Dr. Lapatka is an artist. I am thrilled with the results of my facelift procedure. I now have the defined neckline that I always wanted. My results are very natural looking. If you are considering facial surgery, he is the very best!
I am a 30 year old marketing professional that has hated my profile for many years. My nose has a bulbous tip and a large bridge that I would like to refine. My chin is where the major problem lies - family genes have left me with what I call my "slope chin" and quite frankly it is just going to get worse if my family aging patterns are any indicator. I have very low definition between my jaw and neck, and a weak chin with extra fat. I went in for an initial consultation for my chin and also mentioned my nose. I figure if I am going to do a surgery and pay, I might as well fix the areas of my nose that bother me as well. I don't think I am an unattractive person, but I want to feel confident in myself from every angle. I workout and eat right and I always think my chin makes me look so much fatter then I am. I am scheduled for surgery on June 4, 2015 for a rhinoplasty, small chin implant and a liposuction of my chin and neck with Dr. David LaPatka. I am very nervous, but also excited. My main areas of nervousness lie in the healing time ( I am a very active exerciser and haven't gone 4 -8 weeks without exercise in like 10 years) and I am also nervous about the "after", meaning how will I, and my friends and loved ones, react to the new me. I am inspired and grateful for all of the posts that everyone on here is sharing and I wanted to share my story too. Wish me luck! And please! I would love to hear from everyone about your experiences, advice and any questions. Updated on 19 May 2015: Hi Everyone, I would love to hear your experience about getting back into exercise after surgery. Don't get me wrong, I understand the importance of taking it easy to heal, but I am curious about your story. Were you able to go for walks afterward? When did you start back at the gym? Anyone struggle with taking a break from exercise after surgery? I ask these questions because I love exercise and it is a huge component to my well being. My hope is that I can relax into the idea of not working out and try to heal as quickly as possible. Also, I would love your advice on healthy eating post surgery for quick healing and mitigated weight gain. Thanks! Updated on 21 May 2015: I had my pre-op appointment yesterday with Dr. LaPatka and his RN, Heather Grieco. I am getting very excited and also a little nervous now. I have been instructed to take Bromelain and Arnica for inflammation and swelling now until my surgery in two weeks. I am to also reduce my caffeine and alcohol consumption now until surgery and after as well to reduce swelling, bruising and bleeding. Dr. LaPatka is great. He reassured me about my decision and answered all of my questions. He also explained to me why numbess and movement can be affected after a chin implant. I am the type of person who like to know the "why" so that made me feel better. I will be receiving a silicone implant in my chin, neck lipo and an open rhinoplasty. During my rhinoplasty Dr. LaPatka will shave down my bump and fine tune the tip of my nose. Heather, Dr. LaPatka's RN, was also so great to talk to. She has gone through similar procedures herself and it's a great sounding board. She also warned me of the emotional roller coaster that comes before and after surgery. In the mean time, we are heading out of town for the holiday weekend to relax. Updated on 28 May 2015: I'm getting so nervous and excited. My husband is being very supportive and will be caring for me after surgery. I just purchased some hydrogen peroxide to clean up any blood around my nose, saline nose spray for a week in, some Biotene spray for dry mouth and a big wedge pillow for sleeping upright. I also plan on prepping bags of crushed ice and getting some frozen peas for icing. I have also been advised to stock up on bananas, smoothie ingredients and some saltine crackers. What else do you recommend? I'd love to hear your advice. Updated on 3 Jun 2015: Tomorrow is the big day. I can't believe how quickly the time has flown by. I am scheduled for surgery tomorrow morning at 8 am. My hubby is driving me to surgery and will care for me for the next couple of days. I am nervous, but also excited. I am acting brave and excited, because I read recently that one "should act the way they want to feel". There is a definitely psychological connection between the two. The hardest part in the last week has been being around verbal family members who have basically been negative and unsupportive. They are trying to transfer their negativity and fear on to me and I won't have it. I told them to F off. ;) I bought lots of recovery supplies including bananas for after surgery food, watermelon water for a hydrating beverage, Biotene for mouth moisturization and a big comfy wedge pillow to help me sleep more upright. I'll try to keep you all posted in the days after surgery! Hoping not to be too out of it so I remember to post from bed. Thank you all for your support, advice and encouragement. Updated on 4 Jun 2015: Well, I'm alive. I'm definitely uncomfortable, but