Plastic Surgery + Health Information

Rhinoplasty - Trauma to the Nose
Trauma to the nose can cause a variety of issues. It can cause a bump to form - where there's bone cells that go in to repair a fractured nose - so you're adding more bone cells because the bone is trying to close the gap where the fracture is that creates a hump because that's a growth center in the nose. Trauma to the nose can cause a dorsal hump but trauma to the nose can also cause a displaced nasal fracture where the both nasal bones one or both are crooked, it can cause the upper lateral cartilages in the mid portion of the nose to become inverted or depressed or concave on one usually on one side. Trauma to the nose can also cause a deviated septum that's the dividing line on the inside of the nose that for air flow and when you get hit in the nose it it creates a deviation that deviation is then blocking airflow. There's a lot of things that can happen when you get your nose broken or trauma to the nose from a variety of different issues.

Dr William Portuese
1101 Madison St  #1280
Seattle, WA, 98104
206-624-6200
https://www.seattlefacial.com

Rhinoplasty  - How to Straighten a Crooked Nose
The crooked nose itself is usually there's three components if you will to the nose first you have the on the top of the nose is the nasal bones that's what gets fractured the nasal bones become fractured and displaced and we have to reset those in a more straighter and narrower position with osteotomies placed in those nasal bones in the mid portion of the nose that's more of a flexible cartilage called the upper lateral cartilages and when you have a crooked nose usually one side is concave and the other one is convex so we'll have to add a spreader graft underneath the concave upper lateral cartilage to straighten the mid portion if the nasal tip cartilages are crooked and asymmetric then sometimes what we'll do is we'll take if one side's a little higher we'll take a little cartilage off of one side and add that cartilage to the lower side to balance out the nasal tip cartilages themselves. If you are considering rhinoplasty surgery contact The Seattle Facial Plastic Surgery Center today.


Dr William Portuese
1101 Madison St 1280
Seattle, WA, 98104 USA
206-624-6200
https://www.seattlefacial.com

Shaving Down the Dorsal Hump

A surgical nose surgery is frequently chosen to remove the dorsal hump.
The majority of dorsal humps are made up of roughly two thirds cartilage and one third bone, however this can vary considerably depending on a person's morphology.
To get rid of the hump, it needs to be reduced in size.
In order to correct the open roof (flat-top) nasal deformity caused by the removal of the hump, osteotomies must be performed in the nasal bones.
The most frequent justification for nasal contouring is the dorsal hump.

A rhinoplasty, also known as a "nose job," is a cosmetic plastic surgery technique used to reshape the nose and improve other facial features.
In our medical practice, it is the most frequently carried out procedure.
Our board-certified facial plastic surgeon aims to create a very natural appearance by balancing the new nose with the other facial features and the components of the face as a whole.
The majority of plastic surgeons concur that many undesired characteristics can be altered.
A dorsal hump (bump) can be removed, a large, boxy nasal tip can be refined, and a crooked, possibly fractured, nasal tip can be narrowed if it is too wide.
Functional breathing issues can be treated concurrently with cosmetic surgery if they exist. 

The goal of revision rhinoplasty is to further enhance the nose's aesthetics by performing a second surgery on the nasal anatomy and structure.
Along with the skin soft tissue envelope and nasal septum, the nose is made up of 2 nasal bones, 2 upper lateral cartilages, and 2 lower lateral cartilages.
Making the necessary adjustments to the nose during a revision rhinoplasty results in a very natural-looking outcome for the patient.
Revision
Due to the presence of scar tissue and previous changes to the architecture of the nose, rhinoplasty is far more difficult than a primary rhinoplasty.
The surgeon frequently does not notice those modifications until the treatment is carried out.
Before placing this patient under general anesthesia and giving them a surgical plan, skilled rhinoplasty surgeons typically have one in place.

