Case 94: This patient was seeing the early signs of facial aging including loss of skin tone and elasticity, early jowling, and heaviness under the chin. A lower facelift along with fat transfer to the under eye and cheek area substantially improved the contour and even apparent texture of her skin, making her look noticeably younger. In addition, the overall effect was completed with a rhinoplasty focused on reducing the width, rounding, and thickness of her tip and nostrils which is a challenge in the setting of thick skin.
Case 44: One of the hardest things to accomplish in a nose job is giving a person a smaller version of the same nose. In Los Angeles, where small differences can mean everything, doing Finesse Rhinoplasty is common. Even at 6 months, you can see that, on profile, this patient’s tip is less projected but he still has a strong masculine profile. On base view, you will also notice the deprojection and the fact that alar base reduction can be done with no visible scars and maintenance of the natural nostril curve.
A revision rhinoplasty is a complicated surgery, because the surgeon now has to contend with thick scar tissue—which makes it difficult to raise the skin and soft tissue off the cartilage. “Plus, we often need to reconstruct part of the nose, so we need to take cartilage from other sources,” says Dr. Miller. Surgeons say that the minimum amount of time to wait before you can do revision rhinoplasty, even if there is an obvious problem, is a full year.
Case 38: This beautiful young lady is an early 6 month example of a finesse rhinoplasty. On front view you can see the bridge is narrower and the sense of hang is improved. On profile, the tip looks undone, natural and less projected with correction of the slight hanging columella. The result is a beautiful, natural look that corrects the issues but leaves her looking totally natural and undone.