The Seattle

Plastic Surgery Center

William A. Portuese, M.D.

Facial Plastic Surgery Questions and Answers: Part 09

Question: Getting deep plane facelift & neck lift, do I also need a chin implant?
Answer: Your photographs are rather limited, but it does appear that you have a recessive chin, therefore, a chin implant would be of some benefit to give you a better jawline results from your face and neck lift procedure.

Question: Looking for ways to fix my chin, preferably permanent, any suggestions?
Answer: The photographs demonstrate a recessive chin profile which chin implant can improve. Chin implants are manufactured in a large array of thicknesses, sizes, and shapes. In our practice, we use Implantech brand of solid silicone chin implants with an excellent success rate for over 25 years. Placement of the chin implant can be performed under local anesthesia as an outpatient procedure which takes approximately 30 minutes.

Question: Can this be fixed through cartilage grafting to give my bridge some definition?
Answer: No, a full revision closed rhinoplasty is going to be required with osteotomies to narrow the bridge line and close the open roof created from the hump removal itself. You also have a poly-beak deformity with residual cartilage in the dorsum which needs to be shaved down as well.

Question: 115lb weight loss – what can I do to improve my jawline/jowls?
Answer: Much more information is going to be needed, such as a full set of facial and neck photographs from all angles with your hair pulled back behind your ears, your age, and the skin tone quality in your neck itself. Most likely, you will need an in- person examination to determine the skin tone issue,which will determine which procedure is required.

Question: Can braces after a chin implant cause bone loss?
Answer: No, braces simply move your teeth so they fit together better, and a chin implant simply augments a recessive mandibular bone. Both procedures are independent of each other.

Question: What treatments would help me achieve the Snapchat filter version of myself?
Answer: If yu are trying to accomplish changes to your nose, a full set of facial photographs from all angles are required to make a determination about being a candidate for a rhinoplasty procedure. The nose is a 3-dimensional structure and rhinoplasty is performed in all 3 dimensions. Digital computer imaging would be helpful to see what your new nose would look like upon your facial features. To narrow the bridge line requires osteotomies placed in the nasal bones. To narrow wide nostrils requires an alar-plasty.

Question: Is it possible to undergo a rhinoplasty that will only change my side profile and not the front profile?
Answer: The nose is a 3-dimensional structure, and rhinoplasty is performed in all 3 dimensions. Shaving the dorsal hump down will create a flat top, open roof nasal deformity. Osteotomies are mandatory to be able to close the open roof created from the hump removal itself. It is possible to minimize the changes from your front profile, so its best to explain that to your Surgeon. Digital computer imaging would be helpful to understand what can and cannot be accomplished with your nose upon your facial features. Rhinoplasty is a very difficult endeavor, so choose your surgeon wisely based on extensive experience.

Question: Little result from Lower Blepharoplasty and I’m looking for a second opinion on how to fix my eyes?
Answer: From the limited photos, it appears that there is still residual herniated fat in the lower lids. A trans-conjunctival approach can accomplish a conservative removal of herniated fat bags in the lower lids to rejuvenate them. The incision is completely located on the inside of the lids.

Question: Can you have rhinoplasty and pec implants surgery at the same time?
Answer: Revision rhinoplasty is one of the most difficult operations to perform correctly in the entire field of cosmetic surgery, so it’s imperative to choose a surgeon wisely based on extensive experience. Performing both procedures under one anesthesia with one recovery should be acceptable, as long as both procedures can be performed under five hours, since this is outpatient surgery.

Question: Am I a good candidate for rhinoplasty? What questions should I be asking in my consultations?
Answer: The Photographs demonstrate an overly projecting nose with dorsal hump and very slight bulbous tip. A closed rhinoplasty approach can accomplish shaving down the dorsal hump, decreasing the overall projection of the nose, and refining the nasal tip. Rhinoplasty is 1 of the most difficult operations to perform correctly in the entire field of cosmetic surgery, so chooses your surgeon based on extensive experience. Study their before and after rhinoplasty Photo Gallery which should be extensive with results that you like. In our practice, we would perform closed rhinoplasty without any painful nasal packing. The procedure is performed in a Medicare certified outpatient surgery center, and a board certified physician anesthesiologist is administering the General anesthesia. Ask your prospective surgeon about their touch-up rate for rhinoplasty, and what is the cost?

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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