The Seattle

Plastic Surgery Center

William A. Portuese, M.D.

Facial Plastic Surgery Questions and Answers: Part 7

Question: Would a mini face and neck lift address my issue?
Answer: A mini facelift will not address your issue, since mini facelifts give mini results. Consider placement of a chin implant to augment your recessive mandible forward for better facial balance and proportions. Since you have both jowls and fat deposits located in your neck below the platysma muscle, you’re going to require a lower face and neck lift procedure.

Question: I’m 44 years old and have sagging in my lower face and neck. Should I do a lower facelift or a deep plane facelift?
Answer: From the limited photographs, it appears that you do not have loose skin, and you’re only 44 years of age. Consider a neck lift procedure to remove the fat deposits above your platysma muscle with liposuction, and surgical extraction of the fact about is below the muscle which also includes a platysma plasty to significantly improve your jawline. Skin removal is probably not required at your age.

Question: What sort of eye procedures would I benefit from?
Answer: The picture that you’ve sent is rather blurry,so makes it very difficult to make a determination about how best to proceed. It appears that your upper eyelid skin is rather hooded and resting on your eyelashes, therefore consider an upper blepharoplasty procedure which can be performed under local anesthesia as an outpatient procedure.

Question: Mini facelift: what does it include and cost?
Answer: A mini facelift lift tends to give mini results, and we rarely ever perform them. A mini lift does not include any work in the neck. In our practice, 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 fat deposits in the neck, which also includes a platysma plasty. Regarding your eyelids, upper blepharoplasty and lower blepharoplasty are two different procedures. All of these can be combined when necessary. A full set of photographs would be required to make a determination about being a candidate for these three procedures.

Question: High alar rims. Am I a candidate for alar rim grafts?
Answer: The limited photograph demonstrates a hanging columella and alar retraction. A revision rhinoplasty is going to be required under general anesthesia to improve your nose. This would involve removal of extra skin and cartilage in the columella area, and composite grafts harvested from the ear and placed nostril to bring the alar rim downward.

Question: What procedures are best to reduce a wide face, big cheeks, and a big nose?
Answer: Consider a closed rhinoplasty procedure to reduce the large nose. The dorsal hump can be shaved down, the tip refined in the bridge line narrowed with all the incisions placed on the inside of the nose. No external incisions are required, and no painful packing is required either. Digital computer imaging of your nose upon your facial features would be helpful to understand what can be accomplished with the procedure. Best to leave the rest of your face alone.

Question: What procedures are best to reduce a wide face, big cheeks, and a big nose?
Answer: Consider a closed rhinoplasty procedure to reduce the large nose. The dorsal hump can be shaved down, the tip refined in the bridge line narrowed with all the incisions placed on the inside of the nose. No external incisions are required, and no painful packing is required either. Digital computer imaging of your nose upon your facial features would be helpful to understand what can be accomplished with the procedure. Best to leave the rest of your face alone.

Question: Chin implant and Invisalign? 
Answer: You can certainly undergo a chin implant with your Invisalign braces intact. In our practice, most patients undergo a chin implant under local anesthesia as an outpatient procedure, which takes about 30 minutes. The implant is placed through a small incision underneath the chin. Digital computer imaging can also help you understand what your new chin might look like.

Question: Follow up appointments after overseas rhinoplasty. Would local surgeons be willing/able to do the follow up appointments?
Answer: If you’re planning an overseas rhinoplasty, all of your follow-up appointments need to be done with your operative surgeon. You’re not gonna be able to find a local plastic surgeon that’s going to do your follow up care.

Question: Surgeon’s age – what is your opinion on an older plastic surgeon?
Answer: More important than looking at the age of the surgeon, is to look at their most recent before and after facelift results. Study your perspective surgeon’s before and after facelift photo gallery, and make sure that it is up-to-date and current with great results that you like that look very natural.

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Plastic Surgery Center

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