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Hello, I can tell that you have a deviation on columella and septum and this is actually quite common issue that happens after rhinoplasty. When the septum cannot deal with the height and weight of 'after-surgery nose', it gets crooked. This issue must be causing you a breathing problem. For sure, you would need revision surgery to fix this problem. This revision surgery should have stronger ingredient for strut so it does not get crooked again. For more accurate plans, you should have in-person consultation with a surgeon.

Hi, I got a rhinoplasty about 6-7 months ago and this is what the inside of my nostril looks like. It looks like the actual nostrils themselves are pretty even, but now the inside of the nostril (the cartilage) is all messed up. What are my options to fix this? Do I have to get a revision rhinoplasty?

Cartilage doesn't look right after Rhinoplasty - what can I do? (photos)

Hello. If you are concerned about asymmetry & hooding issue, having a eyelid surgery would be a good idea. The main reason that makes asymmetry would be the difference in eye-opening power. Considering the size of the exposed pupil, right side (from the photo) looks more sleepy. To fix this issue, ptosis correction is recommended. Also, it looks like your medial part is more hooded and I believe this is because epicanthic fold is pulling the medial part of the eyelid down. To fix this issue, you may need epicanthoplasty & incisional ptosis correction (to remove the hooding skin). For more accurate plans, you should have in-person consultation with a surgeon. It would be very important to find a surgeon who is specialized in asian eyelid since your case would not be the simple case, especially in western country. I hope you can find a experienced surgeon to perform your surgery.

Hello! I (20F) naturally have double eyelids but dislike how hooded they are. My goals for surgery would be to make my eyes more stable and less hooded with a slightly higher crease (still tapered), but since my eyes are already a bit asymmetrical I’m unsure if my result after surgery would make the asymmetry even more noticeable? I would go in for consults but since I'm in Michigan it’s difficult to find doctors who have experience with asian eyes. Thanks!

Would Double Eyelid Surgery bring out the asymmetry in my eyes more? (photos)

Hello, Usually, nose surgery that you mention uses incision on the columella and alar area, and lip lift uses incision on the top of the philtrum. These two incision areas are too close. This complicates the suturing process for the surgeon. Also, it will not be the best idea when we consider the healing process after surgery including the blood circulation. It is recommended to do the higher priority first and have several months interval. For more accurate plans, you should have in-person consultation with a surgeon.

Can you do alarplasty/rhinoplasty and upper lip lift together? What if performed by different surgeons but same day? Or how long to wait after rhinoplasty before lip lift. Or how long to wait after lip lift before doing rhinoplasty? Thanks

Rhinoplasty and lip lift - how long to wait before doing the other surgery?

Hello, If you are self-conscious about your side profile, then the rhinoplasty will be a good idea. Based on the photo you posted, reduction rhinoplasty is recommended. This includes tip-plasty, osteotomy, and humpectomy. Possibly, alar reduction can be combined. This procedure will make your nose look smaller and more feminine from the profile. If you are interested in additional procedures as well, fat grafting and V line surgery are also recommended. For more accurate plans, you should have in-person consultation with a surgeon.

I want a nose job but my side profile looks old and masculine. I am 24. What would help feminize my face from the side?

Hate my side profile. It looks masculine. What would help feminize my face from the side? (Photo)

Hello, Based on the photos and information you provided, it looks like you have some breasts tissue left which is so-called gland. Of course, the diagnosis should be made after in-person consultation that the surgeon can actually touch the lump so it is hard to be sure for now through photo consultation. However, considering that the pointy area is right below the nipple and it sticks out in a small circular shape even when you raise your arm, there is a chance you may have actual gynecomastia than "pseudogynecomastia". Please touch the area and feel if it is a bit harder or a bit different than other fat. If it is, you may try follow up appointment and consider revision with pre-areola incision to remove the gland. For more accurate diagnosis, you should have in-person consultation with a surgeon.

Hello. Years ago, I had lipo. My surgeon told me after the procedure that there was very little glandular tissue and that I had “pseudogynecomastia”. I had concerns cuz my lower chest still had this pointed look, though it was much improved. Two consults said further lipo was unnecessary, and after an exam concluded I’d need a mastopexy. Is this true? It looks much better than it was. However, my lower chest seems to “poke out” still. It’s soft, though. When I lift up my arm, it’s flat.

