Justin L. Bellamy, MD

That will not be a very practical or effective solution, in my experience. I would work closely with your surgeon to establish a plan for scar management ahead of time. This may include sequential steroid injections. I would also discuss with your surgeon about superficial radiation therapy. This generally requires you to see a radiation oncologist who performs this procedure ahead of time to plan for immediate treatment after excision by your surgeon. This may or may not be feasible depending upon where exactly the keloid is. Ultimately this will have to be determined with your treating surgeon.

Good luck.
Justin Bellamy, MD

Nose and chin balance definitely affects overall facial balance from both frontal and (especially) profile view. You would benefit from some augmentation of your chin, which would in turn help balance the relative proportions of your nose. The home run result, of course, would be both rhinoplasty and implant-based chin augmentation, however you would likely see benefit from filler to the chin alone as well. There is no harm in starting with that to see if it's a satisfactory change.

Dr. Justin Bellamy, MD

Allergan does not have a "moderate-plus" silicone implant, however you can look at the actual dimensions of the implant to find relative comparison. Ideally your surgeon should review this with you, but if you are motivated you can find the sizing charts for each brand's implants via Google. It so happens that what Allergan calls "Moderate" is actually slightly more projected at a given size/width than what Mentor calls "Moderate-plus". Overall these two are profiles are very close in dimensions, though.

Dr. Justin Bellamy, MD

Hello, all of your desired procedures can be performed safely, comfortably, and effectively under local anesthesia. While not all surgeons perform facelifts under anesthesia, there are many surgeons who offer facelift under local-only anesthesia. Personally, I always perform deep-plane facelifts with fat transfer under local anesthesia as the recovery is much easier for the patient regardless of dementia concerns. Adding lip lift, eyelid surgery, brow surgery, and/or laser resurfacing to the procedure is also an option as all of these procedures can be done effectively with local anesthesia in the right hands.

Dr. Justin Bellamy, MD

From your question I believe you are seeking "profileplasty", or a balancing procedure to improve your profile aesthetics. This often includes rhinoplasty and chin augmentation together to achieve improved facial harmony. I believe you would benefit from both. The details of how exactly that is achieved must be a discussion between you and your surgeon, as there are several ways to proceed. Generally speaking, these procedures can be combined and synergize well with regard to facial balance.

Dr. Justin Bellamy, MD