Dr William Portuese Rhinoplasty and Chin Surgery скачать в хорошем качестве

Dr William Portuese Rhinoplasty and Chin Surgery

Rhinoplasty and Chin Surgery explained by board certified facial plastic surgeon in Seattle WA Dr William Portuese Hi, Dr. William Portuese in Seattle. Today, we're talking about the combination of a rhinoplasty with a chin implant. A patient's biggest concern is usually related to how projecting or over-projecting their nose is, it's too prominent. And that's kind of the driver to come into the office to undergo a rhinoplasty. And that's fine. If the projection of the chin is fine, then all we're doing is reducing the overall projection of the nose with the rhinoplasty. But many patients come in, they have a recessive chin profile. And the recessive chin profile makes the nose look bigger than it really is. So the combination of a chin implant to augment the chin forward and the rhinoplasty to bring the nose backward is a very powerful combination. There's usually a large dorsal hump, so we come in and shave the hump down, perform osteotomies to narrow the nasal bones. We may or may not need to do some tip work, just depends on what's going on with it, if there's bulbous, boxy nasal tip cartilages. And we decrease the overall projection of the nose the best we can, but, remember, the nose has to balance in all three dimensions, front, side, three quarter. And then placement of a chin implant augments the chin forward. Again, the augmentation occurs mostly in the forward projection, but patients also get a little bit of lateral width and a very small amount of vertical height. So both procedures are performed in all three dimensions. The rhinoplasty and the chin implant procedures are performed under general anesthesia here in our Medicare certified outpatient surgery center. The anesthesiologists come over from Swedish Hospital across the street. They're all board-certified physician anesthesiologists in a Medicare certified outpatient surgery center for patient safety and comfort. If patients only want to do a chin implant alone, that can be performed under local anesthesia. But if we're doing both procedures together, they're both done under a general anesthetic. They can see the new chin immediately. And it's a pretty powerful combination. They know their chin already, 'cause there's no bandages on the chin. And they can kind of see the image of the nose through the cast, but as soon as we pull the cast off, then they see the combination. Of course, they're both swollen, but they can see that combination, and they're usually extremely happy. The recovery for the nose involves placement of a cast across the bridge of the nose for a week. Physical bruising and swelling underneath the eyes for usually about two weeks. The chin implant itself really doesn't have much bruising associated with it, but there is some swelling here. And the swelling subsides usually over the first several weeks. This patient has the classic over-projecting nose with a dorsal hump and an under-projecting chin. The under-projection of the chin makes that nose look larger and more projecting than it really is. So I did a closed rhinoplasty on her, shaved down the dorsal hump, adjusted her nasal tip cartilages, narrowed the bridge line a little bit, and then I added a chin implant to augment her chin forward so that it would balance from the side profile with respect to the overly projecting nose. The chin implant itself can accomplish projection of the chin more than I can produce the overall projection of the nose backwards. So I can project the chin more based on putting an implant in than I can bring the nose back. Because if you bring the nose back too far, it won't balance in three dimensions. So she underwent a chin implant and a closed rhinoplasty for better facial balance and proportions. Dr William Portuese 1101 Madison St #1280 Seattle, WA, 98104 USA 206-624-6200 https://www.seattlefacial.com https://g.page/Dr-William-Portuese?share https://www.google.com/localservices/...