The Seattle

Plastic Surgery Center

William A. Portuese, M.D.

Facial Plastic Surgery Questions and Answers: Part 3

Question: Would I be eligible for a tip plasty?
Answer: It’s important to remember that The nose is a three dimensional structure, and rhinoplasty is performed in all three dimensions, and the nose heals three dimensionally. It’s very important that all of the components of those are balanced with themselves, therefore a full rhinoplasty is going to be required even though most of the changes will occur in the nasal tip.

Question: How to improve my double chin and asymmetry?
Answer: Placement of a chin implant can augment the chin forward for better facial balance . Liposuction of fat deposits in the neck can also accomplish improvement definition on your jaw line. Both procedures can be performed together Under one anesthesia with one recovery period.

Question: Risks of revision rhinoplasty?
Answer: Revision rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery, so choose your rhinoplasty specialist wisely based on extensive experience. A closed rhinoplasty approach can accomplish decreasing your hanging columella and drop the rotation and decreased the projection. That’s probably all you would need regarding a revision rhinoplasty. Consider placement of a chin implant for your recessive chin profile which are help with facial balance and proportions, especially with respect to the projection of your nose from the side profile.

Question: I’m unpleased with my side profile and want some input on what surgeries would improve my profile?
Answer: The Side profile photographs demonstrate an overly projecting nose with a dorsal hump and a recessive Chin profile. Consider a closed rhinoplasty procedure to shave down the dorsal hump, refine the nasal tip and narrow the bridge line with all the incisions placed on the inside of the nose.Placement of a small chin implant can accomplish augmenting the chin forward for better facial balance and proportions. Digital computer imaging of your nose and chin would be helpful in the education process.

Question: Can you shave down the dorsal bump a little bit?
Answer: You must undergo a full rhinoplasty procedure when shaving down the dorsal hump due to the fact that once the Hump has been shaved down, you will left with a flat top, open roof nasal deformity. Osteotomies placed in the nasal bones are required to close that open roof. You will also need your tip to be balanced with the new bridge line. In our practice, we perform this procedure under general anesthesia.

Question: How accurate is crisalix 3D model for rhinoplasty?
Answer: It’s very important that you have a very Frank conversation with your surgeon about these results. Computer imaging it’s only a communication tool, not a guarantee of results. Rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, so it’s imperative to choose your rhinoplasty specialist based on extensive experience. Study your prospective Surgeon’s before and after photo Gallery which are the real and permanent results.

Question: Is a revision rhinoplasty possible?
Answer: The photographs presented demonstrate an overly-projecting nose with a hanging columella, and an under-projecting chin. A Closed rhinoplasty with a columella plasty can accomplish decreasing theprojection and rotation of your nose and reduce the hanging columella. Strongly consider placement of a chin implant to augment your weak chin profile for better facial balance and proportions. Placement of the chin implant will help make your nose look less projecting from the side profile.

Question: Am I a lower blepharoplasty candidate?
Answer: You Have herniated fat bags in the lower lids based on the limited photographs presented. Consider a trans-conjunctival lower blepharoplasty for the fat bag removal creating the puffy look. All of the incisions are placed on the inside the eyelids.

Question: Would a lower facelift be the best option for me?
Answer: Since you have had eight syringes of filler placed in the face, you have artificially inflated your anatomy and it is very difficult to make a determination about any surgical procedures. You only have a minimal amount of laxity in the Skin in your neck. When patients have a recessive Chin profile, then consider placement of a chin implant for a permanent augmentation.

Question: What should I tell my doctor when I describe the result I want from a rhinoplasty?
Answer: Digital computer imaging of your nose upon your facial features would be helpful to understand what can and cannot be accomplished with a rhinoplasty procedure. Based on the photographs, a closed rhinoplasty procedure can accomplish shaving down the dorsal hump, refining the bulbous nasal tip, and narrowing it your bridge line with all of the incisions placed on the inside of the nose. No external incisions are required, and no painful packing is required either. Make appointments with three rhinoplasty specialists, perform computer imaging and study their before and after rhinoplasty photo galleries.

The Seattle

Plastic Surgery Center


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