Posts Tagged ‘rhinoplasty’
Thursday, December 29th, 2011
Q: Dr Eppley, I would like the fat tip of my nose made slimmer and the size of my nostrils reduced. While I like the shape of the upper part of my nose, the lower part is too big and disproportionate to how small the rest of my face is. Is this something that rhinoplasty can do, just change one part of the nose without affecting anything else? I do not want to change the shape or height of my bridge. I don’t know how difficult it is to just change the shape of the tip. I also fear that the tip could become too small and give me a reverse problem than what I have now. I do not want a petite nose with a pinched tip, just one still looks like me only in better balance. Thanks
A: Tip rhinoplasty is a very common nose procedure and only changes the shape and size of the lower third of the nose. Whether that will look more balanced without the need to alter any other part of the nose is best determined before surgery through computer imaging. You may very well be right but it can be surprising sometimes other areas look when one part of the nose is changed. Just be certain beforehand by some computer imaging work. It would be rare to take a big tip of the nose and make it too thin. (discounting Michael Jackson who had many nose procedures and is a result that should not be seen as the norm) Usually the question is whether as much tip refinement can be achieved as the patient hopes, particularly if the nasal skin is thick.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, rhinoplasty, tip rhinoplasty
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Sunday, December 25th, 2011
Q: Dr. Eppley, I am pursing getting a rhinoplasty to make my nose look better. In fiddling with my own version of computer imaging, I have made some changes to my nose that I would like to get done. Are these type of nose changes possible? If so, what type of rhinoplasty do I need? I know there are two types of nosejobs, a tip rhinoplasty and a full rhinoplasty. Which do you think is best for me?
A: I would not as a patient get concerned about the different types of rhinoplasties. The differences between a tip and a full rhinoplasty is somewhat artificial. The basic difference that separates the two rhinoplasties is that a more complete technique involves osteotomies or the narrowing of the nasal bones due to hump reduction or bridge modification. A tip rhinoplasty by classic description does not go past the lower tip cartilages. Regardless, many rhinoplasties incorporate techniques that borrow from each basic type of rhinoplasty making the surgical changes that each patient’s nose needs unique. Your attempt at rhinoplasty imaging is pretty good and I think that it is a fairly achieveable outcome. Hump reduction and tip narrowing and elevation are fairly standard changes that can make many noses look better. Your lack of thick nasal skin makes it also realistic that the alterations to the underlying cartilage and bone will be seen on the outside when the swelling goes down. You may call the type of rhinoplasty that you need a more complete one.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: computer imaging in rhinoplasty, dr barry eppley, indianapolis, rhinoplasty
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Monday, November 21st, 2011
Q: Dr. Eppley, I have reviewed your rhinoplasty computer images of what my nose may look like after surgery. While I like the changes that have been done, what I would like to know is if my nose can get even a bit smaller than what you have showed in your imaged pictures?
A: When it comes to reducing the size of one’s nose, what limits the result is how much skin one has and its thickness. All of the maneuvers in rhinoplasty surgery are about changing the underlying cartilage framework. In reducing a large nose that framework is reshaped and made smaller. While the supportive framework of the nose can be changed, the final result seen will also reflect how well the skin shrinks as well. How well the skin contracts is key and the thicker the skin is the less likely it will contract as much as the cartilage has been reduced. The wild card in every rhinoplasty surgery is how the overlying skin will reshape to the new framework.
I try to show on computer imaging realistic results and often the most minimal changes that I think will happen. While anything can be done on Photoshop that does not mean it can be achieved by actual surgery. You should make a decision about whether surgery is worth it based on the least amount that can be achieved…not on the most that you hope can be accomplished. This is particularly true in reduction rhinoplasty.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, rhinoplasty
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Tuesday, November 15th, 2011
Q: Dr. Eppley, I am interested in facial reshaping. I’d like to get a more feminine face. I would like to reshape my heavy jawline and brow, correct the weak chin, do liposuction under chin and I would also like to correct any small asymmetries that would improve the appearance of my face. I have attached a front and side for your assessment of what can be done.
A: Thank you for sending your pictures. In looking at our face what is most striking are two things. First, you have a very strong facial structure as seen in your prominent brow bones and cheekbones. This upper part of your craniofacial skeleton is also broad as reflected in the wide base of your nose and its wide tip. Secondly, and in contrast, your lower jaw (mandible) is actually short both in the horizontal and vertical dimensions. This gives you the impression that your jawline is heavy, when in fact, it is really short which makes it wider than it is tall.
