Kaete A. Archer, MD

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  Making plans for rhinoplasty depends not only on the outside of the nose but also the inside of the nose and the feel of the nose (skin thickness and cartilage strength).  Based on your description, I agree with you, you could definitely benefit from a straight piece of rib cartilage, especially for a revision rhinoplasty.  

These decisions should be based on a detailed discussion with equal input from both you and your surgeon. 

Good luck and best wishes. 

Hello and thank you for your question.  My best advice is to discuss this with your surgeon.  There is some variation in recommendations amongst surgeons after rhinoplasty and some of it depends on the specifics of the procedure.  

In general, after rhinoplasty, patients wear a nasal splint for 1 week.  Once the splint is removed, the face and nose can be gently washed with a gentle face wash.  At 7-10 days, you can return to using your normal facial products with care to not rub the nose firmly.  I would not do a firm exfoliation until about 4 weeks. 

Brow lift recovery somewhat depends on the type of brow lift you are getting.  Most brow lifts are done with sutures or metal clips in or behind the hairline that are removed at 1 week.  By 1 week, you are feeling better and looking better but you may have swelling to some (small) degree for months after the procedure.  

I routinely offer prescription pain medication for patients after a brow lift but that is usually only needed for a few days and then patients switch to Tylenol.  Patients have a headache for a few days and experience some numbness across the forehead and top of head.  

I recommend that patients avoid strenuous activity, heavy lifting, anything that gets the heart rate or blood pressure up for 2 weeks after the brow lift. 

Brow lifts are safe but every procedure and surgery has risks.  The specifics depend on the type of brow lift so I would make sure you discuss this with your surgeon before the procedure.

An endoscopic brow lift is one of many types of brow lift.  Brow lifts are generally classified by the approach including coronal, temporal/lateral, endoscopic, direct, mid-forehead, and pre/trichial.  Which approach is chosen depends on hairline and anatomy.  A coronal lift or any approach behind the hairline will raise the hairline.  An incision right at the hairline or in front of the hairline (pre/trichial) will not raise the hairline.  

The endoscopic approach includes 4 incisions (some variations amongst surgeons) behind the hairline.  These are small incisions that fit thin endoscopic instruments.  The surgeon is able to visualize the tissues magnified on a high-definition TV screen for precision and accuracy dissecting the tissue.  Because the incisions are shorter than other "open" approaches, this approach may have a faster recovery time and less risk of hair loss.  High hairlines or severely curved foreheads are not good candidates for this approach.  

Which option is best for you will depend on your examination and aesthetic goals.  I recommend a consultation with a qualified board-certified facial plastic surgeon/plastic surgeon for an in person exam and discussion of options.

Hello and thank you for your question.  Rhinoplasty pricing depends on many factors such as your location, technique, cosmetic vs insurance, and experience of the surgeon.  Some areas of the country will be more expensive than others.  If a surgeon recommends more techniques or procedures, the surgery will cost more. 

In terms of options for rhinoplasty, the best advice you can receive is from an in-person consultation.  Making plans for rhinoplasty depends not only on the outside of the nose but also the inside of the nose and the feel of the nose (skin thickness and cartilage strength).  Based on your photographs, you may benefit from increased rotation of the nasal tip and slight de-projection (so the tip doesn't feel droopy as you mentioned).  

These decisions should be based on a detailed discussion with equal input from both you and your surgeon.  Look at before and after pictures of real patients who have had this surgery performed by your surgeon.   The most important aspect is to find a surgeon you are comfortable with.  I recommend that you seek a consultation (even more than one) with a qualified board-certified facial plastic surgeon/plastic surgeon who can evaluate you in person.