Facial Plastic Surgery Questions and Answers: Part 06

Question: Can I still do rhinoplasty with a fractured knee?
Answer: Yes you can, but it’s probably best to figure out if you can need plastic surgery on your knee. Best to spread out two general anesthetics a month apart.

Question: I had a rhinoplasty 13 months ago. As you can see I require another surgery. How complicated is it to fix my nose?
Answer: From the photographs presented, your nose looks very good with the exception of the residual dorsal hump and high glabella. This can be shaved down, and will probably require osteotomies. Best to follow up with your operative surgeon since they know what was done in the first procedure. A double board-certified ENT/ facial plastic surgeon should be able to address internal breathing issues as well as cosmetic issues. Revision rhinoplasty it Is less predictable, and more complicated than a primary rhinoplasty.

Question: What causes a sideways nose like this & can it be corrected with surgery?
Answer: You appear to have some degree of facial asymmetry,so it’s important to have realistic expectations regarding straightening the nose even after a rhinoplasty surgery. You have a large dorsal hump which can be shaved down to give you a better side profile, and your mildly crooked nose can be improved, but not perfect.

Question: Will harvesting of conchal cartilage from my ears affect hearing in any way, even if small? 
Answer: For over 30 years, we have performed harvesting ear cartilage and no patients have ever complained about hearing loss.

Question: Can the size of nostril & hooked/large projection be fixed with reducing the middle skin of the nose? 
Answer: Based on these photographs, you do not have an overly projecting nose, and you do not have a hanging columella. Best to just leave your columella alone. The only thing you have is wide nostrils, therefore consider performing and alar-plasty under local anesthesia as an outpatient procedure.

Question: How does deprojection of the nose change the front view?
Answer: A full set of facial and nasal photographs from all angles are required to make a determination about how best to proceed. It’s important to know how much projection of your nose you currently have to determine how much gets de- projected. It also depends on what’s causing the projection, is it nasal tip cartilages or the dorsal hump. As a general rule, the nose can be de-projected a few millimeters, but the more it gets deprojected you do get a bit of a flaring effect which is usually commentated by narrowing the nasal tip cartilages and the bridge line. It’s important to understand that the nose is a three-dimensional structure, and surgery is performed at all three dimensions.

Question: Will threads damage the tissue to the point of a facelift not being an option?
Answer: Threads will not affect the option of doing a facelift later on down the road. In our practice, we have removed many of the old permanent threads in the face that were simply doing nothing and we’re not holding any tissue together.

Question: Should I have upper and lower eye surgery?
Answer: The primary goal of upper eyelid surgery is to get rid of excess skin creating the tired look in your upper eyelids. The primary goal for lower eyelid surgery to get rid of the fat bags creating the puffy look. The incision for the upper lids is located increase, while the incision for the lower lids is completely placed on the inside of the eyelid known as a trans-conjunctival approach. No external incisions are required. Choose your surgeon wisely based on extensive experience producing natural results.

Question: Best option for a near non-existent jawline?
Answer: The Photographs demonstrate only a slight recessive chin, and a small chin implant can augment the chin forward. You also have significant deposits in the neck located above AND below the platysma muscle in the neck, and a neck lift procedure is going to be necessary. During the neck lift procedure, liposuction accomplishes removal of the fat deposits above the muscle, while surgical extraction of the fat deposits below the muscle must Performed. A platysma plasty is then required to significantly improve the jawline. No skin removal is necessary.

Question: Can a rhinoplasty reduce my bridge and make my nose “more flat”?
Answer: Yes, closed rhinoplasty can accomplish decreasing the overall projection of the nose, shaving down the dorsal hump, reducing the hanging columella and narrowing nasal tip with all the incisions placed on the inside of the nose.


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    Anchorage AK 99503

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