Q: Is it possible to have my nose de-projected without lifting the tip? (Photo)
The reason you often see the angle raise with deprojection is that a common technique to achieve de-projection is lateral crural overlay where the lateral crura are cut and overlapped...this causes increased rotation (tip up) as it deprojects. You can use tip sutures to minimize the rotation caused by lateral crural overlay, or perform a more intermediate crural overlap where the cut is closer to the dome (tip). Find a good, experienced rhinoplasty surgeon and you should be fine.
Q: What procedures could make this deep crease across my nose less noticeable? (Photo)
Hi Nana: It probably is from allergies and pushing up on the nose as you were growing. You could try injecting a filler like vollure which should fill the crease and make it about 50% better. This is temporary, but also reversible, which is nice. Over time, you could probably achieve 80% reduction of the crease if you are no longer pushing up on your nose and you keep up with the filler.
If you still have nasal congestion as an adult, and have maximized allergy treatment, a functional rhinoplasty would improve your breathing and also probably reduce the crease by 50-75%.
Q: How safe are cartilage rim grafts?
Hi Jackie: Rim grafts are very safe and very effective. There is typically no real "incision" made, just a pocket dissected along the nostril margin. Rim grafts help maintain a normal nostril shape and normal nostril symmetry over time after rhinoplasty, and can help breathing as well.
Q: Do I need Botox or surgery? (Photo)
I would start with botox. Basically with Bells palsy, the facial nerve gets weak and then when it recovers, it sometimes recovers too much and you get tightness and extra movement, called synkinesis.
I have about 30 patients like yourself that I see every 3 months for botox treatments. It can usually open the eye up, and often insurance pays for it. In your case, if the eye is the only complaint, it would be pretty inexpensive even if insurance didn't cover it as you would only need about 15 units each time.
Surgery would involve cutting a strip of the orbicularis oculi muscle out. This muscle closes your eye. This might work but it is more aggressive and harder to get exactly right. I would wait until you need/want eyelid surgery on both eyes for cosmetic reasons (usually in 40s or older) before doing surgery as I suspect the botox will work well for you.
You should seek out someone who treats a lot of patients like yourself. Usually facial plastic surgeons will have some experience with this, some more than others.