I have done some computer imaging projections based on what I think would make the most significant changes towards a more feminine face. These include brow bone reduction, rhinoplasty and chin augmentation. (both horizontally and vertically) One of the key components of this approach is that your lower face (jaw) needs to be vertically lengthened to change the shape of your face from square to more of an angular or triangular shape. Combined with reduction of the brows and thinning of the nose, your face will become softer and more feminine.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: brow bone reduction, chin augmentation, dr barry eppley, indianapolis, rhinoplasty
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Thursday, November 10th, 2011
Q: Dr. Eppley, I went in recently for a consultation from an Indianapolis rhinoplasty surgeon. During the consultation he recommended a chin implant with my rhinoplasty surgery. While he seemed very honest in this suggestion, I was completely floored as I never thought I had any chin problem. I certainly didn’t think that I had a weak chin. Having had the idea settle in for awhile, I am now more comfortable that maybe I do need one. I like the way my face looks in every way except for my profile which is why I want my nose done. What I am concerned about is that the combination of a rhinoplasty and chin implant will change my face too much. I have attached a profile picture of me for your thoughts. What would you do if you were me?
A: It is not uncommon to perform a rhinoplasty and chin implant together and it can be a powerful changer of one’s profile. But whether it is aesthetically beneficial can actually be determined by you. Make sure that you have done a series of predictive computer imaging. Have shown to you how your profile would look both with and without a chin implant with your rhinoplasty prior to actually undergoing surgery. These images will answer your question better than anyone simply telling you one way or the other. One cautionary note, if you opt for chin augmentation your plastic surgeon needs to be careful about the style and size that is selected for implantation. You have a retruded but long chin. It would be easy to end up with too strong a chin appearance afterwards if the right chin implant is not chosen.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin augmentation, chin implant, dr barry eppley, indianapolis, rhinoplasty
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Wednesday, October 5th, 2011
Q: Dr. Eppley, I would like to start by saying your website and blog have been so helpful as both a research tool and making me feel so much more comfortable in approaching this issue. It is one of the few sources I have found that really takes the time to properly explain things, that most people in plastic surgery don’t understand. I would like to have more balanced facial features and to improve my asymmetries to improve my facial appearance. I feel that I have a long lower face and chin compared to my forehead, which is very low and slopping. I can’t wear hats and have to spike up my hair all the time so I don’t get teased. I recently lost a lot of weight and with it my cheeks, with used to be very full. But I guess what bothers me the most is my nose – I have a deviated septum which makes me look crooked and my nose is very romanesque in appearance. I think that a rhinoplasty and cheek augmentation would help me best but I’m open to suggestions. I just want to be the most attractive me I can be. From my photos can cosmetic surgery help me?
A: Facial symmetry and proportion are the two most important components of facial attractiveness. In looking at your photos, I would agree that the deviated and dorsal convexity of the nose combined with flat cheeks are the two main areas to try and improve. I would propose a rhinoplasty whose objectives are to straighten the nose in the frontal view and bring down the dorsal line to one that is straight between the frontal-nasal junction and the nasal tip. The tip could also tolerate a bit of thinning as well. For your cheeks, anatomical style cheek implants secured high up along the flat malar prominence will bring some highlights to your midface and more angularity to your face.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, dr barry eppley, indianapolis, rhinoplasty
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Friday, September 30th, 2011
Q: Dr. Eppley, I am a 46 year-old female. I would like to get an upper and lower blepharoplasty. However, I have problems with my nose due to a sinusitis and a collapsed septum. I got an x ray last week and the doctor said I have a deviated septum as well as thickening of turbines. I have been on antibiotics for five days. This problem wears me out a lot. I am often tired with headaches and my face always looks puffy due to continous allergy symptoms. My question Dr Eppley is what do you suggest for me to have first or not to have- a Rhinoplasty/Septoplasty to correct the nose issue and then a blepharoplasty? Please doctor I would appreciate your advise. I found your website very helpful, thank you again.
A: There is no question that septorhinoplasty and blepharoplasty can be performed together. This is not a technical nor a safety issue. It is an issue exclusively of how much recovery do you want and how long can you tolerate (socially and workwise) the way you will look during this recovery. When combining rhinoplasty and blepharoplasty the swelling and bruising around the lower eyes can be quite severe, particularly when nasal osteotomies are performed. Otherwise, there is no reason why the two facial procedures can not be performed together. There may also be other advantages beyond one single recovery period for combining them, such as cost.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: blepharoplasty, dr barry eppley, indianapolis, rhinoplasty
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Sunday, September 18th, 2011
Q: Dr. Eppley, The problem with my face is it’s very skinny when I don’t smile. When I smile I have the biggest fattest face ever! I have these fat pockets around my nose. And instead of a smile I look like I’m sneering. I was in an auto accident and it caused nerve damage to my left lip. I want to fix my smile so its even again and you can see more of my teeth. I also have a brow that I hate and would like to get rid of. I also would like some work done on my chin because I hate the way that looks. And also when I smile I have “jowls” and I’d like to get rid of those and my double chin. My double chin is hereditary and being tall and skinny this looks very strange. I would also like to get a nose job because I have my fathers nose and I think it looks very masculine. Overall what I am trying to achieve is a slimmer face, with more feminine features and a better more applying smile. I don’t feel like my face goes with my personality, and how I feel. Also anything else you see that needs to be done please let me know.
