Rhinoplasty Revision

Beverly Hills plastic surgeon Dr. Pincus provides patients revision rhinoplasty surgery as part of his range of cosmetic surgery procedures. The operation consists of correcting areas of asymmetry and deformity resulting from a prior surgery. Generally speaking, additional surgery is performed no sooner than 6 months after the original operation. This allows time for all the swelling to subside and the nose to settle, so that any deformities/asymmetries that were masked will become manifest. As with the original operation, a revision rhinoplasty can be performed under general anesthesia (totally asleep) or under intravenous sedation (twilight sleep). It is usually a more complex operation because of the scarring and disruption from the original surgery. Additionally, material used to correct the deformities such as nasal septal cartilage may not be available as graft material, and ear cartilage, rib cartilage or synthetic material may be needed. Though most corrections can be accomplished in one revision, occasionally additional procedures may be necessary. The postoperative care is generally the same as with the original procedure, and most patients are healed enough to return to work after one week.

Since each additional surgery is usually more complicated than the previous, it is crucial to ascertain your surgeon’s skill in doing revision rhinoplasties. You should look at as many examples of his work as you can. Remember that not all surgeons who do straightforward, primary rhinoplasties know the techniques or have the experience to do revisions.

The Procedure: Lips

The lips should be full and wide with the upper lip slightly rotated, revealing the lower portion of the front teeth. The lower lip should be comparable in size and slightly rolled forward. There are numerous procedures to enhance the appearance of the lips. They can be augmented with the use of fillers like Juvederm, Restylane or fat or they can be enhanced by rolling the mucous membrane from within the mouth to the outside. Additionally, an elongated upper lip can be reduced by excising some of the skin immediately beneath the nose. In this latter instance, the upper lip is considered to consist of “white” and “red” components.

The Procedure: Mid Facelift and Traditional Facelift

Surgeons use the term “facelift” to describe any procedure on the face that results in a tighter, more youthful appearance. I will discuss the two most recognized approaches: the midfacelift and the “traditional” facelift. The midfacelift is a powerful new way to rejuvenate a person’s appearance who is just starting to show signs of aging. Unlike a traditional facelift, which pulls the entire cheek skin and neck skin in an upward and backward fashion to improve sagging jawlines and necks, the midfacelift pulls the area between the lower eyelid and upper lip in a more vertical direction. This serves to soften the fold between the nostril and the corner of the mouth (naso-labial fold) as well as add more fullness to the cheekbone and shorten the aged, elongated lower eyelid. Because the incision is inconspicuously located within the lower eyelid or within the temple, there is no obvious scar.

The traditional facelift, on the other hand, is a powerful procedure for improving the jawline and neck. With some of the more extensive modifications, naso-labial folds and sagging cheek fat can also be repositioned to produce a more youthful contour. The incisions are hidden in the hairline and around the ear and may or may not include a smaller incision under the chin. This latter incision is useful in approaching the anterior neckbands that may need to be modified through cutting, removal or suture tightening.

Facial Plastic Surgeon

Dr. Pincus is board certified by the American Board of Otolaryngology (ABOto) and the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS). He is also a member of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS).

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Since each person’s face is different, the results of a facelift will vary from person to person. Dr. Pincus can explain the details of the various facelift methods along with additional procedures such as rhinoplasty, necklift, eyelid surgery, and forehead lift discuss with you which method will best suit your needs. When combined, these cosmetic surgery procedures can help patients achieve an overall facial rejuvenation to help them regain a more youthful appearance.

If you decide to have a facelift, please contact our office to schedule a consultation appointment. A consultation visit is an important part of every facelift process. Feel free to view our website to learn more about the facelift and other procedures we offer. If there is anything you don’t understand about the facelift procedure, contact Beverly Hills facial plastic surgeon Dr. Pincus for more information or to schedule your consultation visit.

Cheek Augmentation

It has always been my impression that a good looking, balanced face is more square than oval. This necessitates having well developed cheeks and angles to the jaw. For a face to look more feminine, the cheeks are stronger than the angles. And vice versa for a face to be more masculine. To this end, we usually augment the cheeks with either the person’s own fat, injectable fillers or synthetic cheek implants. The implants I use are made of silicone and are screwed to the cheekbone with a tiny titanium steel screw. This ensures that stability and symmetry will be maintained and not change over time. The approach is under the upper lip, and either a malar implant is used to augment the cheekbone area or a combined implant is used to augment both the cheekbone and sub-cheekbone areas.

Cheek augmentation (before & after)

Hairline

One of the most distressing male features in someone transitioning from male to female is the male pattern of baldness. This usually starts out as temporal recessions but may proceed to a significant loss along the entire frontal hairline. A female hairline is rather straight  across and appears to be positioned approximately one third the height of the frontal face when measured up from the eyebrows. Correction to achieve this goal may involve a scalp advancement, hair transplants or a combination of the two.

Facial Feminization Services

So many aspects of the face suggest either a masculine or more feminine appearance. Dr. Stephen Pincus understands the importance of creating a natural result with facial feminization surgery, and he has dedicated much of his practice to meeting the needs of his transgender patients. Over the past several years, he has identified the areas of the head and neck that benefit the most from this procedure. Dr. Pincus has a specialized way of achieving the most feminine, natural-looking results while maintaining the patient’s identifiable facial characteristics.

Forehead

Brow bone is reduced and forehead is occasionally made rounder and softer

Hair

More Feminine hairline is achieved

Neck

The Adams apple is reduced

Nose

Nose is made smaller and more refined

Cheeks

Cheeks are augmented to create a youthful, feminine face

Lips

Upper lip is reduced and are made fuller

Chin & Jawline

A prominent chin or jawline is reduced

Eyebrows

Eyebrows are lifted and arched