Facial Plastic Surgery Questions and Answers: Part 03

Question: Are my expectations realistic?
Answer: The Photoshop results do appear overly-realistic, and are probably not possible. It’s also important not to give a pinched appearance as well. The thickness of the width of the tip is composed of thick skin and wide cartilages. The amount of each one of those components must be determined at the time of the in-person consultation to determine how much you are able to narrow the bulbous tip. Thick skin in the tip of the nose prevents refinement in that area.

Question: How do I reduce the dynamic flare of my nose?
Answer: A Closed rhinoplasty approach can accomplish releasing the depressor septi ligament which dynamically pulls the tip downward when smiling. It’s also possible to reduce the widening effect dynamically from the frontal projection at the same time.

Question: Time between procedures?
Answer: Is probably best to wait at least a month in between two Major surgical procedures to allow your body to heal and get over the anesthesia.

Question: Should I get rhinoplasty to fix deviated septum and off-centre nasal bones?
Answer: A septoplasty is performed in the back of the nose to improve airflow dynamics when there’s a deviated septum present blocking airflow. You have to prove medical necessity first, And then a septoplasty is billed to your medical insurance after preauthorization. Rhinoplasty accomplishes cosmetic straightening of the nose from the front profile. Expect to pay for that component yourself. Both procedures can be performed together under one anesthesia with one recovery period.

Question: Can a cheek implant be a substitute for a facelift?
Answer: No, a cheek implant augments the mid-face, while a face lift accomplishes lifting the neck and lateral face. The goal of a facelift is to tighten loose facial and neck skin, tighten loose facial and neck muscles, perform a platysma-plasty which addresses the two cords in the front part of your neck, lift the jowls, and tighten the SMAS in the lateral face and remove fat deposits in the neck when necessary.

Question: Am I a good candidate for rhinoplasty and which approach (open or closed) is best for me?
Answer: A closed rhinoplasty approach can accomplish decreasing the overall projection of the nose, shaving down the dorsal hump, refining the nasal tip and narrowing the bridge line with all the incisions placed on the inside of the nose. No external Incisions are required. Thick Skin in the tip of the nose is going to prevent refinement in that area, so you will most likely require a few steroid shots for several months after the procedure to prevent a Polybeak deformity.

Question: Which order is best If you are using two different surgeons, facelift then fat transfer or vice versa?
Answer: In our practice, we do not recommend routine fat transfers to the face for a long variety of reasons. If you’re still intent on doing it, it’s probably best to do the facelift first and in fat grafting second.

Question: Direct excision neck lift. Any opinions on this technique?
Answer: In our practice for over 25 years, we have never had to perform this procedure since the scars are quite visible. When. there is loose and inelastic skin the neck, that excess skin is removed from behind the ears during a lower face and neck lift which needs to be performed. This also includes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and removing fat deposits above and below the platysma muscle in the neck which also includes a platysma-plasty.

Question: Am I a good candidate for submental liposuction or should I consider other options?
Answer: The photographs you have presented demonstrate a recessive chin profile, along with fat deposits located both above and below the platysma muscle in your neck. Liposuction can only accomplish removal of fat deposits above the platysma muscle, which won’t be very effective. Most of your fat deposits are below the muscle, which requires a neck lift procedure to remove the deep neck fat. This also includes a platysma-plasty to significantly improve the jawline. In addition, Consider placement of a chin implant to augment your chin forward for better structural support for the soft tissues in the neck. Both a neck lift and a chin implant can be performed together under one anesthesia with one recovery.

Question: Non-invasive options or a neck lift – What can be done to improve my turkey neck?
Answer: At age 55, you going to require a lower face and neck lift procedure. This includes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and removing fat deposits in the neck in addition to a platysma-plasty to significantly improve the jawline. Noninvasive treatments will give minimal if any improvement.


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    The Anchorage Center for Facial Plastic Surgery

    The Anchorage Center for Facial Plastic Surgery ®

    510 West Tudor Rd Suite 7
    Anchorage AK 99503

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