Can ptosis resemble Gynecomastia? (photos)

Hello, Based on the photos you provided, it would be hard to say scar revision will work for you. It looks like you got the lollipop incision and the straight line got infected. For now, it would be hard to try the surgery to remove the scar since the skin is too tight and the scar is too wide. When the skin is too tight, even if the surgeon remove the bad scar and sutures pretty, it will get stretched and bigger. You have to remove the implant or reduce the size of it to get the scar revision so the skin is less tight and breasts have less tension from the heavy implants. Fundamentally, scar revision cannot actually remove the scar but just make them prettier and less noticeable. It would be better to try some laser toning or other scar treatment. For more accurate plans, you should have in-person consultation with a surgeon.

Hi, I got breast implants in 2019 and my surgerical site got infected and as a result, I was left with a nasty scar on one breast. Would a revision be possible? My nipple is also weird shaped

Am I candidate for a breast scar revision? (photo)

Hello, Based on the photos you provided, chin implant or genioplasty will be a good idea. Surely, implant would be simpler way but if you do not want any foreign body inside of face, then you can have genioplasty which only uses your own bone. The most common genioplasty would be sliding genioplasty. Both procedures need titanium for fixation plate and screws. For chin implant, silicone implant would be the most common and safest choice. The size if the implant can be discussed after CT scan. For more accurate plans, you should have in-person consultation with a surgeon.

Hi, I've hated my chin for a very long time and I've finally decided to do something about it. My biggest complex is from the front, but I do think the side profile is a bit weak as well. I only want natural changes, so I'm wondering if a chin implant is an option for me? The picture on the right shows how I want my chin to look, while the left one is how it looks now.

Am I candidate for a chin implant? (photos)

The diagnosis for low eyebrow position would be 'eyebrow ptosis'. Usually, the eyebrow moves down due to the aging process or many people are born with low eyebrow position. Functionally, if your eyebrow is too low, you feel heavy when you open your eyes. Aesthetically, you may look a bit angry and your eyes may look small since you do not have much space between your eyebrow and eyes and the eyelids are all hidden. The most common and safe method for eyebrow lift would be endotine forehead lifting. There will be no scars visible since the incisions will be made inside the hairline. The result will be very immediate after surgery and the recovery time is very short. For more accurate plans, you should have in-person consultation with a surgeon.

I hate my appearance when my forehead is relaxed,, so much so that I first consciously and now subconsciously raise my brows all day everyday which is beginning to give me headaches daily. (All other causes rules out) I usually have deep lines in between my brows but have now had Botox to ease them. It’s likely I still have a slight lift in photos from Botox through the brow too. Wondering what procedure I need to lift my brows and make my eyes more cat like?

Eyelid Lift? What do I need to do to fix my brows and make my eyes more cat like? (photos)

Hello, Based on the photos you provided, a rhinoplasty will be a good idea to deal with the problems you pointed out. Tip-plasty, osteotomy, and septoplasty will be a good surgery plan for you. The deviation of the septum and columella is quite visible from the photos you posted so it has to be fixed through surgery not only for aesthetic purpose but for functional purposes as well. Also, considering that you have the bulging part from side part of the bridge and highly likely it looks like a nasal bone, osteotomy has to be performed to make them slimmer and more straight. For more accurate plans, you should have in-person consultation with a surgeon.

My nose looks perfect from left side face profile and ugly from the right side of face. The nostrils are also irregular and from front view, left side of nose appears swollen and bulging out. Kindly let me know if it can be fixed and by with method.

Shape of nose and irregular nostrils - how can this be fixed? (photos)

Hello, Based on the photos you provided, it looks like the asymmetry is coming from the crooked columella. To fix the asymmetry, we have to fix the columella first which means we have to make it straight. There is a high chance you may need something that can work as a strong strut such as porous polyethylene implant since your columella is too weak. Concerning the nostril showing problems, there will be some limitations to fix it since it looks like your original alar shape and position cannot be altered. You may try alar rim graft but both procedure need bigger anesthesia than local one. For more accurate plans, you should have in-person consultation with a surgeon.

Hi I've had two previous rhinoplasties but still feel my nose could be improved. I was told I have a collapsed columella and understood that the previous surgeon intended to fix it. It's 4 years since I had the last operation and still feel that my nose doesn't blend in with my face, there is a lot of nostril show and asymmetry in the centre of my nose. Can you tell me if this can be fixed with a graft for example and also can this be done under local anaesthetic? Thanks

Lots of nostril show and asymmetry - can my nose be improved? (photos)

Sang Hoon Park, PhD, MD

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