Malcolm Rude, M.D.
Board Certified Plastic Surgeon
979.776.8825

Face

Face Procedures

 

Facelift

Facelift 2 Incisions usually begin above the hairline at the temples, follow the natural line in front of the ear, curve behind the earlobe into the crease behind the ear, and into or along the lower scalp. Facelift 3 Facial, neck tissue and muscle may be separated; fat may be trimmed or suctioned and underlying muscle may be tightened. Facelift 4 After deep tissues are tightened, the excess skin is pulled up and back, trimmed and surured into place. Facelift 5 Most of the scars will be hidden within your hair and in the normal creases of your skin.
If you're considering a facelift in Bryan Texas or in College Station As people age, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jawline grows slack and jowly; folds and fat deposits appear around the neck. A facelift (technically known as rhytidectomy) can't stop this aging process. What it can do is "set back the clock," improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping. If you're considering a facelift, this information will give you a basic understanding of the procedure when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask your surgeon about anything you don't understand.

The Best Candidates for a Facelift

The best candidate for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties as well. A facelift can make you look younger and fresher, and it may enhance your self- confidence in the process. But it can't give you a totally different look, nor can it restore the health and vitality of your youth. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon. The Surgery A facelift usually takes several hours-or somewhat longer if you're having more than one procedure done. For extensive procedures, some surgeons may schedule two separate sessions. Incisions usually begin above the hairline at the temples, extend in a natural line in front of the ear (or just inside the cartilage at the front of the ear), and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision may also be made under the chin.

Forehead Lift

Browlift 2 In preparation for a forehead lift, the hair is tied back with rubber bands in front of and behind the incision area. An incision is usually made across the top of the head, just behind the hairline. Browlift 3 Forehead skin is gently lifted and portions of facial muscle and excess skin are removed. The incision is then closed with stitches or clips.
If you're considering a forehead lift in Bryan Texas or in College Station A forehead lift or "browlift" is a procedure that restores a more youthful, refreshed look to the area above the eyes. The procedure corrects drooping brows and improves the horizontal lines and furrows that can make a person appear angry, sad or tired. In a forehead lift, the muscles and tissues that cause the furrowing or drooping are removed or altered to smooth the forehead, raise the eyebrows and minimize frown lines. Your surgeon may use the conventional surgical method, in which the incision is hidden just behind the hairline; or it may be performed with the use of an endoscope, a viewing instrument that allows the procedure to be performed with minimal incisions. Both techniques yield similar results -- smoother forehead skin and a more animated appearance. If you're considering a forehead lift, this information will provide a basic understanding of the procedure -- when it can help, how it's performed and what results you can expect. It won't answer all of your questions, since a lot depends on your individual circumstances. Be sure to ask your doctor if there is anything you don't understand about the procedure.

The Best Candidates for a Forehead Lift

A forehead lift is most commonly performed in the 40-60 age range to minimize the visible effects of aging. However, it can also help people of any age who have developed furrows or frown lines due to stress or muscle activity. Individuals with inherited conditions, such as a low, heavy brow or furrowed lines above the nose can achieve a more alert and refreshed look with this procedure. Forehead lift is often performed in conjunction with a facelift to provide a smoother overall look to the face. Eyelid surgery (blepharoplasty) may also be performed at the same time as a forehead lift, especially if a patient has significant skin overhang in the upper eyelids. Sometimes, patients who believe they need upper-eyelid surgery find that a forehead lift better meets their surgical goals. Patients who are bald, who have a receding hairline, or who have had previous upper-eyelid surgery may still be good candidates for forehead lift. The surgeon will simply alter the incision location or perform a more conservative operation. Remember, a forehead lift can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them in detail with your doctor.

