Facial Plastic Surgery Questions and Answers: Part 7

Question: Rhinoplasty for wide nose?
Answer: A closed rhinoplasty approach can accomplish narrowing your nasal tip and nasal bridge line. All of the incisions are placed on the inside of the nose. An alar plasty is performed to narrow wide nostrils at rest. It’s also possible to release the lateral ligaments to reduce the dynamic flare and widening when you smile. With an alar plasty, then there’s a small incision at the base of the nostrils. For many examples and our current price list, please see the link below.

Question: Do I have a deviated septum?
Answer: To make the diagnosis of a deviated septum, requires a thorough examination of the internal portion of the nose. A cosmetic rhinoplasty is performed to straighten the external appearance of the nose when it’s crooked.

Question: Facelift, fat transfer, or filler?
Answer: At age 25, you certainly do not need a facelift. Fat injections are very inconsistent, we usually don’t recommend them. For a temporary augmentation of the mid-face, you can consider placement of fillers in the cheeks. For a permanent solution, you can consider cheek implants performed under a brief general anesthesia.

Question: Would I benefit from a facelift for the lax skin under my chin?
Answer: The lax skin that you’re having is probably genetic. Minimally invasive treatments will only give you a minimal, if any results. If this loose and inelastic skin is really bothering you at your age, the only option is to do a lower face and neck lift procedure, which can accomplish tightening this loose neck skin. Choose your plastic surgeon wisely based on extensive experience producing natural results.

Question: Swollen nose tip 3 years post-op: should I consider a revision?
Answer: From the one very limited photograph, there appears to be swollen supra tip, and a hanging columella.The hanging columella can be addressed with a revision rhinoplasty. If the supratip fullness is directly related to thick skin, then a steroid shot will be required. If the supratip fullness is related to excess cartilage, then a revision rhinoplasty would be required. A full set of facial photographs and in-person examination would be required to make that determination.

Question: Are a minilift or fillers the best option for a natural looking uplift at my stage of aging?
Answer: More information is needed, such as a set of pictures from inside profile demonstrating the laxity in The skin in your neck. A lower face and neck lift Will need to be performed to accomplish tightening loose and elastic skin in the neck itself.

Question: What type of surgery do I need to fix the tip of my nose?
Answer: A closed rhinoplasty procedure can accomplish shaving down the dorsal hump, refinement of the nasal tip cartilages, narrowing the bridge line and lifting the nasal tip with all of the incisions placed on the inside of the nose. It’s also important to release the depressor septi ligament, which dynamically pulls the tip downward when smiling. An alar plasty is performed when there’s wide nostrils present. Digital computer, imaging would also be helpful to understand what can be accomplished with your nose upon your facial features.

Question: Can a surgeon please explain the facility fee to me?
Answer: The facility fee refers to the operating room where your surgery is performed. Face lifts are not performed in an office, they are performed in an ambulatory surgery center. The cost of the operating room is the facility fee which includes the anesthesia machine, nursing personnel, equipment, supplies, sutures, etc.

Question: Should I consider a rhinoplasty revision or would a chin implant help me achieve a more balanced look?
Answer: From the one limited photograph, you have an overly projecting nose and an under projecting chin. A closed rhinoplasty revision can accomplish shaving down the residual dorsal hump, and slightly de-projecting the nose. Placement of a chin implant would accomplish Augmenting your chin forward for better facial balance and proportions, especially with respect to the projection of your nose from the side profile. A revision rhinoplasty is performed under general anesthesia, while placement of a chin implant can be performed under local anesthesia.

Question: Is it possible to just finely adjust the area right below the nose?
Answer: You have what’s called a hanging columella, and in particular, you probably have a prominent nasal spine. A columella plasty can be performed to trim this area back, which includes removal of extra skin and cartilage to tuck the hanging columella inwards. This can be accomplished with a closed technique with all of the incisions placed on the inside of the nose.


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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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