Ercan Karacaoglu, MD, FEBOPRAS

It is not true to say that 'Deep plane can not combined with mid face lifting. ' Midface-lifting surgery is challenging owing to the difficulty of adequately releasing the soft tissues overlying the zygomaticomaxillary region. And it is also challenging to resuspend them effectively. A comparison of the extended transtemporal midface-lift and deep-plane face- lift had been performed almost 13 years ago by a group of well known deep plane surgeons and they demonstrated that there was statistically significant advantage of the transtemporal midface-lift on elevating the nasolabial fold, particularly the melolabial suspension suture. If you have prominent melolabial and nasolabial folds then this combination will most probably ensure the best satisfactory result. This study is published in one of the peer viewed journals. Details can be seen there (Arch Facial Plast Surg. 2010;12(5):339-341) Briefly, deep plane lifting can be fruitfully combined with mid face lifting. Best wishes,

Midface-lifting surgery is challenging owing to the difficulty of adequately releasing the soft tissues overlying the zygomaticomaxillary region and resuspending them effectively. A comparison of the extended transtemporal midface-lift and deep-plane face- lift had been performed almost 13 years ago by a group of well known deep plane followers and they demonstrated that the there was statistically significant advantage of the transtemporal midface-lift on elevating the nasola- bial fold, particularly the melolabial suspension suture. If you have prominent melolabial and nasolabial folds then this combination will most probably ensure the best satisfactory result. This study is published in one of the peer viewed journals. Details can be seen there (Arch Facial Plast Surg. 2010;12(5):339-341) Briefly, deep plane lifting can be fruitfully combined with mid face lifting. Best wishes,

Hi. Thank you for your question. You may get temporary benefit from non-surgical skin tightening treatments i.e. CO2 laser or RF microneedle. But I would like to emphasize again that  it would be temporary. Plus, its effect would be limited. A neck lift with deep SMAS tightening will give you the best long lasting results. I will also advice CO2 laser and chemical peeling  to improve the texture of your skin.  I hope this helps.

Dear Nata55, thank you for your question  and photos. It is not clear if one year passed since your last surgery or not. I would strongly recommend  to wait  at least one year after your surgery. It will be immature to comment on before one whole year. After one year, it will be  possible to remove the cartilage but I am strongly suspicious if thus will be necessary or not. You are also telling that this was your fourth surgery. This is something needs to be commented on above all other issues for your nose.I hope this helps . Good luck

The SMAS  face lift can be done in many ways. I prefer deep plane SMAS lifting techniques. Because it helps for the folds running down from the nose to mouth. Cheek implants are not must but cheek implants cane helpful to achieve a better result if you also have some mid face volume loss. So there are many procedures that help the nasolabial folds and I strongly recommend you to discuss all these options with your plastic surgeon. 

The SMAS lift is a not  a pure skin removal surgery but skin needs to be removed to some extend. Because in order to perform SMAS lifting and shaping your surgeon has to elevate the skin off of the SMAS.  Inevitably, some skin is removed almost all of the time.  I guess your question is related to   potential scarring, visible incisions around the ears. At that point i would like to confirm that a plastic surgeon will be able to make these scars almost invisible by concealing them in natural creases. Your plastic surgeon artistic perspective and delicate planning will let him or her to give the least visible scar.  Once you are 3 or more  months out from procedure, the  scars  theoretically should not be visible

Definetely it is too early to judge. Tip will be seen elevated for the first two weeks. It is normal to have swelling at the base of the columella which is the vertical part that supports the tip. It would be better to know the phases of recovery after a rhinoplasty procedure. That will make you feel better and you will feel more comfortable as you would know that these signs are temporary. Good luck

The cost of lower face lift depends on the  number of procedures needed to be down for a perfect result. Some people needs only skin tightening while some others require deep SMAS lifting with  submandibular gland or digastric muscles tightening and suspending. Some others would need platysmaplasty which is a hammock procedure of the neck tissues.  Depending on exactly what is being done, this can vary.  I would consult with a board certified plastic surgeon who specializes in facelift and lower facelift procedures.  Here you will have a full evaluation and be able to discuss your goals for surgery. 

To make it short, yes you can have it removed and with en bloc capsulectomy. It is not clear why you do that. I think it would be better to discuss your reasons and get their answers from your surgeon.  If  the reason for such decision is simple and just to be rid of the implants then only implant removal will be enough and you do not need to get the capsule removed. But if you have some other problems that has been proven such as some kind of breast tumor or some family issues like mutations in breast cancer 1 (BRCA1) and breast cancer 2 (BRCA2) genes then I strongly recommend you to discuss these issues with a board certified plastic surgeon in your neighborhood. 

In all honesty, your result is good.  The asymmetry you refer to is certainly present but it is not the final result of your nose job. You are supposed to wait almost one year post to get a near final result.  There can be always some asymmetry and it is often pre-existing.  There is also something that can be done for these minor asymmetries such as fillers, corticosteroid injection or diluted 5 FU diluted injections. I hope this helps.