BOTOX®

Botox Injections in Bryan Texas or in College Station The cosmetic form of botulinum toxin, often referred to by its product name Botox®, is a popular non-surgical injection that temporarily reduces or eliminates frown lines, forehead creases, crows feet near the eyes and thick bands in the neck. The toxin blocks the nerve impulses, temporarily paralyzing the muscles that cause wrinkles while giving the skin a smoother, more refreshed appearance. Studies have also suggested that Botox is effective in relieving migraine headaches, excessive sweating and muscle spasms in the neck and eyes.
Botox

Injectable Fillers

Browlift 2 Years of squinting and other facial muscle movements can take their toll on the eye area, leaving crow's feet and other noticeable lines. Injectable fillers 3 After treatment, the skin around the eye area appears smoother and more taut. Injectable fillers 4 Lines and creases that form around the mouth are usually caused by gravity and a breakdown of tissues beneath the skin. Injectable fillers 5 The lower face appears firmer and smoother after treatment with injectables. Lines around the mouth are filled in and nearly imperceptible.
If you're considering injectables in Bryan Texas or in College Station As we age, our faces begin to show the effects of gravity, sun exposure and years of facial muscle movement, such as smiling, chewing and squinting. The underlying tissues that keep our skin looking youthful and plumped up begin to break down, often leaving laugh lines, smile lines, crow's feet or facial creases over the areas where this muscle movement occurs. Soft-tissue fillers, most commonly injectable collagen or fat, can help fill in these lines and creases, temporarily restoring a smoother, more youthful-looking appearance. When injected beneath the skin, these fillers plump up creased and sunken areas of the face. They can also add fullness to the lips and cheeks. Injectable fillers may be used alone or in conjunction with a resurfacing procedure, such as a laser treatment, or a recontouring procedure, such as a facelift. If you're considering a facial-rejuvenation treatment with collagen or fat, this information will give you a basic understanding of the procedure - when injectables can help, how the procedure is performed, and what results you can expect. It may not answer all of your questions, since a lot depends on your individual circumstances. Please ask your doctor if there is anything about the procedure you don't understand.

Collagen

Collagen is a naturally occurring protein that provides support to various parts of the human body: the skin, the joints, the bones and the ligaments. Injectable collagen, patented by the Collagen Corporation under the trade names Zyderm and Zyplast, is derived from purified bovine collagen. The purification process creates a product similar to human collagen. Injectable collagen received approval from the Food and Drug Administration in1981. It is produced in various thicknesses to meet individual patient needs. Collagen is used primarily to fill wrinkles, lines and scars on the face and sometimes the neck, back and chest. The procedure: Treatment with collagen can begin after a skin test determines that you're not allergic to the subsstance. The collagen is injected using a fine needle inserted at several points along the edge of the treatment site. If a local anesthesia has not been used, you may feel some minor stinging or burning as the injections are administered. Since part of the substance is salt water that will be absorbed by the body within a few days, your doctor will slightly overfill the area. You may be asked to hold a hand mirror during the procedure to help your doctor decide when you've had enough.

Fat

In the medical world, the fat-injection procedure is known as autologous fat transplantation or microlipoinjection. It involves extracting fat cells from the patient's abdomen, thighs, buttocks or elsewhere and reinjecting them beneath the facial skin. Fat is most often used to fill in "sunken" cheeks or laugh lines between the nose and mouth, to correct skin depressions or indentations, to minimize forehead wrinkles and to enhance the lips. The procedure: After both the donor and recipient sites are cleansed and treated with a local anesthesia, the fat is withdrawn using a syringe with a large-bore needle or a cannula (the same instrument used in liposuction) attached to a suction device. The fat is then prepared and injected into the recipient site with a needle. Sometimes an adhesive bandage is applied over the injection site. As with collagen, "overfilling" is necessary to allow for fat absorption in the weeks following treatment. When fat is used to fill sunken cheeks or to correct areas on the face other than lines, this overcorrection of newly injected fat may temporarily make the face appear abnormally puffed out or swollen.

