Hi, I just had a rhinoplasty and a turbinectomy last year. Ever since the turbinectomy my face has been looking very thin. I am 35 years old and am naturally skinny, but my face didn't look so gaunt before. My nose is smaller and my turbinates are no longer there, but for some reason my nose really stands out, I think due to lack of facial fat. I am 5'5 100 pounds and small boned, my size genetic. Have I just lost facial fat due to my age, and can I get it back by eating more? Should I try Sculptra? I have already tried juvederm in my lip area and botox in my forehead to make me look a bit younger, but it really didn't help any. I look at least 45! Help!
Sculptra to Restore Volume After Nose Surgery?
Doctor Answers (8)
I would echo the sentiment of the other physicians that...
I would echo the sentiment of the other physicians that your best option is a personal consultation with a qualified facial plastic surgeon or plastic surgeon in your area. In a more generic sense, you pose several interesting questions:
1) What are options for cheek fillers?
There are several options for cheek fillers. Temporary fillers such as Restylane and Juvederm can be used as a cheek filler. Radiesse can also be used but should be used with care as there can be lumpiness which is very difficult to remove. Sculptra is another good option. It is a poly-L-lactic acid which must be injected over several treatments and the results actually 'grow' over time. All of these treatments though will eventually fade. For a more permanent solution, consider fat augmentation or cheek implants. Both are fairly easy surgical procedures that can produce lasting and excellent results. Again though - to determine if any of these are right for you, consultation with a qualified surgeon would be necessary.
2) Will I notice a change in my face after rhinoplasty surgery?
While rhinoplasty surgery will generally not change the structure of your cheek, it will alter the relationship between your face and your nose. There are very well established spatial relationships in the face. Altering the shape of the nose can cause the appearance of a change in the cheeks even though no actual anatomic change has occurred.
Good luck in your search.
Maybe sinus or breathing problems caused abonormal fullness before surgery
I have read with great interest the numerous comments below. Kaite, you seem to have come upon something here that many other patients have noted.
It is not that doctors are trying to deny or be decptive about this. It is just not discussed as a possible outcome of surgery.
I have been thinking about this and may have one possible suggestion. It appears that one common thread is sinus and/or turbinate surgery. In most instances, neither are indicated with a primary rhinoplasty, but the vast majority of paitents complaining about the hollowing had their sinuses or turbinates treated at the time of rhinoplasty.
Perhaps due to prolonged swelling or inflammation from the sinusitis, patients experienced abonormal chronic swelling prior to surgery. After surgery, the swelling may have resolved leaving them with impression that their faces had become more hollow, gaunt, or sunken.
Anyway, it's just a thought.
Fillers for volume replacement include:
- Juvederm Ultra Plus
- Autologous fat
Need More Views of Your Nose
Assuming that your picture is current, I would want to look at few more views of your nose to determine if some minor adjustments would improve its proportions and improve the balance of your face.
Most Board Certified Plastic Surgeons understand the importance of both a "functional rhinoplasty" to improve your breathing and an "aesthetic rhinoplasty" which requires artistic talents and planning to create a nose which fits harmoniously with the rest of your face.
Creating this balance is an art - sometimes it involves adding fillers to the cheeks - sometimes it involves shortening or changing the shape of the nose.
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As Billy Crystal used to say on SNL, "You look Mah-Vah-Los"
I have never seen turbinectomy or rhinoplasty result in loss of volume from the face. A syringe or two of Restylane, Juviderm, or Radiesse should be more than enough to restore youthful volume to your pretty face. If you wanted a more permanent fix, fat transfer would be the choice, but you need to be very careful in choosing your physician. I would recommend William Little in the D.C. area. Some physicians are getting good results with Sculptra, but others are seeing complications. I am not using it. Leslie Bauman, MD at University of Miami is whom I would recommend if you choose Sculptra. Be well.
Katie, This is a good question. I doubt that the...
This is a good question. I doubt that the turbinectomy has any direct effect on the appearance of your face, but there are a couple of things that may be going on. The first is the relationship between your nose and the rest of your face.
There are natural proportions that represent aesthetic ideals, for example the width of your mouth as compared to the width of the base of your nose. If these change after surgery, you may notice aspects of your face that were not as obvious before. This, in combination with being thin already, probably is contributing to what you are now noticing.
Without examining you directly, it's difficult to know what the best options are for you. But if we need to increase the volume in your cheeks, I prefer Radiesse to Sculptra. It's very straightfoward to use and will give you results that last at least a year or more. I think this is the best non-surgical option in this area. Other surgical options include fat transfer, which also works well, but requires an operative procedure.
Bottom line is that the best way to know exactly what is going on is to sit down with a Plastic Surgeon, have them listen to your concerns, so that they can lay out your options for you and put together a plan that works.
Volume Replacement post rhinoplasty
The optimal fillers for volume replacement are either radiesse, juvederm, or restylane. Sculptra does not seem to be appropriate choice in your case. You should consult with 3 - 4 experienced and expert board certified plastic surgeons to understand your options.
Sculptra for nose shaping is an off-label use
The use of Sculptra to restore volume after nose surgery is an off-label application. Generally, Sculptra is used to treat larger areas, not something as finite as nose or nasal tip.
I have not encountered a situation where a turbinectomy...
I have not encountered a situation where a turbinectomy has changed the relative volume of the cheeks. This is probably more due to being slender and perhaps to some early signs of facial aging which can include volume loss.
A well qualified plastic surgeon can evaluate you and discuss possible treatments. I have found that Radiesse works especially well in volume restoration and augmentation of the cheeks. This is especially true in younger patients who have good skin. I personally would not recommend Sculptra or fat injections which are other alternatives to Radiesse.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.