Apr 21

Revision Rhinoplasty Frontal View

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Revision Rhinoplasty Frontal View
This patient underwent a Beverly Hills Revision Rhinoplasty by Los Angeles Surgeons Drs. Litner and Solieman to correct a twisted tip and deviated caudal septum.

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Jan 14

How long after having filler injected in your nose can you have surgery?

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Recently, we have seen a number of patients who have had a filler- juvederm, perlane, artefill, radiesse, restylane- placed in their nose. Some of these patients have never had previous surgery while some have had previous rhinoplasty and were using the filler to further revise/correct the nose thereafter.
Universally, the patients that we have seen who had nonsurgical rhinoplasty felt that the procedure was causing their nose to look bigger. Now, in fairness, we are seeing those patients who are unhappy with their results and there are likely to be many patients who are perfectly happy after having done an injection rhinoplasty.

If you have had a filler placed in your nose, the important questions we want to know before considering surgery are:

1. Which filler was used?
a. As you can imagine there is a big difference in approach for someone who had juvederm/ restylane placed in the nose- which generally last about 6-9 months- vs someone who had artefill or silicone- which are permanent fillers.

2. How much was injected?
a. Again, if only a small amount of filler- say 0.1 cc was injected to fill in a single depressed space we can move forward with surgery sooner that with someone who has had 2 or 3 cc of fillers injected during multiple visits at multiple different sites.

3. How long ago was the filler injected?
a. Again depending on which filler was used that will help us determine when it would be best to proceed with surgery.

The reason these details are important is because as we all know rhinoplasty is a procedure of millimeters and the details of how long ago and how much filler was placed are crucial toward the final goal. The last thing we want to do is assume all the filler is gone and go in to do surgery only to find many months later that more filler dissipated and now the nose is smaller than we had intended.

As a result, we do not have a blanket approach toward when to proceed with surgery. These details are all individualized to each patient and the details of the procedures they had undergone.

All this being said, we have operated on patients who have had restylane, juvederm, perlane, radiesse, artefill and silicone and had fantastic success by individualizing each patients treatment plan.

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Jan 7

Happy 2013 from Profiles Beverly Hills

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Happy New Year from Profiles Beverly Hills

At the start of the new year, we want to take the opportunity to thank you, our readers and patients, for your ongoing support of our practice. Last year was an exciting year for us at Profiles. We celebrated our 5-year anniversary in practice together. And, 2012 saw the launch of our new skin care line, JolieMD Metamorphosis. We’re looking forward to seeing what 2013 will bring.

We want to wish you much happiness and success in the coming year. Whether you are actively considering rhinoplasty or facial rejuvenation surgery, or just in the information gathering phase, we hope you find our blog helpful and informative. We are always looking for new and interesting topics of discussion, so please feel free to post questions or comments. If you are interested in a surgical procedure at Profiles, please contact us on our practice website (www.beverlyhillsprofiles.com). All our best to you for 2013.

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Dec 3

Should you massage your nose after rhinoplasty?

In general, it is best not to massage your nose after rhinoplasty as it is possible, although unlikely, that vigorous rubbing or manipulation in the first few weeks could pop a delicate stitch and disturb the corrections made or affect the cosmetic result. Some people habitually rub the tips of their noses. Recognize that this will not likely ruin the result but may cause more irritation and swelling.

That being said, your nose is not glass after surgery. In fact, it can often feel quite stiff and wooden for a period of several months after surgery. Rolling over onto your nose during sleep or lightly bumping your nose will not make it end up on the side of your head. So, you don’t have to walk around in a bubble after surgery.

After about a month, the skin starts to wrap around the cartilage, and the bone is pretty much set, so contact to your nose is less likely to cause any shift or problems with healing. Likewise, a small rind of fibrous tissue or scar has started to form that will likely hold the cartilage in place even if a stitch were to loosen at this stage.

Some surgeons recommend ‘nasal exercises’ which essentially amount to light lymphatic drainage. These will not be harmful but may not do much either. Instead, we ask patients to tape the nose at night for the first month to help skin contract and push out swelling. If you have any questions about nasal massage, ask your surgeon for his or her preferred routine after surgery.

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Sep 7

Just how much younger will you look after plastic surgery?

A favorite question of patients looking to turn back the clock with a facial rejuvenation procedure is how much younger will they look? It’s a good question and one that’s hard to quantify. We know from quality-of-life studies, including one that we did, that facial rejuvenation surgery definitely helps improve quality of life and perceived satisfaction in many facets of life. But, it is hard to put a number on just how many years younger someone will appear after this surgery.

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Aug 31

The Profiles Perspective: Our Belief that Synthetic (Alloplastic) Materials Should Not Be Used in Rhinoplasty

At Profiles, we have always held the standard and belief that when doing rhinoplasty and revision rhinoplasty, there is a hierarchy we can follow when grafting material is needed. Ideally, whenever possible, we use septal cartilage. It allows us to replace any missing cartilage or to build support using tissue that is essentially identical to the normal cartilage we find in your nose. In some cases, the septal cartilage is too thin and flimsy and unsuitable for use; even in primary cases. And in revision rhinoplasty, the quantity and quality of remaining septal cartilage may be inadequate for reconstruction.

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Jul 13

Rib Cartilage in Rhinoplasty Surgery: The Beverly Hills Profiles Perspective

If you are reading this post, you likely had previous rhinoplasty and have now seen a revision surgeon who has recommended that you have rib cartilage removed during your revision surgery. The use of rib cartilage in revision rhinoplasty has become increasingly popular over the last many years as revision rhinoplasty surgeons continue to seek out alternative sources of cartilage for grafts that are often necessary during revision.

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Aug 2

Steroids and Rhinoplasty

Please note: We are happy to see that our blog is of some help to many of you who are considering or recovering from rhinoplasty. While we would like to address your concerns directly, we are not able to dispense medical advice over the internet. Your own surgeon is your best resource in the first weeks and months after surgery. If, after 5-6 months, you continue to feel unhappy with your result, feel free to contact us via our practice site www.beverlyhillsprofiles.com and we can arrange time to discuss your concerns. All the best for a happy outcome.

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Apr 7

Stem Cells and Fat Transfer

Fat transfer has become more and more popular in the last decade  for restoring facial volume lost to aging and even as an alternative to breast implants. And why not? Fat is plentiful, easy to harvest, and it’s your own tissue so no need to worry about a reaction. And it works (well, mostly). The problem that has hampered fat transplantation from becoming universally accepted as the ideal volume procedure is that it can be hard to predict how much of it and how well it will last. That’s because the fat is being separated from its natural blood supply, is then transferred to a new area of the body, and is expected to develop a new blood supply that will allow it to survive. Sadly, not all of the transferred fat makes it.

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Mar 30

What do you do if too much nostril shows?

The Hanging Columella or Notched Ala: Why you see so much of your columella and septum on profile and how we fix it
The Appearance of Retracted Nostrils or of  Too Much Visible Septum

If you are looking at this blog, you (or someone you hold dear) probably had a rhinoplasty (nose job) sometime in the past and now when you see yourself, especially on profile, all you see is that the middle part of your nose at the bottom (the columella and the septum behind it) is way too visible. Perhaps you have been thinking all this time that your septum shows way too much or that the middle part just seems to hang so low.  You may have seen your original surgeon who said you “healed badly” or you just figured it can’t really be fixed. And unfortunately, frequently this is a problem that even many surgeons find confusing.

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