Juvéderm

Juvéderm is a smooth consistency gel made of hyaluronic acid a naturally occurring substance in your skin that helps to add volume and hydration. Your healthcare professional eases Juvéderm injectable gel under the skin to provide a smooth, natural look and feel so everyone will notice (but no one will know)! In fact, studies show superior results of Juvéderm compared to a collagen-based dermal filler.* And, almost 90% of all study volunteers who were treated with both Juvéderm injectable gel and another dermal filler* preferred Juvéderm! In addition, Juvéderm injectable gel is the first FDA-approved hyaluronic acid dermal filler that is proven to be safe and effective for persons of color. With Juvéderm the injection process takes only about 15 minutes and results are immediate. Plus, there's minimal recovery or downtime. So you can step into your doctor's office for treatment and step right back into your life.
Botox

Chemical Peel

Chemical peel 1 Chemical peel is especially useful for the fine wrinkles on cheeks, forehead, and around the eyes, and the vertical wrinkles around the mouth. Chemical peel 2 The chemical solution can be applied to the entire face, or to a specific area -for example, around the mouth - sometimes in conjunction with a facelift. Chemical peel 3 At the end of a phenol peel, a thick layer of petroleum jelly may be applied to the treated area. Chemical peel 4 A protective crust may be allowed to form over the new skin. When it's removed, the skin underneath will be a bright pink. Chemical peel 5 After healing, the skin is lighter in color, tighter, smoother, and younger looking.
If you're considering chemical peel in Bryan Texas or in College Station Chemical peel uses a chemical solution to improve and smooth the texture of the facial skin by removing its damaged outer layers. It is helpful for those individuals with facial blemishes, wrinkles and uneven skin pigmentation. Phenol, trichloroacetic acid (TCA) and alphahydroxy acids (AHAs) are used for this purpose. The precise formula used may be adjusted to meet each patient's needs. Although chemical peel may be performed in conjunction with a facelift, it is not a substitute for such surgery, nor will it prevent or slow the aging process. This information provides basic information about certain types of chemical peel treatments and the results you might expect. It won't answer all your questions, since a lot depends on your individual circumstances. Once you and your plastic surgeon have decided on a specific peel program, be sure to ask about any details that you do not understand. Deciding if chemical peel is right for you Chemical peel is most commonly performed for cosmetic reasons -- to enhance your appearance and your self confidence. Chemical peel may also remove pre-cancerous skin growths, soften acne facial scars and even control acne. In certain cases, health insurance may cover the peel procedure. Be sure to check your policy and contact your insurance company before the procedure is performed. Alphahydroxy acids (AHAs), such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels. These types of peels can provide smoother, brighter-looking skin for people who can't spare the time to recover from a phenol or TCA peel. Trichloroacetic acid (TCA) can be used in many concentrations, but it is most commonly used for medium-depth peeling. Fine surface wrinkles, superficial blemishes and pigment problems are commonly treated with TCA. The results of TCA peel are usually less dramatic than and not as long-lasting as those of a phenol peel. Phenol is the strongest of the chemical solutions and produces a deep peel. It is used mainly to treat patients with coarse facial wrinkles, areas of blotchy or damaged skin caused by sun exposure, or pre-cancerous growths. Planning For A Chemical Peel During your initial consultation, it is important that you discuss your expectations with your plastic surgeon. Don't hesitate to ask any questions or express any concerns that you may have. Expect your plastic surgeon to explain the planned procedure in detail, including its risks and benefits, the recovery period and the costs. If you have a history of herpes, you should inform your physician prior to the procedure. Remember, chemical peel treatments are usually not covered by medical insurance unless they are performed for medically related problems. After your Treatment After an AHA peel, it is common to experience some temporary flaking or scaling, redness and dryness of the skin. However, these conditions will disappear as the skin adjusts to treatment. After a phenol or TCA peel, your doctor may prescribe a mild pain medication to relieve any tingling or throbbing you may feel. If tape was used to cover your face, it will be removed after a day or two. A crust or scab will form on the treated area. To help your face heal properly, it is essential that you follow your doctor's specific post-operative instructions. A TCA peel may also cause significant swelling, depending on the strength of the peel used.