Patients who need to have one or both of their nasal bones that have strayed outward after a previous procedure straightened or narrowed using osteotomies may have a revision rhinoplasty.
A slight dorsal hump that some individuals still have can be reduced with a rasp.
The most frequent irregularity after a primary rhinoplasty treatment, particularly in patients with thin skin, is the inconsistencies across the bridge line, which can be made of either cartilage or bone.
Spreader grafts are put under the concave upper lateral cartilage in patients with an inverted V deformity or concave upper lateral cartilages in the middle of the nose.
For patients who have an inverted V deformity or who merely have a crooked nose, spreader grafts may need to be applied to both sides of the nose.
After a rhinoplasty treatment, the nasal tip cartilages may be asymmetric, hence cartilage grafting procedures are used either as an onlay graft or sutured onto the tip cartilages.
With suture procedures applied to the lower lateral cartilages of the nose tip, which decrease the breadth of the tip, a residually bulbous nasal tip is minimized.
The nose's tip has thick skin and a lot of scar tissue, which prevents the tip's breadth from being significantly reduced.
An alar rim graft is done on individuals who have alar rim collapse to correct the anatomy there and stop the nasal rim from collapsing during inspiration.
A hanging columella is another obvious indication that one has undergone rhinoplasty.
A columella that hangs down makes the nose appear "bottom heavy."
Incisions must be made on either side of the interior portion of the nose, and the extra cartilage and skin in that region must be removed, in order to decrease a hanging columella.
In addition, depending on where the skin and cartilage are removed, the tip of the nose can be twisted either upwards or downwards.
When broad nostrils remain after a primary rhinoplasty, an alar-plasty is done.
A wedge of skin at the base of the nostrils is removed during an alar-plasty in order to narrow them.

Depending on the plastic surgeon preference, revision rhinoplasty can be performed using either an open or closed rhinoplasty method.
In a closed rhinoplasty procedure, all incisions are made on the interior of the nose to allow access to the tip, bridge, and nasal bones for the necessary adjustments. 

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Rhinoplasty - How to Straighten a Crooked Nose
The crooked nose itself is usually there's three components if you will to the nose first you have the on the top of the nose is the nasal bones that's what gets fractured the nasal bones become fractured and displaced and we have to reset those in a more straighter and narrower position with osteotomies placed in those nasal bones in the mid portion of the nose that's more of a flexible cartilage called the upper lateral cartilages and when you have a crooked nose usually one side is concave and the other one is convex so we'll have to add a spreader graft underneath the concave upper lateral cartilage to straighten the mid portion if the nasal tip cartilages are crooked and asymmetric then sometimes what we'll do is we'll take if one side's a little higher we'll take a little cartilage off of one side and add that cartilage to the lower side to balance out the nasal tip cartilages themselves.

Dr. William Portuese is a top rhinoplasty surgeon in the Pacific Northwest and has dedicated a significant portion of his medical practice to the discipline of closed rhinoplasty, revision rhinoplasty and functional nasal surgery – the nose job. The nose is the most prominent feature of the face and rhinoplasty surgery can achieve the goal of a natural looking nose – some of the best outcomes possible.

Dr William Portuese
1101 Madison St 1280
Seattle, WA, 98104
206-624-6200
 https://www.seattlefacial.com

Award winning facial plastic surgeon Dr. William Portuese serving patients from Seattle and Portland offers Facelift, Forehead Lift, Eyelid Surgery, Neck Lift, Rhinoplasty, Rhinoplasty Revision, Cheek Implants, Chin Implants and more. Visit our website https://www.seattlefacial.com or call 206-64-6200.

My name is Dr. William Portuese and I'm the medical director and founder of The Seattle Facial Plastic Surgery Center. The thing I like most about being a facial plastic surgeon is making happy people happier. For example, an 18 year old young woman who has maybe a large dorsal hump on her nose and it's very self-conscious about it. When I shave that hump down and give her a beautiful nose she tends to just blossom with self-confidence and for me that makes my day. I've performed thousands of facial cosmetic surgery procedures on both men and women from age 16 - 86 - face and neck lifts forehead lifts rhinoplasty eyelid surgery and cheek and chin implants. We have over a thousand photographs on our website demonstrating the quality of our work. I'm so pleased and happy for them the day we take their cast off it is a new day.

The Seattle Facial Plastic Surgery Center
1101 Madison St #1280,
Seattle, WA 98104
(206) 624-6200
https://www.seattlefacial.com/

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With this surgical process, the nose will be reshaped to the patient's specifications and needs while maintaining a natural appearance.

After injuries and fractures, breathing issues, unhappiness with looks, or a combination of these factors, this can be done to improve nasal appearance, function, and balance.
There are several methods for performing rhinoplasty, including making incisions on both the inside and outside of the nose.

