The Seattle

Plastic Surgery Center

William A. Portuese, M.D.

Facial Plastic Surgery Questions and Answers: Part 6

Question: Would I be an acceptable rhinoplasty candidate?
Answer: As long as you’re in excellent health, and have reasonable expectations, then you’re Excellent candidate for a rhinoplasty procedure. A closed rhinoplasty approach can accomplish reduction of the bulbous nasal tip, shaving down the small dorsal hump, and narrowing the bridge line.No external incisions are required and no painful packing is required either.

Question: Chin lift? Lipo? Kybella? What’s the best option for me? I’m 5’6″ and 155 LBs.
Answer: The photographs demonstrate a recessive chin profile For which a chin implant can improve the projection of the mandible and give better structural support for the soft tissues in the neck. In the neck itself, you have fat deposits located both above and below the platysma muscle in the neck. Liposuction can only remove the fat deposits above the muscle. A neck lift includes liposuction of the fat deposits above the muscle and surgical removal of the significant fat deposits below the muscle and also includes a platysma-plasty to really improve the jawline. A chin implant and a neck lift are performed under general anesthesia as an outpatient surgical procedure. No skin removal is required.

Question: Time for a mini lift? 45 and not liking my mid/lower face. Want lower/mid face lifted and the jowls and saggy under skin gone.
Answer: The photograph is rather limited, so a full set of facial photographs would be more helpful. A lower face and neck lift is going to be required to tighten loose and inelastic skin in the neck and lift the jowls.

Question: Would I benefit from a chin implant or chin filler? What else could I get to improve my jawline?
Answer: The side profile photograph demonstrates a recessive chin, and no fat in the neck. Consider placement of just a chin implant to augment the chin forward. Liposuction in the neck would be unnecessary. Placement of a chin implant can be performed under local anesthesia through a submental approach , which would take about 30 minutes. Fillers do not work very well.

Question: BBL or facelift surgery first? How far apart?
Answer: It does not really matter which procedure comes first, but you should separate two general anesthetics for cosmetic surgery at least one month apart to give yourself time to recover from either procedure.

Question: Is it true that noses gets hard after rhinoplasty? If that’s the case, will I still be able to pinch and move my nose. 
Answer: Even after a simple primary rhinoplasty, your nose will be rather hard and stiff for the first several months after the surgery because of the fluid retention in your nose. If you’ve had additional cartilage grafts added to the nasal tip, especially from the ear, then you’ll have permanent stiffness in the nose.

Question: When will I be able to go swimming after rhinoplasty?
Answer: In our practice, we would allow you to go swimming after rhinoplasty at two weeks after the procedure. We perform closed rhinoplasty with all the incisions placed on the inside of the nose, and no painful packing is required either. Choose your surgeon wisely based on extensive experience.

Question: Mid facelift, brow lift, what would be the best approach to avoid any problems?
Answer: we do not perform a mid facelift due to the fact that the mid-face looses volume, and does not descend vertically with aging process. For mid face rejuvenation, we place small cheek implants in the midface to augment the lost volume. The implants are placed thru an intra-oral approach under a brief general anesthesia. The height of your eyebrows is more than acceptable, and a brow lift be unnecessary. Also important to see a full set of facial and neck photographs to see if you are a candidate for a lower face and neck lift.

Question: Chin implant? Or lipo as well? I’m 5’4 and 116lbs, so fairly thin.
Answer: The Side profile photographs demonstrate a recessive chin profile for which a chin implant can improve. The implants can be placed through a small incision underneath the chin under local anesthesia as an outpatient procedure which takes approximately 30 minutes.

Question: Crooked nose after an injury. What do you think should be done?
Answer: Trauma to the nose can cause a variety of the issues, such as a deviated septum blocking airflow. A CAT scan of the sinuses is required to document chronic sinus infections. Straightening the crooked nose is considered cosmetic and not covered by medical insurance. Functional surgery such as breathing difficulty and endoscopic sinus surgery can be submitted to medical insurance once medical necessity has been documented and preauthorization has occurred with your medical insurance. Anticipate co-pays and deductibles.

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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