minimal pain. Waking up from anesthesia was very weird, but uneventful. The staff in Dr. LaPatka's office was wonderful. They took great care of me and wrapped me up like a delicate package. I've had minimal bleeding thus far and no nausea. I've just had a sip of smoothie, a saltine and some banana and took another pain pill and an antibiotic. My compression garments aren't very comfy. And I've been icing as much as possible. My amazing husband is doing a great job caring for me. Husband of the year award fo' sho. I haven't been able to fall asleep because I am so uncomfortable, but maybe I will be able to soon. I'll share more as I can. Updated on 5 Jun 2015: Last night I was able to sleep, but woke up to take pain meds. The pain wasn't unbearable, but I've been keeping it down by taking my meds regularly as needed. I had my post-op appt this morning. Everyone in the office was great again. Dr.LaPatka removed my packing from my nose and I was able to breathe. This has relieved a lot of my discomfort, even now as swelling and congestion has built up inside my nose. Dr. LaPatka also checked my incisions and taught me how to clean those and my nostrils. It wasn't particularly painful, just sensitive. I am very swollen, but have been icing regularly. I am less bruised then I anticipated, perhaps from the arnica pills and bromelain I've been taking. I've been eating small meals whenever I take my meds. So far they have been a few banana slices, 2-3 saltines and some juice (watermelon juice or Naked Juice smoothie). My jaw/chin/neck are the most sore, I expected my nose to be, but that's not the case. Icing and regular pain meds help. The nurse taught my husband an ice pack combo of socks filled with ice packs, tied together and placed on my head. When I wear a hoodie we can tuck these "rabbit ears" in place keep the ice on my jowls. Then he clips a glove, filled with ice in the fingers, to my hair and let's the fingers of ice run on either side of my nose. It's a good trick and seems to work. I'll try to post a pic next time I ice. Overall, things are fine, but it still feels like I got hit by a small truck. Lol. I didn't expect this to be easy, but it's definitely a healing process. It's really, really great to have someone care for you the first 24 hours. My husband had been tracking my meds and helping to get my ice packs on and off, and bringing food and drinks. He is seriously being amazing. Updated on 5 Jun 2015: The nurse taught my husband an ice pack combo of socks filled with ice packs, tied together and placed on my head. When I wear a hoodie we can tuck these "rabbit ears" in place keep the ice on my jowls. Then he clips a glove, filled with ice in the fingers, to my hair and let's the fingers of ice run on either side of my nose. It's a good trick and seems to work. Updated on 6 Jun 2015: Woke up this morning feeling pretty good. Didn't take any pain meds during the night and managed to sleep ok. My giant foam wedge pillow is very nice, everyone should get one who needs to stay elevated. . I briefly removed my compression bandages this morning to fix my hair and clean my face up a bit. I feel better after that. My chin looks great, even though I'm still very swollen. I can tell already the shape will be very nice and was a good size. Minimal brusing is on my neck from lipo as well. Updated on 6 Jun 2015: My photos didn't upload earlier, so I am uploading those again. Updated on 7 Jun 2015: Again, I am feeling pretty good today. No pain. I slept through most of the night, but my upper back is bothering me from sleeping and sitting inclined for so many days. I am only on Tylenol at this point which is great. I took a shower this morning and carefully avoided my face. After the shower I used some witch hazel around my face to gently clean the areas around my incisions that are dirty. I have tightness in my chin from the implant and lots of brusing and swelling in my chin and jowl area. My eyes are bruised, but the swelling around them seems to be going down. I clean the incision in my nose and inside my nostrils twice a day with a little hydrogen peroxide and then use some polysporin in the area as well. Yesterday was a TV and movie marathon. Today I might attempt to paint a little because I am sick of watching TV. Updated on 8 Jun 2015: So it's day 5 and it's the beginning of my week working from home as I heal. I feel good and have been working most of the day, but I am tired and have been taking breaks to ice my face. Icing regularly has been keeping the swelling down a bit and helps with any pain, although I don't I have much. I've been sleeping fine, although I never sleep great on my back. I am a total stomach sleeper with like 14 pillows (I exaggerate) all around me, so sleeping on my back is not ideal. Although, beauty is pain (literally for us RealSelfer's) and I will make due. The wedge pillow is buh-bye, since it was bothering my back. I am having a hard time smiling, as I read for many other people with chin implants too. My chin is tight and numb and will probably be that way for quite some time. But overall, the response from family and friends is that it looks great and I have much more of jawline. I took a shower today and washed my hair