The Seattle

Plastic Surgery Center

William A. Portuese, M.D.

Facial Plastic Surgery Questions and Answers: Part 02

Question: Primary or Revision Rhinoplasty cost? 
Answer: Since you’ve not had rhinoplasty, it should be the cost of the primary rhinoplasty. The bigger question is whether or not you need any cartilage grafting during your primary rhinoplasty procedure, so it this point you may not have any cartilage left over on the inside of your nose due to previous nasal surgeries. Ear cartilage may have to be an option, which is just a little more complicated.

Question:  Is this advisable to have blepharoplasty and rhinoplasty under the same anesthetic?
Answer: Not only is it advisable, we would highly recommended so that you have one anesthesia with one recovery period. Since rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery, It’s very important to choose your rhinoplasty specialist wisely based on extensive experience.

Question: hich procedure do you suggest for my chin?
Answer: The photographs demonstrate a very recessive chin profile and fat deposits in the neck above and below the platysma muscle. Consider placement of a large chin implant to augment the chin forward, and a neck lift procedure to remove fat deposits above and below the platysma muscle which also includes a platysma plasty. No skin removal is required.

Question: Do I have a weak chin? Any suggestions on what I should do next?
Answer: The Photographs demonstrate a weak and recessive mandible and chin profile for which a chin implant can significantly improve. Chin implants are manufactured in a large array of thicknesses, sizes, and shapes. They are usually placed through a small incision underneath the chin under local anesthesia as an outpatient procedure.

Question: How would you change my nose?
Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, decreasing the overall projection of the nose, and narrowing the bridge line with all the incisions placed on the inside of the nose. No external incisions are required, and no painful packing is required either. A septoplasty is performed in the back of the nose to improve air flow dynamics when it is crooked and blocking airflow. Both a septoplasty and a rhinoplasty can be performed simultaneously. Rhinoplasty is the most difficult operation to perform correctly in the entire field of cosmetic surgery, so to choose your surgeon wisely based on extensive experience producing natural results.


Question: Are there less invasive options that can minimize the appearance of a bony nose bridge?
Answer: A closed rhinoplasty approach is less invasive then open rhinoplasty, and a closed rhinoplasty approach can accomplish shaving down the hump, minimizing the bulbous tip, and placement of spreader grafts in the midportion of your nose where it is concave. The concave upper lateral cartilages in the mid vault are concave, and that makes your hump look bigger than it really is, especially on the three-quarter profile. You also have very thin skin, so all this shows through. Digital computer imaging would be helpful to understand what can be accomplished with the procedure. In our practice, we do not recommend fillers placed in the nose for a variety of reasons.

Question: Can a deep plane facelift be performed 2.5 years after a parotidectomy?
Answer: Yes indeed, a facelift can be performed after a parotidectomy. In our practice, we have done several of these successfully in last 25 years. Make sure you find a surgeon who is very familiar with the facial nerve anatomy, and preferably a surgeon who performed parotidectomy’s in the past and understands how to go about performing a facelift after that procedure. In addition, if you have sweating every time you’re eating over that area, that can be corrected as well.

Question: Lower blepharoplasty, RGP contact lense wearer – How long would I have to wait before wearing my lenses again after surgery?
Answer: A trans conjunctival lower blepharoplasty can accomplish removal of the puffiness in the lower lids created from the herniated fat bags. There’s two small incisions located on the inside of the eyelids. We recommend not wearing contact lenses for two weeks after the surgery.

Question: Is it possible to achieve the look in this photo without moving the tip up?
Answer: Much more information is needed, such as a full set of facial and nasal photographs from all angles to Make a determination about how best to proceed. Digital computer imaging of your nose from different angles can be accomplished. Also important to remember the nose is a three-dimensional structure, and rhinoplasty is performed at all three dimensions, so it’s important to look at all the angles, not just focused on one three-quarter angle. choose your rhinoplasty specialist wisely based upon extensive experience producing natural results.

The Seattle

Plastic Surgery Center


Award Winning Highly Rated & Reviewed plastic surgeon Dr & medical clinic serving Seattle Wa 98104, King County, Bellevue, Kirkland, and Surrounding Areas. We offer a variety of surgical procedures and non surgical treatments for enhancement and rejuvenation.

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