Adam D. Stein, MD

Great question! Absolutely- at my practice I exclusively perform facelift procedures under local IV sedation. The "twilight" sedation approach ensures that patients are comfortable and relaxed, but breathing on your own. While some surgeons may choose to only utilize general anesthesia, a facelift does not have to be performed with it.

Yes, you are a candidate for a rhinoplasty. Although all rhinoplasties are complex and challenging because it is a difficult procedure, there is nothing about your nose in particular that would make performing a rhinoplasty any more difficult than another case. I would recommend getting a consultation with a rhinoplasty specialist (someone who is board-certified in facial plastic surgery) to evaluate.

A rhinoplasty and a lip lift can be done at the same time only if there is going to be no alar base reduction surgery, as the incisions would conflict with the sub-nasal lip lift incisions. If your rhinoplasty does not include nostril changes, then you are perfectly fine to do those three procedures at the same time.

I would definitely recommend doing any face lifting surgery prior to any deep laser or chemical peel resurfacing.  There is always a transition zone between the face and the neck under the jawline where the laser/peel treatment must end.  The neck can not tolerate deep resurfacing in the same way the face can. If you have the resurfacing first the more hidden transition zone under the jawline will be moved into a more visible location as the skin is re-draped for the facelift. This can result in a "line of demarcation" between the treated and untreated skin (either different color or texture) being much more visible. 

If you are planning on undergoing just a lower facelift and rhinoplasty without eyelid surgery and forehead/midface lifting the I believe it is fine to do both at the same time.  I do it routinely. I have found that when I combine a rhinoplasty with full facial rejuvenation including all facial rejuvenation procedures at the same time it is a little to tough on my patients for the first 24-36 hours in the recovery.  In those cases I now separate the facial rejuvenation surgery from the rhinoplasty. I usually perform all the rejuvenation procedures on the first day and perform the rhinoplasty one week later so that my patient will still complete most of the recovery with in two week. Good Luck.

It is really too early to know what your final outcome will be. The tip is the place where the swelling takes the longest to resolve. If it is still firm and hard, that is a sign it is still healing. Numbness is also a good indicator of healing. When the numbness at the tip wears off it is usually at a time when most of the swelling has resolved also, although this is not exact.  Noses take about 12 months to heal completely and can even take up to 18-24 months if the skin is very thick. I usually tell my patients that approximately 60-70% of the swelling resolves in the first 6-8 weeks (depending on skin thickness) and by 6 months 80-90% of the swelling is resolved. The final 10-20% finishes in 12-18 months or even longer.  Good luck.

Although it certainly will not hurt to use it, I generally do not find it necessary to use silicone scar gel or any other scar reducing ointment after Facelift surgery. If the surgery is performed with good surgical technique there should be little tension on the wounds and they usually heal very well on their own. Good luck.

It is all completely normal to have what you describe after face lifting surgery. Things feel tight, particularly in the neck. The ears are usually numb. The scalp can be numb which makes the hair feel "different". These things will all resolve with time.  Although it will be considerably improved at 6-8 weeks. It can take 6-12 months for all of these things to completely resolve. Good Luck.

The most likely answer is that it is related to the fat transfer portion of the procedure. The fat has died in that small area or scar tissue has begun to form around the transplanted fat. I would definitely recommend speaking with you surgeon and letting him examine you. He will then be able to best advise on course of action. Good luck.

After nasal surgery there is a lot of inflammation present in the lining of the nose. This inflammation can cause a number of nasal symptoms including congestion, runny nose, post nasal drip, and sneezing. As the healing process continues your sneezing should become less frequent.  After 4-6 weeks I will sometimes recommend a nasal steroid spray such as Nasacort to help resolve some of these post rhinoplasty symptoms sooner.  I would recommend you discuss your concerns with your surgeon and get a recommendation from him/her. Good luck.