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Question:
I think that a cheek implant will make my face look more youthful. I had problems at my donor site when I had a bone graft to repair my broken nose. Are cadaveric bone grafts a safe option for grafts because they come from a deceased donor?

Answer:
Although cadaveric bone is a good option for facial reconstruction in many circumstances I do not use this material for cheek augmentation. I prefer silastic prefabricated implants for cheek reconstruction, or injections of facial filler such as hyaluronic acid, Radiesse, or autologous fat for midface and cheek augmentation. Each of these procedures is extremely safe and when the procedure is performed correctly, cheek augmentation can give striking results.

Posted by Dr. Philip Schoenfeld

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Question:
I want Dysport injection for the cosmetic benefits, but I am not looking forward to the pain and discomfort. How much pain should a person expect when having injections like Dysport to improve their appearance?

Answer:
Dysport treatments for provide a great deal of cosmetic benefits. The injections take a very short time to perform and with the use of extremely small needles, the injections are quite well tolerated and feel like a mild bug bite. If you are truly needle averse, and who among us is not a little skiddish, application of a topical numbing agent to the area will be of help to you. Ice packs applied to the area prior to treatment are also tremendously helpful in reducing the pain of the injection.

Posted by Dr. Philip Schoenfeld

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Question:
Even though women of African American descent often have large voluptuous lips, I would like mine to be reduced. What sort of procedure can accomplish this?

Answer:
It is true that many women would like to have large voluptuous lips, however, there can definitely be too much of a good thing. For lips that are naturally over sized there are surgical procedures that can reduce the size of the lips. The incisions are made inside the lips so they are well hidden. The procedure is very well tolerated and the results are quite appealing.

Posted by Dr. Philip Schoenfeld

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Question:
I would like to have my columella narrowed and its length reduced. How are incisions made to such a conspicuous area well concealed?

Answer:
As you are probably aware, there are two types of approaches to rhinoplasty. One is an open approach and the other is closed. I use both approaches to perform rhinoplastic surgery. In someone who needs a great deal of tip work, revision rhinoplasty, or significant changes that need to be performed on reducing or increasing the length of the nose, I like to use the open approach technique. The incision is an inverted V incision made in the columella (the portion of your nose between your nostrils). The incisions heal very nicely when this is done. If your desire is to narrow the columella and decrease what sound like columella show, then a closed rhinoplasty may be performed in which case the incisions are all intranasal.

Posted by Dr. Philip Schoenfeld

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Question:
The alars of my nose are extremely thick and discolored. When the surgeon makes the incisions, how will they be hidden but also made effectively to repair my problems?

Answer:
Having rhinoplastic procedures performed to address the nasal ala is a very good way to narrow an otherwise widened nostril. I am somewhat hesitant to tell my patients that the actual bulk of the nostril will be thinned if the problem is thick, fatty, and discolored skin. The incisions that I use to address any nasal alar issue during rhinoplasty are either hidden in the nasal facial skin crease or along the inside of the nostril along the floor of the nose. These insisions heal quite well and have very little incidence of significant scarring.

Posted by Dr. Philip Schoenfeld

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Question:
I am getting a nose job after years of debate. I know that I will want this surgery to be my last because I’ve never done well with pain and hospitals. What percentage of your patients return for revision rhinoplasty?

Answer:
As good as the surgeon can be there are always variables that can occur during the healing process that can lead to slight changes in the nose that require revision rhinoplasty. I perform a great deal of revision rhinoplastic surgery and although there can be surgeon error during the initial rhinoplasty, I have found that unrealistic expectations is one of the greater causes for patient dissatisfaction and there desire for revision rhinoplasty. I spend a great deal of time with my patients going over their rhinoplasty desires and what changes they would like to see to their nose and more importantly, what changes I am capable of providing. My revision rate is around 2% and most if not all of my revisions are short procedures that are significantly less involved than the initial surgery.

Posted by Dr. Philip Schoenfeld

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Question:
My nose has an unsightly hump that isn’t too noticeable to anyone except me. I want the hump smoothed down, but only slightly. Are there techniques or surgeons that specialize in rhinoplasty with a goal of slight changes in nose shape?

Answer:
Most good rhinoplasty surgeons will work closely with you so that the nose that you desire is the nose that you will get. I always ask my patients what bothers them about their nose during our consultation. If they tell me that all they want is a specific thing changed to their nose I will listen carefully and address only that specific change. Having said that, if I feel that one change will lead to other changes that should be made in order to bring the nose into balance, I will also suggest to the patient the changes that I see will need to be performed in addition to the changes that they have suggested in order to create the nose they really had intended on having. If nothing else will add anything to the final rhinoplasty result then I will perform the surgery exactly as my patient had requested.

Posted by Dr. Philip Schoenfeld

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Question:
I know that during a neck lift the neck muscle are tightened to add definition. What techniques, implants, or tools does the surgeon use to make sure the neck lift is a permanent solution?

Answer:
In order to perform a neck lift the patient has to be evaluated for the tissue that is causing the sagging of the neck. Often times it is a combination of skin and the muscles of the neck that for a natural sling for the neck that have aged and thus have developed laxity. If fat is present in the neck, this will also have to be addressed in some way to better define the neck lift procedure. Muscles of the neck will need to be trimmed during the neck lift and then sewn back together in order to recreate the natural sling that support the neck and gives the neck youthful contour. Excess skin of the neck will need to be removed and the incisions are generally hidden behind the ear and into the hairline. I only use implants if during your initial consultation I find that your chin is deficient and needs to be augmented, otherwise no implants are used. The longevity of the results is usually about 15 years as you will continue to age and will likely require a touch up procedure in that period of time.

Posted by Dr. Philip Schoenfeld

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