Revision Rhinoplasty

Facial Feminization Surgery

Facial Reconstructive Surgery

Ear Surgery

Cheek Augmentation

Rhinoplasty

Jaw Reduction

Cheek Implants

Facial Fat Transfer

Cleft Lip And Palate Repair

Deep Plane Facelift

Jaw Implants

It would be helpful to see profile photos, as well as a bird’s-eye view to better assess the nostrils. However, I agree that your nose remains wide despite two rhinoplasties. You will likely need a revision rhinoplasty to narrow the nasal vault and alar base, and to correct the retracted columella. Because this is a revision case, you will most likely need rib cartilage grafting for structural support. We primarily use cadaveric rib cartilage. Most importantly, this procedure should be performed by a board-certified plastic surgeon experienced in revision rhinoplasty.

I have had two rhinoplasties - my original nose wqs long, had a hump and super pointy. The revision got rid of the hump which is great however is quite wide for my face, the columella is very retracted, there is a dent just under the tip ( surgeon said we can add a graft) and it’s short, low projection. Jut after some advice - What should I be asking for in surgeon speak to fix this ? The more clear I am, the easier it will be to explain the issue which I do think the surgeon acknowledges anyway.

Post revision nasal width and shortness - retracted columella - how can I fix this? (Photo)

Being HIV-positive with an undetectable viral load is NOT a contraindication to having a facelift. You can safely undergo a facelift or any other elective surgery with proper evaluation and routine precautions.

I am 55 years old and I am looking to possibly getting a deep facelift in a couple years. My question is that I am HIV positive since 18 years old. I’m extremely healthy never been ill. I am on medication and I have an undetectable viral load. Are plastic surgeon is going to have issues with this.

HIV positive - Can I have a deep plane facelift?

All nasal structures are interconnected, and in my opinion, addressing only one part of the nose often leads to unfavorable results. In some cases, a very minor touch-up can be reasonable, but in your situation, I would recommend either doing nothing or, if you truly wish to improve the bulbous tip, proceeding with a formal rhinoplasty to achieve the best outcome.

I'm 60, 5'5", and in good health. My skin has always been oily, but it's always healed well. Would I need a full rhinoplasty or just a tip plasty? I have a very bulbous tip.

60 year old - rhinoplasty or tip plasty? (Photo)

In my opinion, nasal implants are a poor option and should not be used. I have seen severe complications when they extrude, which can cause permanent damage. There are other techniques to improve nasal shape without these risks. Jaw and chin implants are different. While there is still a small risk of infection, extrusion is very uncommon. The difference is that the jaw and chin have significantly more soft-tissue coverage, including muscle and subcutaneous fat, providing better support and protection for the implant. In contrast, nasal implants sit just beneath the skin, and constant pressure can eventually lead to extrusion.

Context: I had jaw implant &amp; chin implant back in 2018. Haven’t had any issue but what’s spurring this general anxiety is because my nose implant failed after 5 years and had to removed because it fell out of position and essentially was protruding through the skin. Anyways my questions are. should I expect my jaw/chin implants to fail anytime soon? Are the built to endure bruxism ? any general advice to ease my anxiety would help.

Should I expect my jaw implant to fail? Can they endure bruxism?

You have sufficient eyebrow projection, so I would not recommend implants to the forehead area for additional projection. However, I do agree that you are lacking projection in the malar region and under the eyes. Cheek implants would help address this issue.

Hello! I had double jaw surgery a few years ago. I'm happy with how much it's helped my breathing, but it has thrown off the rest of my face. I had a very flat face with little to no projection prior to the surgery, and now I just have jaw projection while the rest remain flat. I had a consult with a plastic surgeon, but it didn't lead to any answers or help, so after research I realized that what I was missing is facial projection (Which was at least harmonious prior to surgery). I think what would help me is implants for eyebrow projection and under-eye orbital rim support, along with perhaps some fat injection. However, I don't know what I don't know, and would love some input to make my face more masculine and stronger. Thank you! PS: I am aware I need to lose weight and that will help some. However you can see from the profile shot that my face is very flat.

