The fat underneath the skin of the neck was removed, and the skin was
repositioned up and back. If a patient is only 30 to 40 years old, I can
sometimes perform only a liposuction under the chin, without the face lift. However, if the skin has lost some of its elasticity,
removing only the excess fat won't help, because the skin won't
"shrink-wrap" to the neck after the fat removal; it will hang loosely,
and the appearance might be worse than if nothing had been done.
The combination of removing the fat and repositioning the skin is our best
bet in patients older than about 45 years of age.
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I'm trying to understand my surgeon's operative report in order to understand what was and wasn't done. Please help?
As the photos demonstrate, my primary rhinoplasty was not successful in any way, shape, or form. Since acquiring my surgeon's operative report, I've been trying to make sense of the medical terminology in order to understand what was done to my nose during my operation... Thus educating myself. I want to fully understand as I navigate my revision consults. I keep telling people that the "tip wasn't touched at all," but aside from that, could someone please help me interpret the report? (Photos).
(Questioner submitted photos)
Dr. Denenberg's answer: It doesn't look as though much was done to your tip.
The report says "a portion of the lower lateral cartilages" was removed. That *can* result in a tip that is less wide, or less projecting, but it's the rare, rare tip that will respond completely to a simple removal of some of the tip cartilages as described. Perhaps your tip requires much more advanced work to change it's size and shape.
If you are seeking a revision, be very careful. Revision rhinoplasty is far, far more difficult than a first-time rhinoplasty, and even in a first-time rhinoplasty, most plastic surgeons are not expert enough to handle more difficult tip structures. You must see before and after photos of a doctor's work before deciding whether to use him for your revision. See the attached video and the Web reference link for examples of the changes that are possible in expert hands.
Link to this question on RealSelf.com