Facial Plastic Surgery Questions and Answers: Part 09

Question: Where are spreader grafts harvested from during Rhinoplasty?
Answer: In our practice, we usually harvest the spreader grafts from the dorsal hump, which is composed mostly of cartilage itself. If there is no dorsal hump removal, then the spreader graphs are harvested from the nasal septum. If you have a deviated septum that is significant enough causing airflow issues, you definitely should have that fixed simultaneously, otherwise your nasal obstruction will probably get worse after a rhinoplasty if you’re trying to make the nose smaller.

Question: Should I get cheek implants? If so, should they be malar or submalar?
Answer: From the photographs presented, you appeared to be a candidate for malar implants. Cheek implants are manufactured in a large array of thicknesses and shapes, and are usually placed through an intra-oral approach under general anesthesia as an outpatient procedure. They offer a permanent augmentation to the mid-face when patients have a flat cheek profile as demonstrated in the photographs.

Question: Is it possible to correct the side view of my nose while keeping the front the same?
Answer: There will be some slight changes to the front profile of your nose, however most of the changes will occur from the side profile. A closed rhinoplasty approach can accomplish reduction of the bulbous tip, decreasing the overall projection of the nose, and straightening narrowing the bridge line with all of the incisions placed on the inside of the nose. The side profile photographs demonstrate an overly projecting nose and an under projecting chin. It’s only possible to de-project the nose a few millimeters, so consider placement of a chin implant to augment the chin forward for better facial balancing portions, especially with respect to the overly projecting nose from the side profile. Placement of a chin implant will make your nose look more proportional to your face.

Question: Is liposuction of neck and chin with masseter Botox enough to deal with this?
Answer: A full set of facial photographs from all angles in a chin neutral position are going to be required to make a determination about how best to proceed. Your BMI also needs to be below 34. It’s important to understand you have fat deposits above AND below the platysma muscle in the neck. Liposuction can accomplish removal of fat deposits above the platysma muscle In the neck, while a surgical neck lift is required to rear the fat deposits below the platysma muscle the neck.

Question: What could I do to get rid of the fat under my chin and tighten my jawline?
Answer: From the photographs presented, there appears to be loose skin in the neck, fat deposits in the neck, and a recessive chin profile. To address the fat removal and tightening the skin in the neck requires a lower face and neck lift procedure. Also consider placement of chin implant to augment the chin forward for better facial balance and proportions. A lower face and neck lift also significantly improves the jawline with a platysma-plasty.

Question: Eyelid Lift: Should I do upper and lower?
Answer: From the one very limited photograph, it appears that there’s hooded and excess skin on the upper lids, and puffiness with fat bags in the lower lids. Both your upper and lower eyelids can be improved with an upper and lower blepharoplasty. Upper eyelid surgery is performed through an incision directly the upper eyelid crease with removal of hooded and excess skin in the upper lids. The fat bags in the lower eyelids is with a sub-conjunctival approach on the inside lower eyelids which prevents an external incision.

Question: Rhinoplasty, nose tip reduction?
Answer: A full rhinoplasty is going to be required in order to reduce the dorsal hump, refine the nasal tip and narrow the bridge line. A closed rhinoplasty approach can accomplish these goals by placement of all incisions on the inside of the nose.

Question: If I get a septoplasty will it fix the curve in my nose?
Answer: No a septoplasty will NOT fix the curve in your nose. A septoplasty is performed in the back of the nose to only improve airflow. A cosmentic rhinoplasty will straighten the crooked nose. Both procedures can be performed together under one anesthesia with one recovery period

Question: Would AccuTite help address under eye bags and circles? Hoping to avoid surgical procedures
Answer: Noninvasive treatments are not going to make the 6 herniated fat compartments in your lower lids go away. A trans-conjunctival lower blepharoplasty can accomplish removal of those fat deposits creating the Puffy look. All The incisions are on the inside of the eyelid and the procedure is performed under a brief general anesthesia as an outpatient procedure.

Question: Am I an ideal candidate for a chin implant and will this make my nose appear smaller?
Answer: A chin implant is going to augment your chin forward for better facial balance and proportions. Most of the augmentation is from side profile, so it may make your nose look slightly smaller but only from the side profile. If You’re trying to make your nose look smaller, then consider a rhinoplasty procedure In addition to a chin implant. Chin implants can be performed under local anesthesia, while a rhinoplasty procedure is performed under general anesthesia.


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    Anchorage AK 99503

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