There are over 250,000 rhinoplasty or nose surgery procedures performed in the United States alone every year. Many of these patients desire other surgical improvements at the same time. Combination rhinoplasty and other procedures are very common and safe. Mostly, other facial procedures are desired and can be performed. However, breast surgery, abdominal surgery, and fat removal can also be considered and safely performed simultaneously.
RHINOPLASTY, NOSE SURGERY, REVISION RHINOPLASTY
Because of the problems, in my opinion, created by the open technique of nose surgery or rhinoplasty, we are seeing more and more revisions. In my opinion, the open technique causes more potential problems than it’s worth. I favor the closed technique for both primary and revision. Even if the revision requires cartilaginous grafting the closed technique is preferred.
UPPER LID LIFT-LOWER LID BAGS-NOSE SURGERY
Very frequently when a patient requires a more elegant and refined nose, that patient may also benefit from an upper eyelid lift. This, of course, is dependent upon age. Usually, the rhinoplasty patient in their twenties may not need an upper lid lift. The combination of rhinoplasty and upper lid lift is more commonly seen in the 30 to 40-year-old age group. Also, some of us acquire lower lid bags sooner then we might prefer. Lower lid bags can be removed with a lower lid blepharoplasty which if needed can be performed simultaneously with the upper lid left.
BROW LIFT-FULL AND LATERAL
It should also be noted that upper lid sagging may also be caused by brow ptosis or brow sagging. Traditionally a full brow lift, with forehead muscle trimming as well as frown line glabellar muscle removal will produce a very rejuvenated forehead as well as eliminate or reduce the lid sagging.
The lateral brow lift is slightly more conservative and requires a shorter strategically placed incision that can raise and elevate the lateral brow and in most instances create a more glamorous look. I have summarized, hopefully with clarity the relationship between rhinoplasty, nose job, primary
or revision, along with other facial rejuvenating procedures. These include brow lift, lateral brow lift, upper lid lift, lower lid bag removal, and even body procedures if desired. In the right hands, these procedures offer overall anatomic improvement for our patients in combination with a nose surgery.
THOMAS TREVISANI, MD
BOARD CERTIFIED PLASTIC SURGEON
MEMBER AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY