Can I have a mid face lift at same time as revision Rhinoplasty? (photos)

Question

Hello Drs, I am considering a mid face lift with a revision rhinoplasty to rejuvenate me- in my late thirties. I hope facial asymmetry can somewhat be addressed by this. I am also tired of fillers which haven't lasted and never really address my naso labial folds. Do you recommend a mid face lift? Would it help my face and nasolabial folds properly and is it a good idea to do at the same time as a revision rhinoplasty? regarding which I have asked another question. Thank you so much!

Jamil Asaria, MD · Answer

Thank you for your question. Certainly both procedures could be performed at the same time. There would typically be some more bruising and swelling related to the procedures being performed together, but at least the downtime would be combined for you. At your age, you might think about deferring a midface lift for a few years and consider facial fat grafting at this time. This could help to create a more contoured facial balance for you.Make sure to select a surgeon that has a lot of experience with both procedures who can provide you with the best advice. -Dr. Asaria

Bahman Guyuron, MD · Answer

Based on the included photographs you would be a good candidate for a facelift, removal some fat under chin, which they often go hand to hand and revision rhinoplasty. However, the type of facelift is something that has to be decided between you and your surgeon after understanding  your goals, examination of your face and your tissues coupled with the expertise and knowledge of the plastic surgeon. I suggest that you consult someone who has expertise in both revision rhinoplasty and facial rejuvenation to deliver gratifying results in both areas you of concern.

Andrew S. Frankel, MD · Answer

Based on these images you seem to be an excellent candidate for both procedures. There are no specific technical issues doing these two procedures together but you will likely be more swollen and bruised for a longer time than if you did either of them alone.

William Portuese, MD · Answer

In our practice, we recommend cheek implants when there is  cheek asymmetry and patient's desire further augmentation of the mid face. The mid face is tends  to age  with volumetric loss, which is best treated with volume replacement such as a cheek implant. The mid face does not  descend downward with aging process. A revision rhinoplasty can be performed at the same time as cheek implants. For many examples of both procedures, please see the link below

David Reinstadler, MD · Answer

I think you would be a good candidate for both procedures. You would need an in person consultation to make sure, but there should not be a problem doing both at the same time. you will be very swollen and bruised for longer than if you did each separately. If you have tried fillers and are unhappy, surgical suspension of the midface tissue is a good option. Best of luck

R. Stephen Mulholland, MD (retired) · Answer

Dear Xelaju,

Thank you very much for your clinical post and well done
serial photography.From the description of your concerns and photographs it does
appear that you have some loss of volume in the mid face with some descent of
the cheek and early pre-jowling, which affects the depth of your nasal labia
fold.  There’s also some asymmetry of the
left cheek being somewhat flatter than the right, which may indicate that you
sleep on the left side of your face more than the right side as your nasal
labia fold is deeper and more extensive on the left side. Analysis of the views you provided with your
nose shows relatively nice rhinoplasty skeletal dorsum, but a slightly long and
over-projected tip.  There’s some degree
of supratip fullness and Polly Beak appearance with a hanging columella.  This is a long elegant nose, but still there
is some nasofacial imbalance and proportion with a dominant nasal projection.

You certainly can perform both an endoscopic mid facelift or
mid facelift procedure together with your revision rhinoplasty and, in fact,
one anesthetic and one recovery would be preferential to two.  Mid face repositioning in my hands would be
performed through the temporal hairline and in the mouth approach.I create an elevation of the mid face fat
above the bone and then re-suspend this until the soft tissue of the cheek heals
to the underlying bony anatomy creating a very long-term improvement in your
cheek contour, improvement in the lower lid deflation that has occurred with
age and some improvement resolution in the smile lines.  This will certainly provide a much longer
term improvement than soft tissue fillers or fat grafting to the face. At the same time revision external rhinoplasty to improve the
nasal tip projection, hanging columella, slight alar asymmetry (the left side
being more collapsed than the right) can be performed.

These are complex procedures and you would want to seek the
consultation advice of rhinoplasty surgeons and plastic surgeons with extensive
experience in both.  I am fortunate in
being trained in both plastic surgery and ear, nose, throat, head and neck
oncology and facial trauma.  I have been
performing endoscopic mid facelifts and external rhinoplasties for over 20
years and feel that you may be a good candidate for this combined approach.

I hope this information helps and best of luck.

For more information, please review the link below.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto

Richard W. Fleming, MD (retired) · Answer

Both procedures can and should be done at the same time so you have just one operation, one anesthetic and one recovery.

Francis R. Palmer, III, MD (retired) · Answer

Hi based upon the attached photos, the anterior (front positron) of the cheeks are are bit flat, there are indications of slight jowling with a chin that is weak.  This all tends to make the face appear relatively elongated and prematurely aged.  The nose is slight curved to the left, has some supra-tip area fullness with a slightly thickened nasal tip.  Closed Rhinoplasty could be performed at the same time as a facelift addressing the facial areas mentioned above.  My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:very small incisionsminimal tissue dissection = less bruising and swelling = rapid recoverycan be performed in 90 minutes or less, with or without general anesthesiano incisions within the hair = no hair lossexcess fat can be removedexcess skin removedcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Perlane) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-opHope this helps.

Can I have a mid face lift at same time as revision Rhinoplasty? (photos)

Answers (8)

More Revision Rhinoplasty Questions

Fat Grafting for Revision Rhino - Pros and Cons? Is it safe?

Can you get a revision rhinoplasty done if you have a septal perforation?

Is there less cosmetic risk between removal of spreader graft or thinning of spreader grafts? why?

How much would a columelloplasty cost in the LA/OC area? San Diego?

weak alar cartilage and a collapsed nostril what can be done this is after a septorhinoplasty.

Is it true areas where grafts are placed swell a lot? Is this bump swelling? (photo)

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