Skin Analysis

Dr. Rude uses the Obagi System. Obagi
Managing healthy skin From early on, we learn that having a smooth, clear complexion is an attribute of physical attractiveness. However, as we age, maintaining that healthy glow becomes more difficult. The face is the most exposed part of the body, vulnerable to the harsh rays of the sun. The face is also subject to acne, rashes, allergic reactions, and injuries that may leave permanent scars. A number of non-surgical "refinishing" treatments are available for individuals who want to eliminate or soften imperfections on their facial skin and achieve a clearer, fresher look. These treatments include glycolic acids (sometimes called "fruity acids"), which are natural fruit substances blended into facial preparations and are used to eliminate rough or dried surface skin, and Retin-A®, a vitamin A-enriched cream that changes the cellular metabolism of the skin's surface and is used to combat fine facial wrinkles and blotches from sun damage.

Retin-A Treatments

In general, Retin-A® is most effective in older patients who have some fine facial wrinkles, or blotchy pigmented areas caused by sun damage. However, Retin-A® is often prescribed to younger, active individuals who want to combat the aging effects of sun exposure. Patients who are planning to have a chemical peel treatment are often instructed by their doctors to use Retin-A® as a preparation treatment; Retin-A® thins the skin's outer layer, allowing the acid solution used in a peel treatment to penetrate more deeply and evenly. Retin-A® is not recommended for pregnant women or nursing mothers, because its effects on the fetus and nursing infant are still being studied. Reactions/side-effects. Although no serious medical problems have been associated with Retin-A®, it's possible that its use could result in temporary skin irritation and redness. If this happens, your doctor may recommend a milder formulation. Beginning treatment. Your initial application of Retin-A® will include a lesson on how to continue your skin-care routine at home. After your face has been washed thoroughly, a small amount of Retin-A®, in either cream or gel form, is rubbed over your face and nose. Only a very small amount of Retin-A® - a pea-sized dab - is needed to cover the entire face. You will be instructed to apply Retin-A® every night before you go to bed. Because Retin-A® is drying to the skin, your doctor may also recommend that you apply a moisturizer once or twice a day. This routine is usually continued for about eight months to a year, after which you'll be switched to a less-frequent schedule of maintenance, with Retin-A® applications only two or three times per week.

Facial Implants

Facial implant 1 Facial surgery is most often done to bring the face into balance by building up the chin, the cheeks, or the jaw. Facial implant 2 A short incision under the chin or inside the mouth allows the surgeon to place a chin implant directyly on the bone. Facial implant 3 Cheek implants are usually inserted through an incision in the mouth and placed directly on (or even below) the cheekbone. These implants can vary in size and shape. Facial implant 4 Jaw implants are placed directly on the jawbone to create a stronger, more defined jawline. Facial implant 5 Facial implants help change the basic structure of the face to give a fuller, more balanced look.
If you're considering facial surgery in Bryan Texas or in College Station Plastic surgeons use facial implants to improve and enhance facial contours. Frequently, these implants will help provide a more harmonious balance to your face and features so that you feel better about the way you look. There are many implants available, manufactured from a variety of materials. They may help strengthen a jawline or bring the chin or cheekbones into balance with the rest of the face.

