Description:

Description:

Technique: Open Revision Rhinoplasty with Costal Cartilage Grafts
Graft Types: Bilateral Spreader, Columellar Strut, Bilateral Alar Rim, Dorsal Onlay
Graft Source: Costal (Rib) Cartilage

Patient Story

This patient is a retired woman currently living in Georgetown, Texas who was referred to Dr. Weinfeld by another Plastic Surgeon in Round Rock for consideration for Revision Rhinoplasty. This patient suffered significant nasal trauma with a severe nasal fracture (broken nose) in her late teen years. This event had a significant negative impact on her breathing and on the appearance of her nose. In here early twenties she underwent a rhinoplasty which she states worsened her nose leaving her with very small nostrils that are difficult to pass air through, a very short nose, and an over rotated tip. She desired a revision rhinoplasty to improve the appearance and function of her nose. This was a very emotional issue for her and in particular she stated that she wanted her nose to have the appearance that it did prior to the injury and the first rhinoplasty. In particular she wanted a slight convexity to the dorsum (i.e. a slight hump) which was consistent with the character of her nose as she remembered it. She underwent the complex revision rhinoplasty using rib cartilage some of which was fashioned into a dorsal onlay graft which was essential in the process of restoring dorsal contour and nasal length. She has been very happy with the transformation in the appearance of her nose and its function. She is now considering having Dr. Weinfeld perform a facelift.

Description:

Description:

Improvement Focus: Excess upper eyelid skin, cheek decent with jowls, obtuse angle between face and neck with loose skin.

Technique: Cervicofacial Rhytidectomy (Face Lift, Neck Lift), Sub SMAS Dissection / Flap, Platysmaplasty, Upper Lid Blepharoplasty

Patient Story:

This patient is a woman in her early seventies from the Hutto / Round Rock area outside of Austin, Texas.  She was referred to Dr. Weinfeld by and Austin Dermatologist.  The patient has been very happy with her results and was surprised and pleased by the fact that the discomfort was significantly less than she expected.  She only required prescribed medications for discomfort for one day.

Description:

About 7 months following rhinoplasty and chin augmentation with implant.
Notice how on the front view the chin implant provides more support for the lower lip and her mouth. Rhinoplasty surgery (nose job) is often combined with other procedures to improve overall facial balance. These additional procedures include chin augmentation (chin implant), chin reduction (genioplasty), eyelid surgery (blepharoplasty), fat grafting, brow-lift, neck liposuction, and buccal fat reduction.

Description:

Chin augmentation with porous, polyethylene, implant, and submental liposuction

Description:

Early follow-up (2 months) from endoscopic brow lift, upper lid blepharoplasty, lower lid blepharoplasty, and fat grafting. Great combination of procedures for this woman in her early thirties who wants to look more awake and “slow down” the aging process.

The brow lift was what is best described and Turbo Powered Endoscopic Brow Lift. Why turbo powered? First endoscopic brow lifts are performed through small incisions made in the scalp and an endoscope, which is a thin surgical camera, is inserted beneath the skin in order to dissect it down to the brows so that they can be freed and repositioned at a higher location. Most endoscopic brow lifts are done through three such incisions. However the “Turbo Powered” version involves two additional small incisions further off to the side in the scalp part of the temple. When you add these two additional incisions it allows you to dissect further down on the face down to the cheekbones and allows you to reposition and elevate the skin surrounding the lateral portion of the eyelid and Peri orbital region. By doing so you’re able to elevate additional tissues in the temple region and even the upper cheep turning a routine brow lift into what is better described as an upper facelift. This was paired with a very minimal upper lid blepharoplasty to remove any residual excess skin in the upper eyelid to give a really smooth look to the upper eyelids and reduce lateral hooding. It’s important to keep in mind with any upper lid blepharoplasty that there needs to be some residual skin left behind in order to prevent an issue where the eyelids wont close. A transconjunctival lower lid blepharoplasty is where the incision to address the lower eyelids performed on the inside of the lower eyelid. This allows you to liberate and reposition the fat pad in the lower eyelid to drape it over the bone and blend the lid cheek junction. This can help reduce the tear trough and create a smooth transition from the lower eyelid to the upper cheek that mimics the anatomy seen in much younger people. When we look at these photos we must bear in mind that lower eyelid procedures often have a longer recovery time as it relates to swelling. For that reason her lower eyelids do you look somewhat puffy but it is a good demonstration of a reduced tear trough. Fat grafting was performed in the upper cheek to further reduce the tear trough and to further blend the lead cheek junction.

