Sacramento Rhinoplasty doctors

Andrew Pichler, MD Andrew Pichler, MD
Sacramento Facial Plastic Surgeon
6633 Coyle Ave Suite 2, Carmichael
41 answers
Travis T. Tollefson, MD, MPH Travis T. Tollefson, MD, MPH
Sacramento Facial Plastic Surgeon
2521 Stockton Blvd Suite 6206, Sacramento
41 answers
Chase Lay, MD Chase Lay, MD
Bay Area Facial Plastic Surgeon
10050 Bubb Road Suite #1, Cupertino
34 answers
Thomas E. Kaniff, MD Thomas E. Kaniff, MD
Sacramento Facial Plastic Surgeon
631 Fulton Avenue, Sacramento
22 answers
Reginald Rice,  MD Reginald Rice, MD
Sacramento Facial Plastic Surgeon
4300 Golden Center Dr Suite D, Placerville
8 answers

Recent Answers

Can an Alarplasty Be Done Under Local Anasthesia?

Im curious as to whether alarplasty can be done under local anasthesia? Can any rhinoplasty be done this way?

A: Alarplasty under local anesthesia

If you mean narrowing the alae (Weir procedure) then it certainly it can be done under local. If you mean tip plasty then perhaps some sedation would be advisable. For complete rhinoplasty it maybe more comfortable to do under general anesthesia although conscious sedation is also acceptable. The most important point is the experience of the surgeon

Andrew Pichler, MD
Sacramento Facial Plastic Surgeon
Do You Recommend Augmentation Implant or Just Plain Alar Reduction? (photo)

Hello thanks for viewing,I have been wanting to do this for over a decade but I just dont know what the problem is . My mom tells me that it would be ugly to reduce the alar, that I should just opt for an implant to augment the bridge cause she says it will raise the sides of my alar, reducing the ridiculous flare (it looks like mickey mouse ears). I want the alar trimmed but I am scared if the results are bad, its irreversible. Whats the safest approach? I really hate the flare. Please help!:(

A: Nasal dorsal augmentation vs. alar base reduction

Hi Uluala1,

You can have a very concervative alar base reduction.  You can't really reverse it so it's good to be conservative. . .if you wanted to do a bit more much much later you could.  Keep in mind, when you smile your nasal ala will still flare a bit, even if you had an aggressive reduction.

You could start small wit just the alar reduction.  As for the bridge, it's pretty nice.  I would do minimal augmentation as most and you should probably "try it out" with a filler first.

What I see when you smile that adds to the flared look is that your tip (which is a nice tip) just minimally droops when you smile.  If you were to refine that and reinforce it with a cartilage graft it would look great.

But you know, you're nice fits your face.  Make sure you consult with a few facial plastic surgeons before doing anything.

Chase Lay, MD
Bay Area Facial Plastic Surgeon
Do I Have Open Roof Deformity?

Six months ago, I had a closed rhino-septoplasty. Now, it feels like I have one thin, unconnected bone running down my nose, and when I touch the sides of my bridge, it feels like I have three separate bones. When I lightly squeeze both sides together, I get this strange sensation in my nose. Do I have an open roof deformity? I think this would also explain why one side of my nasal tip somewhat leans. My surgeon suggested a revision to correct my tip, but made no mention of ORD...Help?

A: ? Open roof deformity

 Without a "hands-on" examination it is almost impossible to ascertain what your problem is and what the best solution is. Suggest obtaining additional in person consultations.

Andrew Pichler, MD
Sacramento Facial Plastic Surgeon
Use of this website and the posting of any reviews or other content on this website constitutes acceptance of the RealSelf® Terms of Service. The material on this site is for informational purposes only, and is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider. © 2011 RealSelf, Inc. All rights reserved.