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This patient is shown three years after her surgery.  Long term results are the best measure of a successful outcome. This case highlights the subtle but critical contribution that a small chin implant makes to the final result.  It evens the facial plane from top to bottom and by itself makes the nose appear less prominent. An extra small size is most commonly used in women and it is a “one and done” procedure. Rhinoplasty is complex and time consuming. Every imperfection is visible “on the table” and the procedure cannot conclude until all is perfect, regardless of the time necessary. 

#nose #surgery #chin

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Lower eyelids typically require more maneuvers than upper eyelids for both to look evenly rejuvenated. Skin quality is more visible on the lower eyelids. So besides removing loose skin it may be necessary to improve its texture with either a laser or chemical peel treatment at the same time. Older patients with weak lower eyelids may require a tightening procedure in the outer corner. This patient is actually a candidate for that but this would change his eye shape considerably, a prospect outside our goals. Instead he had only a temporary tightening to get him through the swelling period.  In contrast, young patients with familial bags typically just need them removed as a single maneuver.  In any event, regardless of what is involved, patients generally look good in two weeks after upper and lower eyelid surgery. 

#eyes #young #surgery

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Rhinoplasty has evolved and is technically more complex today despite its simple conceptual nature. The nose has three structural parts: the upper third are bones, the middle third are cartilages that affect both appearance and breathing, and the lower third are the tip cartilages. Changes are typically made to all three areas. This is shown in schematic representation here but the actual changes made are much more extensive than indicated. It takes a lot of time, effort, and finesse is to create a pleasing and elegant shape, with no margin for error!  Rhinoplasty surgery is truly a labor of love. 
#nosejobbeforeandafter #nasalbones #cartilage #rhinoplastysurgery

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