What to expect from a Facial Implant

Facial implants can enhance your appearance and bolster your self esteem. If you are looking for improvement, not perfection, in your appearance and are realistic in your expectations, you may find that a facial implant is the right choice for you. Plastic surgeons will frequently use such implants to bring better balance to the features of a younger patient. For instance, a teenage girl may want her nose reshaped or her chin brought forward so that these traits are better proportioned. The more mature patient may choose to have an implant placed in conjunction with another cosmetic procedure. For example, during a facelift, a patient may wish to have implants placed over the cheekbones to help restore a more youthful appearance. Implants may also be selected to fill out a face that appears "sunken" or tired. Chin Surgery Insertion of a chin implant may take anywhere from 30 minutes to an hour. During the procedure, the surgeon selects the proper size and shape implant to enhance your appearance and inserts it into a pocket over the front of the jawbone. The small incision to create the pocket and insert the implant is placed inside the mouth (along the lower lip) or in the skin just under the chin area. Cheek Surgery Cheek implant surgery usually takes about 30 to 45 minutes. When cheek implants are being placed in conjunction with another cosmetic procedure, such as a facelift, forehead lift or eyelid surgery, the implants may be inserted through the incisions made for those procedures. Otherwise, an incision will be made either inside your upper lip or your lower eyelid. A pocket is then formed and an implant is inserted. Lower Jaw Surgery Insertion of a jaw implant usually takes about one to two hours. Internal incisions are made on either side of the lower lip to provide access for creating a pocket into which the lower-jaw implant can be inserted. Dissolving sutures are used to close the incisions. Getting Back Normal Remember, with any facial surgery, you may feel and look better in a short period of time. However, it may not be advisable to participate in certain activities -- especially activity that may result in the face being jarred or bumped -- for several weeks. It's best to check with your plastic surgeon about such matters. Your New Look You may not be able to accurately evaluate your appearance for weeks, or perhaps even months. Give yourself plenty of time to get used to your new look. You may be surprised to find that most people won't recognize that you've had facial implant surgery -- only that you look better.

Chin Surgery

Chin surgery, also known as mentoplasty, is a surgical procedure to reshape the chin either by enhancement with an implant or reduction surgery on the bone. Many times a plastic surgeon may recommend chin surgery to a patient having nose surgery in order to achieve facial proportion, as the size of the chin may magnify or minimize the perceived size of the nose. Chin surgery helps provide a harmonious balance to your facial features so that you feel better about the way you look.

Ear Pinning Surgery (Otoplasty)

Otoplasty 1 Ears that appear to stick out or are overly large can be helped by ear surgery. Otoplasty 2 An incision is made in the back of the ear so cartilage can be sculpted or folded. Stitches are used to close the incision and help maintain the new shape. Otoplasty 3 Creating a fold in the cartilage makes the ear lie flatter against the head and appear more normal.
If you're considering ear surgery in Bryan Texas or in College Station Ear surgery, or otoplasty, is usually done to set prominent ears back closer to the head or to reduce the size of large ears. For the most part, the operation is done on children between the ages of four and 14. Ears are almost fully grown by age four, and the earlier the surgery, the less teasing and ridicule the child will have to endure. Ear surgery on adults is also possible, and there are generally no additional risks associated with ear surgery on an older patient.

More Natural-Looking Ears

Most patients, young and old alike, are thrilled with the results of ear surgery. But keep in mind, the goal is improvement, not perfection. Don't expect both ears to match perfectly-perfect symmetry is both unlikely and unnatural in ears. If you've discussed the procedure and your expectations with the surgeon before the operation, chances are, you'll be quite pleased with the result. The Surgery Ear surgery usually takes about two to three hours, although complicated procedures may take longer. The technique will depend on the problem. With one of the more common techniques, the surgeon makes a small incision in the back of the ear to expose the ear cartilage. He or she will then sculpt the cartilage and bend it back toward the head. Non-removable stitches may be used to help maintain the new shape. Occasionally, the surgeon will remove a larger piece of cartilage to provide a more natural-looking fold when the surgery is complete.

Eyelid Surgery

Blepharoplasty 1 As people age, the eyelid skin stretches, muscles weaken, and fat accumulates around the eyes, causing "bags" above and below. Blepharoplasty 2 The surgeon closes the incisions with fine sutures, which will leave nearly invisible scars. Blepharoplasty 3 Before surgery, the surgeon marks the incision sites, following the natural lines and creases of the upper and lower eyelids. Blepharoplasty 4 Underlying fat, along with excess skin and muscle, can be removed during the operation.
If you're considering eyelid surgery in Bryan Texas or in College Station Eyelid surgery (technically called blepharoplasty) is a procedure to remove fat--usually along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes - features that make you look older and more tired than you feel, and may even interfere with your vision. However, it won't remove crow's feet or other wrinkles, eliminate dark circles under your eyes, or lift sagging eyebrows. While it can add an upper eyelid crease to Asian eyes, it will not erase evidence of your ethnic or racial heritage. Blepharoplasty can be done alone, or in conjunction with other facial surgery procedures such as a facelift or browlift.

