Virginia Facial Plastic Surgery Blog

Dear Mugii,

Thanks for the email.  A plastic surgeon should be able to give you a rough estimate on cost based on good pictures most of the time.  I do not do any body plastic surgery and my practice is focused on facial plastic surgery and especially Rhinoplasty.  If you are looking for doctors in the DC area, email me at info@nadericenter.com and I will give you some names.

Hi,

Rhinoplasty surgeons like to wait till patients are at least 16 for 2 reasons.  We want the face and nose to have gone through its major growth and changes and we want the patient to be mentally and emotionally mature.

16 is a good arbitrary minumum age but there are cases where we would do a Rhinoplasty on a mature 14 or 15 year old if they can demonstrate mental, emotional and physical maturity.  If the 14 year old's mom and dad and siblings are all very tall and he or she is not yet, we like to give it more time to make sure the teenage growth spurt is completed.  There are many 40 year olds who lack the emotional and mental maturity to undergo an elective cosmetic surgery and there are many teenagers who are very mature and good candidates for Rhinoplasty.  It all just depends.  I would say 16 is a good safe minimum age but a few patients are OK as young as even 14.  But it never hurts to wait longer.

Hi,

First off I am not sure if you are a serious patient or playing a prank.  I hope its a prank because no one should look to Michael Jackson as an ideal or a goal for cosmetic surgery.  Although he was an amazing artist and singer, he was very misguided and needed psychological help rather than all the plastic surgery that he got.  Unfortunately there are plenty of doctors out there who can be talked into doing anything by a paying patient.  Doctors should NOT have allowed his desires for drastic face change to get as far as it did.  They could have likely saved his life if they had said "no" to him.

Now, some patients do suffer from patchy Vitiligo and significant emotionaly distress from that.  Skin lightening treatments can be done for that by skilled dermatologists.  That is much more involved and irreversible compared to the use of routine bleaching creams with Hydroquinone used for typical melasma or hyperpigmentation.

I would urge you to see some good doctors and get their opinion.  My practice is focused on nose surgery (Rhinoplasty and Revision Rhinoplasty). 

Best of luck

Hi,

Thanks for the question.  Our website is a comprehensive cosmetic surgery website and its goal is information and education rather than just marketing.  95% of my practice is focused on Rhinoplasty and Revision Rhinoplasty.  However, many of my patients do seek concurrent body cosmetic surgery such as Breast Augmentation at the same time as their Rhinoplasty.  Some of the top Board Certified Plastic Surgeons in Virginia work closely with me on these cases.  Just to name a few: 

Dr. Behzad Parva
Dr. Michael Brown
Dr. David Berman
Dr. Christopher Hess
Dr. Talal Munasifi
Dr. Timothy Mountcastle

I would suggest starting your search there.  The cost should be in the $6-7K range but will vary depending on weather you choose Saline or Silicone implants with Silicone being about $1000 or so more expensive.

Hi Srour,

I do not personally know any surgeons down in Roanoke.  I also try not to make recommendations since I cannot ever vouch for anyone else's results.  However, there are some well known surgeons at UVA.  Dr. Stephen S. Park is a well known Facial Plastic Surgeon there.  You can start your search there. 

Good luck

Hi

From the sounds of things you would be leaning more towards a lower facelift / neck lift than a mid face lift.  I would definitely have to see you to see if this is an accurate assessment as often a combination of fillers and skin care and resurfacing (lasers or peels) can tighten the skin nicely.  If you truly have jowls and loose neck skin then a lower facelift combined with a neck lift would be best.  If you have very minimal jowls then a mini cheek lift would also work.

Cost ranges from $6K for the mini cheek lift to about $10K for the lower facelift.  One takes about an hour while the other takes 2-3 hours.  As far as my schedule, I would recommend you calling my office and speaking to one of my patient coordinators.  They would be able to look up my operative schedule and let you know.  Typically we book surgery 3 months in advance or more but occasionally we are able to be VERY flexible on short notice.  My staff are amazing as making miracles happen with the schedule when needed!

But the first thing is diagnosis and seeing if you even need any of these procedures.

Hi Emily,

Glad to hear you made it out of the car accident alive. 

From your description, you had an extensive injury to the chin and lips and gums.  It will take a long time to heal and revisions may be needed. 

But what you are feeling may be scar tissue or even a trapped foreign body.  I am hoping an xray was done at the time of injury and no foreign debride was found or left behind.  Scar tissue can develope and initially the treatment of choice is steroid injections. 

It takes 1-3 years for the area to fully heal or even longer.  You do need to see your surgeon or a Plastic Surgeon to be examined and follow up to see if you need further treatments, injections or surgery.

But what you need to be aware of is the danger of the statement "I want my old chin back."  That may not be realistic but improvements can be.

Good luck

Hi Paula,

A two part excision is also known as serial excision.  This can be done for large moles or large scars or small areas of hair loss on the scalp.  When one excision would result in a very large excision and a long scar, the surgery is split up and part of the scar (or mole or alopecia) is removed then the rest is removed after the area has healed.  It can even be done over 3 to 4 times. 

The length of scars is much less important than their orientation, color, surface characteristics and location. 

Depressed scars dont respond to Lasers alone.  Sometimes filling with Restylane or Juvederm does not even work if the scar is tethered down.  The filler just ends up to the left or right of the scar.

Releasing the scar and filling it is an option.  Excision and dermabrasion is an option.  There are multiple options in scar revision but the options are limited by the patient's skin color and ethnicity. 

If you email me some pictures, I would be glad to take a look and make more specific comments.

Good luck

Hi Kristin,

I just read an old blog of yours on makemeheal.com about dermal grafting for acne scars. At that time you said you do perform both dermal grafting and punch grafting. You went on to say if the epidermal character is so poor that mere filling is not adequate and that the whole skin thickness may need to be replaced. If the scar is large enough it should be excised, if it is small enough if should be punched.

That is correct.  I did say that.  When you say the filler "donuted around the scar" it means that the scar is tethered down and there is simply no potential space for it to be filled.  There are options in such cases.  Your doctor can use the Restylane needle or a larger needle to release some of the deep scar bands.  Subcision is a more aggressive form of this.  This will create a space for filler or fat to sit and lift the skin up.  Alternatively, the scar and the overlying skin can be excised.  With proper closure technique, it should not get depressed again.  It requires multi layer closure with proper skin edge eversion.  Sometimes, an additional deep fascia or dermal or even Alloderm graft is needed underneath the skin.  This is usually followed by Dermabrasion 6 weeks later IF YOUR SKIN COLOR allows that type of resurfacing. 
Unfortunately without seeing and examining you, I cannot be more specific about your individual skin and the best treatment for you.  But these are some ideas for your research.

Hi Jennifer,

Occasionally Restylane or Juvederm canbe used to fill in slight depressions on a nose.  However, the new catch phrase of "non surgical rhinoplasty" is a relatively new term coined mostly by non-surgeons or doctors trying to "make a quick buck!"

Rhinoplasty is a surgical procedure.  Fillers and implants do not belong in the nose usually.  These can become infected and cause horrible scars that are next to impossible to erase.  Small amounts of Restylane or Juvederm can be used to fill in small depressions in a nose.  This is used usually after a rhinoplasty that may have left a small depressed area.  Fillers can give a temporary fix, trying to buy time before doing a minor revision and placing a small cartilage graft in the area.

Larger amounts of fillers needed in the "non surgical nose jobs" are just unsafe and usually not very cosmetically acceptable upon close examination of the nose.

I hope this helped.