Matthew Brace, MD

Thanks for the question Candice. It is very wise to have a realistic expectation going into any surgery especially a rhinoplasty. From these photos, I would classify your nasal skin as medium thickness. It is not so thin that every contour of the underlying cartilage is visible, but there are some visible contours in your tip. You have the ideal skin thickness in that changes in the cartilage will translate into visible refinements of your nose but not look too sharp or angular requiring additional camouflaging grafts. A full in person exam of your nose would be needed to confirm this assessment.  Best wishes on your rhinoplasty journey if you decide to pursue surgery! Dr. Brace

Excellent question and understandable worries. Your perforation looks to be in the membranous septum as you described. This is soft tissue and can be sutured closed. We sometimes make a similar incision during rhinoplasty called a full transfixion incision to deproject or set the nose back. Speak to a board certified rhinoplasty surgeon (facial plastic surgeon or plastic surgeon) and they should be able to help you correct that. There is no need to worry about a saddle nose developing as this is not in the cartilage that supports your nasal bridge. Your columella may become lifted or tucked up in the process of closing this but it will not deteriorate. A small graft using cartilage could address the lifted or tucked in appearance of the columella if it were to develop or be obvious during the closure.  All the best, Dr. Brace

I tell all my CO2 laser patients to expect a sun burn like redness to last for 40 days to 3 months. You are still in the healing phase. Using an recovery complex topical skin lotion can help immensely in speeding this up. The burning in your eyes is more concerning as you may be experiencing dry eye symptoms as a complication of the blepharoplasty. Make sure to use eye drops (natural tears) during the day. If your eyelids don't close completely you should be using a lacrilube ointment at night. Have your surgeon evaluate your eyelids and eyes to ensure there is no excessive drying. All the best, Dr. Brace

Great question. A septoplasty can be done to straighten your septum and make your breathing more equal, the question I would ask is regarding the integrity of your nasal valve and if any grafting is necessary to optimize your breathing any further. Changing the shape/bridge would be an individual cosmetic consideration for you and your surgeon to discuss.  All the best, Dr. Brace

A rhinoplasty can put your nose in better harmony with your face. It should not drastically change your appearance, rather make your nose less prominent and distracting. An expert rhinoplasty surgeon can perform surgery to give you lifelong natural looking results. It is possible to place all the incisions inside your nose and avoid all visible scars. Make sure you see an expert.

In order to fully address your concerns an in person consult would be necessary. From your photos, you look like you may be a candidate for a number of non-surgical technologies that can tighten the skin. No face lift will address your forehead size. Botox will not change the shape of your forehead either. A surgical forehead reduction can pull your hairline down, but this requires an in depth discussion and assessment. See an expert with access to all tools and techniques (injectables, lasers, radio frequency technology, surgery)  to know all your options and get the result you are looking for.

The simple answer is absolutely, you can have Botox injected to soften your forehead lines while still retaining movement. It all depends on how much is injected. See an expert and explain your goals. A Board Certified injector should be able to help you achieve what you are looking for. All the best,  Dr. Brace

The answer to your question all depends on how long ago your surgery was. If you are still in the first year of healing then all that is required is patience as you will continue to see changes as everything heals. If this surgery was more than a year ago, you could consider a revision surgery to narrow your bridge and correct other asymmetries. I recommend speaking to your surgeon about your concerns. All the best, Dr. Brace

What you are noticing has to do with the curvature of the underlying cartilage that supports your ala. It appears from these photos as if your cartilage has a concave curvature. You would need a proper nasal exam to confirm this. This curvature is correctable with surgery. See an expert rhinoplasty surgeon to discuss this more. You are likely a candidate for a limited rhinoplasty to address this.  All the best, Dr. Brace

Generally speaking, Voluma is injected deep against the bone and bruises are uncommon but not impossible. Unfortunately you have bruised. Talk to your injector about possible VBeam treatments for the bruise to help it resolve quickly. Otherwise, they should resolve on their own within the next 10-14 days. All the best, Dr. Brace