Don't know where to begin - would like dermatologist who "partners" with me. Rosacea, melasma, need rhinoplasty, Botox? (photo)

 I have melasma on my forehead, cheeks, nose and chin. I also have rosacea. I have a crooked nose that has gotten worse with age. I have little bumps under my eyes. I have been treating my melasma and rosacea but need something to make it disappear. Would like rhinoplasty but I am scared of the recovery and would make my rosacea worse. Would like Botox for my 11s between my eyes. And finally...would like to get rid of the bumps under my eyes. How should I approach all this?

Doctor Answers 3

Rhinoplasty plus dermatologic issues

A rhinoplasty procedure is performed to change the underlying cartilaginous and bony structure underneath the skin.  It is not a skin procedure.  It is performed by a rhinoplasty surgeon to straighten the nose.  The other issues you have described are skin issues best treated by a dermatologist either before or after the rhinoplasty surgery.  For more information  and many examples of crooked nose repair in our practice, please see the link and video below

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Treatment of face and nose.

Hi Louise, For the rosacea and melasma you may be well treated by an aesthetician.  There are several treatments such as IPL that can improve both rosacea and melasma. The bumps under the eyes are the most difficult to improve.  The appearance of your nose can be improved with a rhinoplasty.  Most plastic surgeons have aestheticians to do skin care and the doctor can do the rhinoplasty. May not need to see a dermatologist and plastic surgeon if your concerns can be addressed in the same office.

William H. Sabbagh, MD
Detroit Plastic Surgeon
4.7 out of 5 stars 37 reviews

Multiple concerns

You describe multiple concerns, and will likely need more than 1 specialist to address them.  Your photo provides limited information, and is no substitute for a detailed in-person exam.  I think you would do well to consult with a dermatologist, and a plastic surgeon or facial plastic surgeon who performs rhinoplasty/ nasal surgery.  As you probably know, both melasma and rosacea are often challenging, chronic conditions that are at best controlled, and not cured.  I'm not sure about the bumps under your eyes, but these could represent rosacea-associated acne, blocked oil glands, or a variety of other conditions.  Botox for the "11 lines" is a common treatment performed by all the specialists listed above.  To have a comprehensive plan, you may do well to ask your consulting physician to speak with each other.  Good luck!

Inessa Fishman, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.