


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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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