The Best Candidates for Eyelid Surgery

Blepharoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon. The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Most are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age. A few medical conditions make blepharoplasty more risky. They include thyroid problems such as hypothyroidism and Graves' disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes. A detached retina or glaucoma is also reason for caution; check with your ophthalmologist before you have surgery.
Blepharoplasty 5 In a transconjunctival blepharoplasty, a tiny incision is made inside the lower eyelid and fat is removed with fine forceps. No skin is removed, and the incision is closed with dissolving sutures. After surgery, the upper eyelids no longer droop and the skin under the eyes is smooth and firm.

Laser Resurfacing

In laser skin resurfacing a laser is used to remove areas of damaged or wrinkled skin, layer by layer. The procedure is most commonly used to minimize the appearance of fine lines, especially around the mouth and the eyes. However, it is also effective in treating facial scars or areas of uneven pigmentation. Laser resurfacing may be performed on the whole face or in specific regions. Often, the procedure is done in conjunction with another cosmetic operation, such as a facelift or eyelid surgery.

Lip Enhancement

If you're considering Lip Enhancement in Bryan Texas or in College Station Injected collagen and fat are primarily used to improve the appearance of the skin's texture. They can also be used to add a fuller, more sensuous look to the lips. Soft-tissue fillers, most commonly injectable collagen or fat, can add fullness to the lips.

Nose Surgery

Rhinoplasty 1 Before surgery, these rhinoplasty patients have large, slightly hanging noses, with a hump and an enlarged tip. Rhinoplasty 2 Incisions are made inside the nostrils or at the base of the nose, providing access to the cartilage and bone, which can then be sculpted into shape. Rhinoplasty 3 The surgeon removes the hump using a chisel or a rasp, then brings the nasal bones together to form a narrower bridge. Cartilage is trimmed to reshape the tip of the nose. Rhinoplasty 4 Trimming the septum improves the angle between the nose and upper lip. Rhinoplasty 7 A splint made of tape and an overlay of plastic, metal, or plaster is applied to help the bone and cartilage of the nose maintain their new shape. Rhinoplasty 8 After surgery, the patient has a smaller nose, a straighter bridge, a well defined nasal tip, and an improved angle between the nose and upper lip.
If you're considering rhinoplasty in Bryan Texas or in College Station Rhinoplasty, or surgery to reshape the nose, is one of the most common of all plastic surgery procedures. Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems. If you're considering rhinoplasty, this information will give you a basic understanding of the procedure-when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask your surgeon about anything you don't understand.

The Best Candidates for Rhinoplasty

Rhinoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon. The best candidates for rhinoplasty are people who are looking for improvement, not perfection, in the way they look. If you're physically healthy, psychologically stable, and realistic in your expectations, you may be a good candidate. Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes-to correct birth defects or breathing problems. Planning Your Surgery Good communication between you and your physician is essential. In your initial consultation, the surgeon will ask what you'd like your nose to look like, evaluate the structure of your nose and face, and discuss the possibilities with you. He or she will also explain the factors that can influence the procedure and the results. These factors include the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin, your age, and your expectations. Be sure to tell your surgeon if you've had any previous nose surgery or an injury to your nose, even if it was many years ago. You should also inform your surgeon if you have any allergies or breathing difficulties; if you're taking any medications, vitamins, or recreational drugs; and if you smoke. The Surgery Rhinoplasty usually takes an hour or two, though complicated procedures may take longer. During surgery the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to the desired shape. The nature of the sculpting will depend on your problem and your surgeon's preferred technique. Finally, the skin is redraped over the new framework.
Rhinoplasty 5 If your nostrils are too wide, the surgeon can remove small wedges of skin from their base, bringing them closer together.

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