Plastic Surgery of Boston

A: Hello and thank you for your question. I'm unaware of skin allergies increasing the risk of complications with silicone implants. I have had experience with patients who unknowingly had some hypersensitivities to certain types of adhesives used postoperatively or prepping solution utilized for skin sterilization prior to the surgery. These were just superficial reactions on the skin and did not have any impact on the surgery outcome, short-term or long-term. The next step for you is to seek out a board certified plastic surgeon who specializes in aesthetic plastic surgery. In your consultation, be sure your surgeon addresses all your concerns and discusses the surgery details including the position and size of the incision used, the type of breast implants available, the risks and benefits of the procedure, recovery time, and post-operative course. Also, be sure to see plenty of before-and-after pictures in women who have a similar breast appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome. And lastly, I think the most important component of the consultation is to establish a good connection with your plastic surgeon. It’s the connection that allows you to clearly define your desired breast outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you. For more information on breast augmentation, please refer to my link below. Good luck. Mark K Markarian, MD, MSPH, FACS Harvard-trained Board Certified Aesthetic Plastic Surgeon

A: Hello and thank you for your question. I do agree that an alternate source for cartilage is necessary once you've had a septoplasty and your septal cartilage can no longer be harvested. However, I would much rather utilize a donor/cadaver cartilage graft instead of making an incision along your chest to harvest rib cartilage with a subsequent risk of injury to your lung. I commonly utilize MTF (Musculoskeletal Transplant Foundation) cartilage for all my revision rhinoplasties and/or primary rhinoplasties in patients who have undergone a prior septoplasty. The next step for you is to find the right aesthetic plastic surgeon. In your rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course. Also, be sure to see plenty of before-and-after pictures in women who have a similar nose appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome. After seeking out a board-certified plastic surgeon who specializes in aesthetic plastic surgery, I think the most important component of the consultation is to establish a good connection with your plastic surgeon. It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you. For more information on rhinoplasty, please refer to my link below. Good luck. Mark K Markarian, MD, MSPH, FACS Harvard-trained Board Certified Aesthetic Plastic Surgeon

A: Hello and thank you for your question. It is difficult to answer your question without a photograph or an in-person examination. However, if you are considering camouflaging a dorsal hump with augmentation from diced cartilage and temporalis fascia (DCF), you can likely accomplish the same thing with nasal fillers. I don't suggest this as your nose will be augmented overall (made bigger) to camouflage the hump. Moreover, I tend to avoid temporalis fascia harvesting as this may cause alopecia along the incision site. I prefer mastoid fascia for my rhinoplasties. The next step for you is to find the right aesthetic plastic surgeon. In your rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course. Also, be sure to see plenty of before-and-after pictures in women who have a similar nose appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome. After seeking out a board-certified plastic surgeon who specializes in aesthetic plastic surgery, I think the most important component of the consultation is to establish a good connection with your plastic surgeon. It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you. For more information on rhinoplasty, please refer to my link below. Good luck. Mark K Markarian, MD, MSPH, FACS Harvard-trained Board Certified Aesthetic Plastic Surgeon

A: Hello and thank you for your question. The septum thickness in unchanged during a septoplasty. A dorsal and caudal component of the cartilage has to be maintained, however, to optimize stability and structure of the nose profile -- this is called an L-strut and should be about 1.5cm wide along the dorsal and caudal aspect of the septum. I am unsure about the bending sensation/pressure you're experiencing as you lean your head to the side -- you may have some residual congestion or sinus pathology. I would suggest an ENT evaluation where a fiberoptic exam of your nasal passages may be helpful. For more information on rhinoplasty, please refer to my link below. Good luck. Mark K Markarian, MD, MSPH, FACS Harvard-trained Board Certified Aesthetic Plastic Surgeon