In rhinoplasty, the "hump" on top of the nose may be reduced, the nose may be made narrower or wider, the projection may be increased, the "tip" may be altered, or other objectives may be pursued. The nasal septum may occasionally be "deviated," and this can be altered or straightened. Your nasal appearance will be scrutinized, with special focus on the upper, middle, and lower portions.

Any previous nasal conditions or medications you are taking, as well as any prior nasal treatments you have had, if any, should be brought up with your Seattle plastic surgeon.
It is advised that you have several consultations with your rhinoplasty surgeon before the procedure to carefully create a strategy that is ideal for you.


What to anticipate
Your board-certified surgeon, as well as your anesthesiologist or anesthetist, will confer with you before starting your medical operation. Typical procedures entail making a tiny incision on the skin below your nose. The cartilage and internal tissues of your nose can be changed from this incision and other incisions made within your nose utilizing reduction and augmentation procedures to carry out a plan developed by you and your Seattle surgeon.
Sometimes rib or ear cartilage can be beneficial, but often the septum and nasal tissues are used.


The healing process: Nasal packs are occasionally required and are taken out in the office 1-2 days after your rhinoplasty procedure. Sometimes it is essential to wear an external splint made to fit your nose, which may be made in the operating room by one of our doctors and removed after a week or two. After rhinoplasty, often known as a nose job, there may be some swelling and bruising that lasts for several months but usually goes away within a few weeks.

Washington Plastic Surgery is located in Everett WA and offers plastic surgery procedures for the breast, body and face including facelift surgery, breast augmentation,  liposuction and more

I'm Dr Lloyd Krieger I'd like to welcome you to Rodeo Drive Plastic Surgery show you around and introduce you to our approach to plastic surgery procedures.  We've tried to create an environment that's both welcoming and reassuring well at the same time very sophisticated and elegant.  As we go through this hallway or headed towards our exam rooms where we'll see you both before your procedure and follow-up and also towards our surgery center where we'll do your procedure.  We have five exam rooms and we use different ones for pre-op appointments and different ones for follow-up - this is where we meet patients and consultation and get to know you and to understand what types of procedures you're interested in what types of issues you seek to address and what types of changes you want to make to your lifestyle once we get to know you and we do a thorough exam understand your medical history and goals then together we can come up with a plan for how plastic surgery might help you as we step this way we'll enter our surgery center and I'm extremely proud of what we've built here in terms of our surgery center it's up to the highest standards having been built to both Medicare and Triple H C certification meaning that our equipment the layout the training of our staff and our processes are inspected by the federal government and found to reach that high standard we are doing surgery here and there's nothing more important than safety so we've created the Beverly Hills Surgery Center and built it and maintain it to make safety our number one priority as we go this way you'll see where we actually do our procedures our operating room and this gives us the space to do any type of procedure that we would be interested in doing for you and it has the equipment that will allow us to do that smoothly and safely we do all of our procedures with an anesthesiologists another doctor who helps me take care of you so that I'm concentrating on the surgery and the anesthesiologist is concentrated along with me on your safety when your procedure is completed we'll need this operating room and we'll go to our recovery so the continuation of our surgery center in Beverly Hills is our recovery room where our nurses will take care of you following your procedure and I'm very proud of the nurses that we have here they're among the best that I've ever met and certainly but some of the best that I've ever worked with they will work to assure that you're safe and comfortable that the process following your procedure is smooth that we have good communication with your family or caregivers as you're ready to leave here in our surgery center both in the operating rooms in the recovery room it's designed to be up to the standards of safety of any Hospital so it's a bit of a contrast between the two parts of our office here it's about your safety and your comfort people often ask what is our approach to plastic surgery what is our philosophy I think it's about creating natural results creating changes that match your overall appearance and it goes even a little bit deeper we try to understand what sort of lifestyle changes you're looking to embrace by having plastic surgery and what are you looking for in terms of feeling better about yourself being able to do more and different things that you might not have done before once we understand that big picture of what you're looking to embrace and enhance about your lifestyle then we can get into specifics of which plastic surgery procedures might help you achieve those goals we look for a natural look that blends in and meshes with the rest of your overall appearance