The Seattle

Plastic Surgery Center

William A. Portuese, M.D.

Facial Plastic Surgery Questions and Answers: Part 05

Question: Advice requested, neck lift results. Should I seek a revision?
Answer: Much more information is needed, such as a full set of facial photographs from all angles that are unadulterated to make a determination about what your next best step should be. You appear to have resistant platysmal bands, which can be treated with a combination of Botox, and a myotomy placed in the band themselves during a lower face and neck lift procedure.

Question: Can I get a revision rhinoplasty to improve a dent on my nose bridge and breathing difficulties? 
Answer: Much more information is needed such as a full set of facial and nasal photographs from all angles,and a copy of the operative report to find out what was accomplished in the first procedure. If you’re having breathing difficulties, you may need a septoplasty, turbinate surgery, or nasal valve repair. It’s very important to know how much cartilage is left over on the inside of the nose for potential grafting purposes. An in – person examination is most likely going to be required to make that determination.

Question: Neck laxity and Morpheus8?
Answer: Noninvasive treatments will be a waste of time and money at your age. The goal of a lower face and neck lift is to tighten loose facial and neck skin, tighten loose facial and neck muscles, lift the jowls, and remove the fat deposits that are present in your neck above and below the platysma muscle. Choose your facelift surgeon wisely, based on extensive experience producing natural results.

Question: Can an upper lip lift change the shape of nose and nostril openings? I need to know because I will be getting a rhinoplasty?
Answer: In our practice, we do not perform an upper lip lift due to extensive scarring we have seen with this operation. Perform the rhinoplasty first, since it will give you the majority of the changes

Question: What is the procedure to fix the upper third of the nose like this?
Answer: Once the dorsal hump has been removed, osteotomies are then required to narrow the bridge line. This involves making 2 small cuts in the nasal bones which accomplishes narrowing and closing the open roof created from the hump removal itself.

Question: Do I need a revision? Will the bump go away? In certain light it is much more obvious?
Answer: The decision to undergo a revision rhinoplasty is made at one year after year primary rhinoplasty. In the meantime, you should follow up with your operative surgeon about nuances regarding the healing process at this point

Question: What would be the best treatment for my asymmetrical nose?
Answer: A closed rhinoplasty can accomplish straightening the crooked nose and making it more symmetrical. The dorsal hump can be shaved down, and spreader graft placement can be used to adjust inwardly displaced upper lateral cartilages in the midportion of the nose. The nasal tip can be refined if necessary. All of the incisions are placed on the inside of the nose. Digital computer imaging would be helpful to understand what can be accomplished with the procedure. To make a diagnosis of a deviated septum requires a thorough internal examination of the nose. A septoplasty is only performed for airflow improvement.

Question: What kind of revision is suitable for my chin?
Answer: It appears that the tail of the chin implant has slipped below the edge of the mandible, and is probably palpable upon examination. In our practice, should that happen. we will take the implant out through submental approach, create the appropriate pocket, and reinsert the implant in the proper position.

Question:  What treatment is best to treat my double chin? Is Kybella appropriate?
Answer: From the limited photographs, it appears that you have a small amount of fat deposits located above the platysma muscle, therefore simple liposuction should probably solve your issue. This can be performed under local anesthesia. When patients have significant fatty deposits in the neck and are located below the platysma muscle, and neck lift is then required along with a platysma-plasty, which is performed under general anesthesia.

Question: What’s the best solution to tighten up the chin, aka double chin?
Answer: The photographs demonstrate fat deposits in the neck and a recessive chin profile. More information is needed such as your age and the status of her skin tone will determine which procedures are best to perform. The fat removal can be accomplished with liposuction, and consider a chin implant to augment the chin forward which gives better structural support for the soft tissues in the neck.

The Seattle

Plastic Surgery Center


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