Saint Petersburg Facial Plastic Surgeons

Recommended Downtime for Sculptra?

How much vacation time do you advise workers to take for Sculptra injections? My boss does not allow "bruised and swollen" employees to work in his casino.

Although patients heal differently, downtime is seldom factor with Sculptra. Most of my patients return to work the next day.

Patients may have a small amount of bruising and some puffiness after Sculptra injections. Frequently the puffiness actually looks good because it replaces some of the lost volume that we are trying to build up.

With the first treatment, I suggest that patients have a weekend or at least have one day where they can be off work if needed. This gives them a chance to see what their appearance will be after the injections. Minor bruising can easily be covered with makeup the next day. Ice packs on the first day help minimize inflammatory swelling. Also taking supplements such as Bromelain after the injections can minimize bruising.

It is important to massage the areas of the face where Sculptra has been injected. This should be done several time a day for 3 to 5 minutes for five consecutive days.

Andrew Coundouriotis, MD

Saint Petersburg Facial Plastic Surgeon

Shortening Nose Length During Rhinoplasty

What measures are taken to shorten the overall length of the nose during a Rhinoplasty surgery? 

Before answering this question I would like to define the term "length" as it relates to the nasal dimensions. When I refer to the length of the nose, I refer to the distance between the tip of the nose and the origin of the nose close to the eyebrows. An upturned nose will appear shorter than a downturned, hooked nose.

The distance that the tip of the nose extends out from the face, away from the lower lip, as viewed on profile is called “projection”. Many times we need to increase projection and decrease the length of the nose. This would be with a hooked nose where the tip extends down towards the upper lip.

Most of the work involved in changing the length of the nose has to do with cartilaginous changes, both of the septum which give support to the cartilaginous lower part of the nasal bridge as well as the lower lateral cartilages that form the shape and substance of the tip of the nose. If the bony part of the dorsum, higher up, has appropriate dimensions there may be no need for bony work. This minimizing postoperative bruising.

Andrew Coundouriotis, MD

Saint Petersburg Facial Plastic Surgeon

Can a Broken Nose Be Reset Years After Being Broken?

Nose was broken in the late 90s. Can it be reset by a ENT doctor now?

Yes, a broken nose can be reset years after being broken. Typically this requires precisely cutting the nasal bones and also sometimes refining fractured areas that have been repaired by the body. Typically this “repair” is a thickened callus formation and bony overgrowth of the fractured areas.

Sometimes this procedure can be challenging. When the nose has been fractured in early adulthood, or in the teenage years, and the patient is looking to repair it in midlife or later, one must consider the other changes that have occurred to the nose since the fracture. These changes come from the aging process, and fit the overall aging of the face.

Repositioning the fractures will help the appearance of the nose, but will not restore the appearance of the nose completely to its original state. Other maneuvers, designed to reverse the signs of aging may also be necessary. In this case, it’s important to maintain harmony with the rest of the face.

Andrew Coundouriotis, MD

Saint Petersburg Facial Plastic Surgeon