and shaved my legs and I feel 100 times better. My face is greasy, but it's not like anyone is gonna see me soon. I've been eating small, soft meals. I am not supposed to eat anything hot or hard for a little while since my chin area is still so numb. I've probably lost some weight since surgery because I haven't really had an appetite. Last night was the first time I actually ate a real food meal (pasta with meatballs made by my mom). I am still recovering and healing, but I am trying to eat less in the next few weeks in an effort to stave off any weight gain. I've been giving my face a break from the compression bandage since the fabric was irritating my skin, but I do think it helps keep the swelling down. I've been wearing it every night as well. Let me know if you have any questions about my process. I am happy to answer any questions. Updated on 10 Jun 2015: Day 7 and I am feeling good. No pain. Discomfort is very minimal now. My chin is still very numb, tight and swollen. I am unable to smile normally, which is worrisome, but I know I am only a week out and this seems to be something that people experience after an implant and chin/neck lipo. From what I read, it can be from swelling, the stretching of the muscle and of the stretching of the nerve. It also looks like it is common for this to take some time to improve, so I am hoping it will get better each day. Some accounts I read noted over a year before they could smile again and that would be a bummer. I can also feel a small hard bump on the right side of the jaw near my chin. I have my one week post-op appointment with Dr. LaPatka tomorrow afternoon and will address my concerns with him then. Tomorrow I will get my stitches out and my cast off of my nose. From what I can with my cast on my nostrils look asymmetrical right now, but that can't be a fair observation because my cast is still on and I still have stitches in my nostrils. I am still working from home, but continuing to ice frequently. Only taking Tylenol as needed at night and today is my last day of my antibiotics. Updated on 11 Jun 2015: The nose cast came off this afternoon and the stitches came out. It was a liberating day, but so strange too! The removal of the stitches was not painful, but it wasn't fun either. It was nerve wracking having someone in my tender nose removing stitches with little tiny snips. But Dr. LaPatka was gentle and there was no pain except one little pull of a stitch. He also removed my chin stitches and the stitches behind my ear lobes from lipo. Under my chin is so numb so I barely felt a thing. The removal of the cast was also pretty painless, except the gentle tugging on the nose really brought home how delicate my nose still is. Seeing my nose for the first time was full of awe and shock. It is weird seeing yourself with a changed facial feature. Dr. LaPatka did everything I hoped, but it still was weird to see on my own face. The doctor said that my nose is still very swollen, which I can see and feel, including my columella (where my stitches were). He also said my chin is still very swollen and he wants me to keep wearing my compression garment as much as possible. My sister came with me to my appointment and she didn't seem shocked or scared or anything by my new nose. She said it looked good and that it didn't seem too different from before. She did note that my tip seemed swollen, but we knew that. My husband and everyone else had the same reaction; I looked different, but still like me and that the side profile was the most changed. Overall I think I'm looking good. My profile is so much more balanced even with all of this swelling. It weird to have a new nose, but I bet that novelty will wear off as each day passes. Has anyone else experienced? I would love to hear how others felt about there new nose/chin etc. Updated on 11 Jun 2015: A quick side-by-side comparison really made me love everything even more so far! Updated on 12 Jun 2015: Since getting the cast off of my nose yesterday the swelling in my tip and bridge have gone up. My doctor told me this was to be expected. I still have a hard small lump on the right side of my chin on my jaw. Dr. LaPatka told me it might be the wing of the implant, but that we will need to wait for swelling to go down to tell. He said the wing isn't flipped. So my guess is that it's the edge of a wing. I can't see it through my skin, since I'm so swollen in my jowls, under my chin and in my cheeks. Updated on 13 Jun 2015: I put a little make-up on today and it's helping me feel more like myself. Updated on 14 Jun 2015: Anyone else ever experience this? I hop they will even out a bit as I continue to heal. Updated on 15 Jun 2015: Today is my first day back in the office. Only my work friends know what I did and no one else seems to notice anything differently. So far the feedback has been great for those who know. They say I look great and that they can see some swelling, mainly in my neck and chin area, but if they didn't know about my surgery they wouldn't have noticed. I lightly bumped my nose yesterday and it hurt, but I don't think I have anything to worry about in terms of having messed it up. I spent the weekend doing things with friends and family and felt