Flat Midface After Double Jaw Surgery - how can I make my face more masculine? (Photos)

There is nothing particularly wrong with your profile. If these are selfies, keep in mind that they are not ideal for assessment, as camera angles can vary greatly and significantly affect how facial features appear. That said, you may be referring to slightly reduced volume in the malar (cheek) area. Some asymmetry between the right and left sides of the face is completely normal &mdash; everyone has this. If you are seeking more volume in the malar region, this can be addressed with fat grafting or cheek implants. I would not recommend cheek implants in your case, as it does not appear that you need a significant amount of added volume. Fat grafting would likely provide excellent and natural results.

Hello! I dont know in which group to post this question but I need advice about what can be done for my right profile to make it more harmonious. I love my left profile but cant stand my right..… it looks like..… flat ? Thank you for any insights!!

What is wrong with my right side profile? How can it be improved? (Photos)

While rhinoplasty will address your concerns about the shape of your nose, it will likely have minimal or no effect on your smile or tooth show. You may consider an upper lip lift, which can be performed at the same time as rhinoplasty. A “lip flip” usually refers to Botox injections to the upper lip, which can offer only temporary improvement. For a more predictable and longer-lasting result, I recommend a surgical lip lift.

Hard to smile with upper teeth, they usually don’t show and nose is in the way. Lwith the shape of my nose and how the tip is positioned. Teeth are straight and look ok in my adulthood but unable to smile fully. Want to maybe correct the droopy tip of nose in near future but wondering if I’ll be able to smile with all my teeth showing. Wondering about lip flip as well Also can this be performed under local/light sedation and not go fully under with general anesthesia , just curious

More tooth show - Do I need rhinoplasty or rhinoplasty plus another procedure to correct this? (Photos)

Open vs. closed rhinoplasty often depends on the surgeon’s preference. In my opinion, open rhinoplasty provides better access to the nasal structures and can yield more precise results. In your case, the asymmetry is likely due to underlying structural issues. These must be addressed to correct the nostril asymmetry and notching at the soft triangle. Most likely, you would need at least a septal-extension graft to support the tip, along with alar rim grafts to support the ala for improved symmetry and reduction of notching.

40 yo male here. Had tip refinement 7 years ago and ive been living like this for a long time now feeling incredibly self conscious because of people staring at my nose when im talking to them. Is there any way to fix this without any open rhinoplasty?

Nostril and tip asymmetry - can this be fixed without an open rhinoplasty? (Photos)

If you raise your nasal bridge to the level of the forehead, as shown in the picture, it would create a very unnatural appearance. In my opinion, the issue is not a low bridge but rather the dorsal hump. Gently reducing the hump would create a more natural-looking nose. In general, when bridge augmentation is needed, my preferred method is facial grafting with diced cartilage. I strongly recommend against silicone nasal implants, as they can lead to serious complications such as implant extrusion. Yes &mdash; the nose also can be straightened and the tip projection improved using standard rhinoplasty techniques.

I’m wondering if it’s possible to raise the bridge of my nose without an implant, straighten the nose (mine leans a bit more to the right) and decrease how much the right side of the tip of the nose extends out?

Raise bridge without implant, straighten and decrease right side of tip - Realistic rhinoplasty outcome? (Photos)

I agree with your assessment &mdash; the results are not ideal. The upper part of the ears remains over-projected, while the middle portion was brought too close to the head, creating what is known as a “telephone-ear” deformity. Unfortunately, this will not improve on its own and would require revision surgery to correct.

A year ago I had an otoplasty, where cartilage was removed from the concha and some stitches were placed to make the ear move back. I always had my right ear more prominent than my left. A year after the surgery, I am still unhappy with the result. My right ear is still larger, not to mention that both have taken on a very curved shape. What could be done in my case if I don't want my ears to be closer to my skull than they already are?

Otoplasty with asymmetric results - Options? (photo)

Artur Fahradyan, MD

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Plastic surgeons specialize in the full spectrum of cosmetic and reconstructive surgeries for the face, eyes, nose, breasts, and body.

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Beth Israel Deaconess Medical Center, Harvard Medical School Teaching Hospital, Boston, MA

Plastic and Reconstructive Surgery, University of Southern California (USC), Los Angeles, CA

Craniofacial Surgery, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, CA

Yerevan State Mdical University

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