Description:

Two months after, and the scopic brow lift and lower lid blepharoplasty. This combination of procedures is wonderful for younger patients who desire a refreshed, vibrant, and energetic look. It is also often performed in older individuals, but in these situations it is also combined with other procedures, such as a face and neck lift. The endoscopic brow lift uses small incisions small incisions within the hair to dissect beneath the soft tissues down to the brows to provide powerful control over shape and elevation. The procedure also allows for elevation of the temple and upper-outer cheeks, providing what can also be described as an upper facelift. The lower lid blepharoplasty in this case was done through a small incision on the inner surface of the eyelid in order to reposition shape, and reduce the lower lid bags. This results in a blending of the lid cheek junction that is seen in young people, providing a very attractive look to the lower eyelids and upper cheek region.

Description:

Buccal fat pad reduction has the powerful ability to reshape the lower cheeks. The procedure removes a small amount of fat from between the cheekbone above and the jaw bone below through two small incisions inside the mouth. The incisions are near where we sometimes accidentally bite our cheeks. There are no external incisions and thus there are no visible scars. Removing precise amount of the buccal fat gives a puckered appearance which can enhance cheek bone fullness, jawline contour, and can even make it look as if a patient has lost weight. The procedure is quick and can be performed awake in the office or asleep as part of other procedures to enhance facial appearance, as was the case with this patient.

Description:

Description:

Improvement Focus: Dorsal Hump, Dorsal Width, Tip Shape, Nostril Shape

Technique: Open Rhinoplasty

Graft Types: Bilateral Spreader, Columellar Strut, Sub-Domal, Bilateral Alar Rim

Graft Source: Costal Cartilage (Rib)

Patient Story: This patient is a young Woman from north Austin. She had suffered a cheerleading injury that resulted in altered nasal shape and deviated nasal septum. She underwent a septoplasty by prior  to coming to see Dr. Weinfeld. While this surgery improved her breathing somewhat, it was not normal and the shape was still problematic. She underwent a rhinoplasty by Dr. Weinfeld. Costal cartilage was used as graft source for the procedure due to the fact that septal cartilage was not available (prior septoplasty). This patient was extremely pleased. It is interesting to note that here recovery was so rapid that she was able to walk as a runway model in a fashion show the day her splint was removed (her brother is a fashion designer and was participating in a charity fashion show). This case highlights the important fact that if you are going to undergo a septoplasty, but believe you may later want to undergo a rhinoplasty, find a surgeon like Dr. Weinfeld who is experienced with both, board certified, a member of the American Society of Plastic Surgeons, a member of the American Society of Aesthetic Plastic Surgeons, and The Rhinonplasty Society.

Description:

Description:

Procedure: Upper Lid Blepharoplasty, Lower Lid Blepharoplasty (Subcilliary Approach with Canthoplasty) – “Quadralateral Blepharoplasty”

Patient Story

This patient knew of Plastic Surgeon Dr. Weinfeld from a relative who was one of his former patients. She visited with him in his office in Austin, Texas. She initially stated that she wanted an “eyelid lift.” After more conversation it became apparent that she wanted to remove the excess skin from her upper eyelids and smooth her lower eyelids. The patient and Dr. Weinfeld decided the best option for her was a combined upper and lower blepharoplasty (four lid blepharoplasty). Due to the laxity of her lower eyelids she required a lower lid canthoplasty (tightening of the lid) to prevent lid malposition post operatively. She recovered well and enjoys the results. Of note is the fact that Dr. Weinfeld recommended as special diet to reduce swelling and bruising and the patient adhered to it indefinitely following the surgery and has sustained weight loss that can be seen in the photographs.