Dear Dr. I am looking for a specialist in nose reconstruction. I have had 4 surgerys in the past 25 years. It looks worse now then it did. Can you help me?

Answer

Hi,

I would be happy to take a look at your pictures and see what can be done.  There are those who have had one bad previous nose job and those who have had 4, 6 or even 8 poorly performed previous nose jobs.  Both benefit from a proper revision rhinoplasty.  There are also those who will practically never be happy with their nose no matter how well the previous surgery was done.  I need to see your nose initially via pictures and then examine your nose, inside and out and do computer imaging to show you what may be realistically possible as far as a revision nasal reshaping.

Tags: botched nose job, Revision Rhinoplasty, unhappy cosmetic surgery patient

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Dear Dr. Naderi,

Answer

Dear Kelly,

The down time with String lift or Thread lift or contour lift or feather lift or any of the minimally invasive lifts is less than a traditional face lift or cheek lift or neck lift.  However my issue with the string lift or thread lift is that there is no true dissection made and the only thing holding up the results are sutures, strings, threads or barbed wires.  There is very little longevity of results as tissue will always pull through and gravity will win and the improvements are short lived.  Often the strings or threads are non absorbable and they are left behind permanently making subsequent facelift more hazardous.  I have also seen several cases where the branches of the facial nerve were snagged and damaged by the threads that had been passed blindly under the skin.  Most of these procedures are performed by Dermatologists who are not surgeons or even family doctors and other non-surgeons.  Unfortunately some Plastic Surgeons have found the temptation of a willing-to-pay patient too strong to refuse offering such procedures.  I, along with many other cosmetic surgeons, am not a fan of the thread lift or string lift, etc.  I think a well performed mini cheek lift would be a much better procedure however the key phrase is well-performed!  A poorly performed cosmetic surgery is much worse than the actual effects of aging and time!

Tags: contour lift, facelift, feather lift, String lift, lifestyle lift, thread lift

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Hi Dr. Naderi,

I've read that botox injected into the masseter muscle is an effective way to reduce jaw prominence and make a wide face appear slimmer. Is this a procedure that you offer at your office? If so, how many sessions of botox are usually needed to see a difference, and about how much does each session of botox cost for something like this?

Thank you

Answer

Hi,

yes you are correct and I do this procedure.  Essentially if your face from the front view has a wide lower jaw and its caused my a thick masseter muscle then injection of botox every 3-4 months will reduce the bulk of the muscle and reduce the width of the jaw.  Many asians undergo this procedure.  20-30 units of botox may be needed every 3-4 months ($300-$450 per injection session).  Over time the botox will relax the muscle and when its relaxed, you are not flexing it and it atrophies over time.  Its like not going to the gym.  Your muscles shrink when you dont go to the gym.  However, if the width of the jaw is due to a wide jaw bone then botox will not do much and further more extreme surgery may be required.  Again, these are very common procedures in China and Korea.

Tags: Botox for reducing wide jaw, facial sculpting with botox

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I have had aquamid injections at both my upper cheaks here in thailand.One looks great and the other has to much aquamid.My question is can i shave some of t off.Is it shaveable?.Can it be done and how much will it cost me? I dont want to remove all of it just part of it.Thanking you nick adams

Answer

Hi,

In the US, we have no experience with Aquamid.  As a permanent filler, it is somewhat similar to Artefill.  Its not a solid implant for it to be shaved or modified.  Removing any of it will result in removal of someof your own normal tissue as well.  surgery in the area can risk infecting the material as well making it an even bigger problem.  That is precisely why I do not recommend injection of large amounts of permanent fillers in the cheeks and would rather see patients get Hyaluronic acid fillers like Perlane, silicone cheek implants or fat injection.  I would check with doctors in Europe and Asia and see what their experience is with modifiying or "shaving" Aquamid.

Tags: artefill, silicone, aquamid, permanent fillers, cheek augmentation

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