Question: I am looking into rhinoplasty, facelift, and necklift. I have braces, how will that affect my recovery?
Answer: Much more information is needed, such as your age, and a full set of facial photographs from all angles. A closed rhinoplasty approach can accomplish making the required changes to your nose with all incisions placed on the inside of it. No external incisions are required. Braces will have no effect with a rhinoplasty or any other facial cosmetic surgery. A neck lift is a component of a facelift in our practice.

Question: One year post surgery and still too big. What should I do?
Answer: Thick skin is a significant impediment to seeing refinement in the nasal tip, so it is very important have realistic expectations. You can also follow-up with your operative surgeon for steroid shots and taping which can be of some benefit. An alar-plasty can accomplish narrowing wide nostrils. This procedure can be performed under local anesthesia. The side profile photograph also demonstrates a recessive chin profile for which a chin implant could improve facial balance and proportions, especially from the side profile with respect to the overlying projecting nose.

Question: Follow-up question: Is transconjunctival skin pinch canthopexy to left eye and transposition to both eyes still valid?
Answer: The primary goal for upper eyelid surgery is to remove excess skin creating the hooded look and a small amount of fat on the inner corners next in the nose. The Incision is located in the upper eyelid crease. The primary goal for lower eyelid surgery is to remove the fat bags creating the puffy look through a trans- Conjunctival incision on the inside of the lower lids.

Question: Would you perform a revision or leave it be?
Answer: The photographs presented look like a very natural nose. If you were to do a revision, the amount of change would be pretty insignificant. There’s a bit of a hanging columella can be reduced but the overall nose looks very nice in the photographs. An in-person examination would be required to make any better determination.

Question: Is this goal photo a realistic rhinoplasty goal?
Answer: The photograph on the left shows an overly projecting nose, and an under projecting chin. A rhinoplasty procedure can accomplish decreasing the overall projection of the nose and shaving down the dorsal hump, but it is important to keep it natural looking. Consider placement of a chin implant to augment the chin forward which helps facial balance and proportions, especially from the side profile.

Question: My nose is too thin after rhinoplasty, is it possible to make my tip bigger?
Answer: It is possible to make the nose wider with a revision rhinoplasty procedure, but it is important understand this is more difficult due to the fact that there has been previous alterations to the normal anatomy and scar tissue formation. It is very important to know how much cartilage is left over on the inside of the nose for potential grafting purposes. The previous operative reports would also be helpful. Spreader graft placement in the midportion of the nose will help with widening that area.

Question: I want a small upturned nose. Is that possible?
Answer: There are limitations to what can be accomplished with a rhinoplasty procedure based upon your pertinent anatomy of your skin, bone, and cartilage. Digital computer imaging of your nose upon your facial features would be helpful to understand what can be accomplished. Rhinoplasty is the most difficult operation to perform correctly in the entire field of cosmetic surgery, So choose your surgeon wisely based on extensive experience.

Question: When can I start wearing makeup on my nose after rhinoplasty and alarplasty?
Answer: In our practice, we perform closed rhinoplasty with the incisions placed on the inside of the nose. Patients are able apply makeup at any time after the surgery. After a rhinoplasty procedure, anticipate a cast applied across the nose for one week, and visible bruising and swelling for two weeks. You will not be ready for a wedding at eight days after a rhinoplasty procedure.

Question: Can I get a revision at 9 months due to polly beak at 2 months post rhinoplasty?
Answer: It’s very important to know what is causing the Polly beak, is it thickened skin with fluid retention and scar tissue, or is it residual cartilage? A physical examination of the nose is required to make a determination about how best to proceed. Steroid shots control swelling in the tip of the nose, while revision surgery can shave down residual cartilage.

Question: How can I reduce internal scar tissue after a rhinoplasty surgery?
Answer: Revision Rhinoplasty is more difficult than a Primary Rhinoplasty, especially after 3 rhinoplasty procedures. A thorough internal and external examination of the nose will be required to determine the thickness of the skin and the extensive scar tissue formation. Always best to have copies of the operative reports to know what has occurred on 3 previous procedures. Steroid shots mixed with 5-FU can also be helpful to reduce scar tissue.