The Seattle

Plastic Surgery Center

William A. Portuese, M.D.

Facial Plastic Surgery Questions and Answers: Part 10

Question: Does it look like I have saddles nose? Options?
Answer: Much more information is needed, such as a full set of facial photographs from all angles, a copy of the operative report and an in-person examination. A rhinoplasty can accomplish shaving down the dorsal hump, and possibly adding small cartilage graft to the depressed area, if needed. Also important to know how much cartilage is left over on the inside of the nose for potential grafting purposes, since you had a septoplasty in the past.

Question: Possible candidate for lower eye blepharoplasty? I’m 39 years old.
Answer: The photographs demonstrate herniated fat pads in the lower lids, and you are an excellent candidate for a lower lid blepharoplasty. The primary goal for lower eyelid blepharoplasty is to remove the fat bags in the lower lids. The fat is removed through a trans–conjunctival approach completely located on the inside of the lower lid. If there is excess skin at rest ( not when smiling), then a small external pinch of excess skin could be performed at the lash line. In our practice, we close this incision with tissue glue. No stitches are required.

Question: Nose cartilage. Is a rhinoplasty that only moves the cartilage slightly upwards possible?
Answer: Without a full set of pictures, it’s impossible given a determination about whether you’re a good candidate for a rhinoplasty surgical procedure. You must have enough of a droopy tip to make it worthwhile to undergo this surgical procedure. For many examples and our current price list, see the link below.

Question: What can I do about this impending double chin?
Answer: A full set of facial photographs in a chin-neutral position from all angles are going to be required to make a determination about how best to proceed. Liposuction can remove fat deposits above the muscle, however a surgical neck lift is required to remove deposits that are located above and below the platysma muscle.

Question: What procedures will improve my appearance? I’m insecure about my nose, lips, lick of jawline, and facial fat
Answer: Started out with just a simple chin implant to Augment your recessive chin profile. This procedure can be performed under local anesthesia as an outpatient procedure. If you decide you want to do a rhinoplasty, that procedure must be done under general anesthesia as an outpatient.

Question: Can I have this hump on my nose fixed?
Answer: A closed rhinoplasty approach can accomplish shaving down the dorsal hump, narrowing and straightening the bridgeline, and adding a small cartilage graft just below the hump where there’s a depression. Digital computer imaging would be helpful to understand what can be accomplished with your nose upon your facial features. You will also need to get your deviated septum fixed as well, otherwise the breathing can be worsened when you make the nose smaller. Choose your rhinoplasty specialist wisely based on extensive experience.

Question: I have always disliked the brige of my nose. What would you fix/how?
Answer: The photograph demonstrates a small dorsal hump from the side profile and a wide nasal bridge from the front profile. A closed rhinoplasty approach accomplish shaving down the hump And narrowing the bridge line with all of the incisions placed on the inside of the nose. No external incisions are required, no painful packing is required either. Choose your rhinoplasty specialist wisely based on extensive experience.

Question: What can I do to look less tired and unhappy?
Answer: In order to give a determination about the best surgical procedures, a full set of facial photographs from all angles are going to be required. A trans- conjunctival lower blepharoplasty helps with fat bags in the lower lids, when they’re significant enough to warrant surgery. Probably should have the fillers reversed before making any surgical determination.

Question: Is this considered a deviated septum?
Answer: No, the limited photograph demonstrates a crooked nose, which is best treated with a rhinoplasty procedure. A septoplasty is performed on the internal portion of the nose when there’s a blockage of airflow. Nostrils are always asymmetrical, and will continue to be so after the surgery.

Question: What can I do to improve the shape of my nose tip?
Answer: A closed rhinoplasty approach can accomplish reduction of the bulbous nasal tip with a conservative cartilage removal and suture techniques that narrow your nasal tip cartilages and get rid of the cleft between the two cartilages in the nasal tip itself. Thick skin in the tip of the nose may prevent some refinement, but that determination is made at the time of the physical exam. All of the incisions are placed on the inside of the nose with closed rhinoplasty, and you’ll heal faster without an incision across the columella.

The Seattle

Plastic Surgery Center


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