DR. NASSIF: Good morning, Ms. Linda.
LINDA: I have always been very self conscious about my first rhinoplasty. The tip of my nose has totally collapsed and dropped down on the right side so esthetically of course I would like that to look better and I have a hard time breathing so I would like that corrected.
DR. NASSIF: With Linda we have talked about many procedures. We talked about a revision or secondary rhinoplasty, a septoplasty, a turbinoplasty and the reason why we are doing all these is to help her breathe better and make the nose look better.
LINDA: I also went through cancer and six months of chemotherapy and that kind of took a toll on my face and my neck. So I am just hoping to look a little more refreshed.
DR. NASSIF: She really just wanted to focus on her neck and maybe do a little liposuction of her jowls.
LINDA: I did a lot of research, mostly on-line and started off just interested in the revision rhinoplasty but as I have gotten older, I realize that if I am going to be having the surgery, I might as well just get a few other things done.
DR. NASSIF: You have that old fashioned little button chin implant. We are going to make the little incision here. We have to use this incision to go to your neck, take that chin implant out and we are going to use one that has a little bit more volume here. So we are going to the eyebrows, we are going to do a little conservative upper lid lift, make a little incision in the crease of your eye and remove some skin. We are going to tighten these muscles and remember I am going to make a little incision behind your ear and tighten the muscle this way.
LINDA: I am hoping to have a nicer profile and a more balanced profile. I think it will probably just give me more confidence around other people that do not know me well. Of course, I am worried. I am nervous but excited at the same time.
DR. NASSIF: We performed initially an endoscopic brow lift. She has a lot of horizontal wrinkles from the muscle there. I am going to try to weaken that muscle so we can see if we can improve some of those wrinkles that she is concerned about.
We just completed the brow lift and now we are going to start the upper eyelid lift. We are going to make some marks for the upper eyelid incision. We want to make sure that it is nice and symmetric. We just removed the excess skin and now we are looking for the little fat pad, we want to remove that.
Linda has a little bit of jowls so what I wanted to do is just do a smidgen of jowl liposuction and we will put in a little longer and larger implant. Additionally, we take the neck muscles and we stitch them together to make them nice and tight. We then made a little incision behind her ear and that gave us the opportunity to remove a little bit of the excess loose skin and pull her muscle very, very tight. This is a very aggressive neck lift where we are really trying to give her a significant improvement.
We just finished the neck lift. We are going to start the open rhinoplasty. In addition she has a deviated septum and I would like to open up her airway. After removing the deviated bone and cartilage, she really should be able to breathe a lot better.
The next goal is to put the tip together and make it appear symmetric. What has made it very difficult is the asymmetry of the tip cartilage.
We just completed the rhinoplasty. We are putting on her dressing and then we are done.
DR. NASSIF: Hi Linda! How are you doing?
LINDA: Dr. Nassif met and exceeded my expectations. In the very beginning I felt very comfortable with him and very happy with my eyes and my chin. I love what he did there.
DR. NASSIF: Her nose looks fantastic only at two and a half months.
LINDA: What affects my everyday life the most was probably the revision rhinoplasty because I had a previous rhinoplasty 30 years ago and I was very unhappy with it. Over 30 years it just continued to get worse. The cartilage was deteriorating and it was very uncomfortable, and I was very uncomfortable in front of a camera.
DR. NASSIF: She had very, very low eyebrows and very heavy upper eyelids. With doing the eyebrow and upper eyelid rejuvenation it really made a different.
I am happy with all her results. I think she is doing fantastic. She was realistic before the surgery. She is realistic now. She is just extremely excited about her results.
LINDA: My youngest son got married September 5th and I think it was finally the first time in years that I faced a camera without being very uncomfortable. It has been two and a half months and I am quite pleased with the results.