comfortable going out in public. In fact I ran into my surgeon at the grocery store! Ha! One thing I have noticed is that my nose is extra greasy lately. I have been washing my face twice a day as I normally do (gently of course), but I am definitely experiencing some extra oil production. I did a search here on Realself and found that others have experienced the same thing. In the meantime I am keeping powder on hand. I also have noticed that my smile is coming back a little. My chin and neck are still very swollen and actually feel warm to the touch which I need to talk to my doctor about. Updated on 17 Jun 2015: I am nearly at the 2 week mark. It is crazy how I've just integrated this healing process into my life. No one has noticed, or at least had said anything to me, which I find interesting because I still have some bruising under my chin. I think I notice that each day my swelling is going down, which is great. I spoke with the RN at Dr. LaPatka's office. She was great at reassuring me that the hardhttp://www.npr.org/2015/01/24/379326224/not-my-job-we-quiz-funk-legend-george-clinton-on-the-british-parliamentness under my chin is normal. She also let me know that the swelling in my nose will continue to go down. I am surprised to say this, but I haven't been missing my exercise routine too much. Maybe by next week I will be going crazy though. I have been walking the dog about twice a day this week so that probably helps a little. One of the hardest parts is not being able to wear my sunglasses. My eye are super sensitive to the sun and I've been squinting my way through the days. Lol. I have been wearing a big floppy hat on walks though, to keep the sun out of my eyes and off of my face. I am hoping the tip of my nose continues to go down. And that my chin swelling also will start to relax in the next couple of weeks. Otherwise I am loving everything so far. Updated on 19 Jun 2015: Today marks 15 days post-op and I am feeling particularly pretty today. As the swelling continues to go down I feel better and better about my chin and nose. My smile is starting to come back and things are settling in nicely. My nose is also healing well, and is becoming less and less sensitive to touch. I still miss my sunglasses and being able to make out with my hubby, but all in due time. Oh, and I miss working out too. I feel like my muscles are melting. Updated on 19 Jun 2015: I have read countless reviews on here in which people freak the [RS bleep] out so soon after surgery. Everyday I see improvements in my healing in terms of swelling, refinement of my new features, scars, I want to show you guys what I mean. Updated on 2 Jul 2015: Made it to 4 weeks! Feeling great. No one seems to notice which is still so crazy to me! Met with Dr. LP this week. I still have swelling in my chin and jowls. And a little dimpling on the right side, but he said we need to be patient. Updated on 4 Jul 2015: Great comparison of swelling at 10 days post vs. 20 days post. Updated on 14 Jul 2015: Getting close to the 6 week mark. My nose continues to look better and better. My chin seems to have these pockets of fat in my jowl area that I haven't seen much change in. My thoughts are that the implant wings have added more to that area and it may just look bigger now. I see Dr. LP in a few weeks and we'll see how it looks from there. It also may just be extra swelling still. It is still tight right under my chin, but everything is healing nicely. My nose is feeling more and more normal. It's becoming less sensitive and a lot of feeling is coming back to the collumella. Overall, I love the results so far and will continue to share my progress. I am back to working out. Although much less than before since I got completely out of shape while healing. No problems working out so far. I take it easier with low impact cardio and weight lifting. No running or jumping just yet and no heavy lifting. Also, I stopped using my compression garment at night last week. I wore it for a total of 5 weeks because I felt it kept the swelling down in the morning. I also started to wear sunglasses again, although only my lightweight ones and not for very long periods of time as they start to get uncomfortable. Happy to answer any questions you may have! Updated on 3 Aug 2015: Thought I'd share some 8 week progress shots. Feeling good and healing nicely. Updated on 30 Aug 2015: Hi all! It's been awhile since I've posted, so I wanted to share my close to 3 month update. Things look great and I am loving my results. About a week ago I had an apt with Dr. LaPatka to see how things are. He noted that the tip of my nose is a little wider than he would have liked to see, and I agree, but that we should wait a full year to reevaluate things. I do think my nose looks great and so much better than before and I am not sure I would want to go through surgery again. We'll see how I feel after a full year. As for my chin, it's feeling like mine now and the numbness is getting better. My scar is a little pink and more visible then t was about a month ago, so I am looking for recommendations to calm it back down. My swelling still seems to be going down, even if it is just to my own eyes. However, my jowls do still seems to be lingering. Dr. LaPatka told me to keep waiting, that they may continue to come down and that he liposuctioned that area very vigorously. All in all, I feel great about everything. Updated on 30 Aug 2015: Just wanted to share an old photo I found of my nose before surgery. Updated on 9 Oct 2015: Hi All! Just wanted to check in with my 4 month post surgery update. I am absolutely in love with my results. I continue to heal notice slight changes. My nose feels almost completely normal now. Still sensitive to pressure in certain ways, but my nephew can bop me in the face with a blankey and it doesn't bother me. The tip of my nose and columella is still a little numb, but it seems to be continuing to improve. The tip of my nose is a little uneven. The right side bulges out a little bit more, but I will continue to watch it as time goes by. And my scar is almost completely faded. As for my chin implant, my scar is lightening up and almost no one notices. My chin is much more balanced with my profile now, but I do think it made my face a little more boxy from the front, with a hint of jowl look. My smile has completely returned, but it looks a little different now with the implant. I think it is an improvement, but I want to lose some extra pounds and see if that effects the look even more. Overall, things are great! Updated on 14 Nov 2015: Hi all! Thought I'd share some 5 month photo updates. I also received some Restylane Silk injections in my lips last week. I love the results. Very natural, but warning! I did swell up a lot the morning after. The swelling went down by the third day. Updated on 14 Nov 2015: I should add that my lip injections were done by Heather Grieco, RN in Dr. LaPatka's office. She is amazing. We used about half of a syringe, because she didn't want to over do it. I think the results are great. Very subtle and pretty. Updated on 27 May 2016: I haven't posted in a while and thought that must for my 1 year anniversary which is actually June 4. I love my result and although subtle, my nose continued to change for the full year. Updated on 19 Jun 2016: A little before and after. Updated on 5 Aug 2016: I continue to love my results. I had a causal conversation with my plastic surgeon in person last week when I ran in to him out and about. We discussed the fullness at my tip and said a second surgery would help. I have very thick strong cartilage and that I have residual fullness because of this. I am considering a revision, but I also don't know if my husband would put up with me doing this again. I think it was very emotional for him. Regardless, I love the look. Here are some updates shots from this week. Updated on 5 Aug 2016: Grab a quick shot of my before and after last time I was in the office and thought I should share.
I would do both together since there is rarely an urgency to do a septoplasty . You have a minimal hump and I would suggest imaging so you can discern possible result with and without a chin implant or other augmentation depending on your occlusion. It is imperative that you have a finesse rhinoplasty since over resection of the dorsal hump will not achieve your desired result . There is no true lateral view so it is difficult to say but it looks as though your nose may be slightly over projecting. In conclusion , you are a pretty girl whether you do your rhinoplasty or not.Best
This is not a " cobra deformity" . You have some swelling and irregularity in the submental/ submandibular area ( right greater then left ) . I can also see your submandibular gland which can become more obvious after facial surgery . Has any steroid injection been tried ? I would try steroid and if it has not helped you can consider revision surgery in the next few months . ( if you are not a smoker you could do sooner then later ) . Although not an ideal result if you had a very "full" neck prior to surgery this can happen and I would discuss with your present surgeon .Thanks
You are on the right track with the treatment you have received and are doing with the taping and massaging of the lower lid . If there is no improvement in position after 2 or 3 months then revision surgery may be necessary .
Thanks for your great question . Longevity of any rejuvenation surgery depends on your age when the initial surgery was done , skin elasticity ( sun damage to skin ) , and other factors such as stress in your life . I agree with your surgeon that BOTOX or other neuromodulator may be helpful but of transient duration ( 4 months ) . At your age , a simple conservative skin only excision of the excess skin would almost certainly accomplish your goals . It must be conservative since as you age your brow will become more of a factor and too much skin excision would bring your brow down sooner . I would not recommend a brow lift at this time . Best Dave LaPatka ,M.D.,F.A.C.S.
Photos are necessary for a more informed answer but in general you must wait 1 year following the surgery to make any decisions . If this was a revision surgery swelling may last longer and be more obvious at 7 months post op . Call your surgeon and make an appointment for re evaluation . He or she would be best able to give you an answer . Patience is necessary . Best ,David LaPatka,M.D.,F.A.C.S.