A: Thank you for sending your pictures. In looking at your face and reading your objectives I would consider the following procedures. A rhinoplasty is needed to make your nose thinner and less wide, particularly in the tip. I would also recommend buccal (cheek) fat pad removal (subtotal) and small cannula liposuction of the fullness above the nasolabial (lip-cheek) grooves. A lip lift (vermilion advancement) done with differential skin removal (left greater than the right) will help with better lip symmetry and overall fullness. A submental chin reduction is needed to decrease the amount of chin prominence and protrusion. Liposuction can be done in the neck and jowls to remove fat in these areas.
Unfortunately, I can only do limited computer imaging because your pictures are inadequate. Smiling photos make a lot of facial feature distortion.
You mentioned a dislike for your brows but I am uncertain what specifically you do not like about them. Until I know more, I can not make any recommendations on whether they can or cannot be favorably changed.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin reduction, dr barry eppley, indianapolis, lip lift, neck liposuction, rhinoplasty
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Wednesday, September 7th, 2011
Q: Dr. Eppley, I am 54 years old and am interested in getting a facelift, rhinoplasty, and blepharoplasty surgery. I’m trying to achieve a more youthful look, less sagging, and not so tired looking appearance. I have attached some pictures of me so you can show me by imaging what the results may be like.
A: Thank you for sending your pictures. Here is some imaging for the following procedures; a facelift (neck-jowl lift) and a rhinoplasty.You could get a really significant improvement in your neck wattle as it is a large amount of loose hanging skin. That would dramatically change your neck-jawline profile. It is interesting as to why you have such a large amount of hanging neck skin even though it appears you are relatively thin. Perhaps you have lost a lot of weight ?? Regardless a full facelift will remove inches of skin from the neck and tighten up the entire jawline.
From a nose standpoint, you tip is wide and thick and turns down slightly. There is also a small bump higher up on the nose. A full rhinoplasty would take down the bump, shorten and narrow the tip with some lifting and narrow the size of the nostrils. This type of nose change at your age changes the structure of the nose and makes it look smoother and more refined, a look that has a more youthful quality.
The combination of these two procedures, as the imaging illiustrates, would make significant rejuvenative changes to your overall facial appearance
As an addendum, I did not do nor is it possible to do realistic blepharoplasty computer changes. It is clear from the pictures that you have some extra eyelid skin that can be removed as well as some herniated fat from the lower eyelid. Your lower eyelid shows no significant skin excess, however, other than a few millimeters. Together, this type of upper and lower blepahroplasties will make you look less tired.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: blepharoplasty, dr barry eppley, facelift, indianapolis, rhinoplasty
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Sunday, September 4th, 2011
Q: Dr. Eppley, I want to get rid of the little bump in my profile, and I’m wanting to smooth out my nose. It looks really bumpy in pictures and it usually looks bad in certain kinds of lighting. I would really love my nose to look anything like these celebrities: Carrie Underwood, Lauren Conrad or Blake Lively. I think their noses are great but I don’t know if they would look good with my face.
A: In looking at your pictures, your nose is bumpy because of the disproportion or asymmetries between the three regions of your nose. Your upper nose has wide nasal bones, the middle third or upper lateral cartilages of your nose is more narrow and the tip cartilages of your nose (lower alar cartilages) are separated or wide. When put together, this gives your nose an almost hourglass configuration in the frontal view as opposed to straight parallel dorsal lines. In the side view, this gives an uneven straight dorsal line with an upper hump and a downward dip in the middle third. This is why your nose appears bumpy and irregular to you. A full rhinoplasty is needed to reshape all three areas to create an overall more harmonious blending of the three regions to create a smoother nasal appearance. I have done some imaging to show what these changes may look like. In regards to the celebrity noses you have mentioned, it is important to realize that rhinoplasty can not make your nose look like that of another person. Rhinoplasty can only make your own nose look better.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, indianapolis, rhinoplasty
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