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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.

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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.

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

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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.

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This 50-year-old woman underwent a deep plane facelift and deep plane neck lift. Her neck lift included submandibular gland reduction and reduction of the anterior belly of the digastric — steps that are essential in select patients to achieve the most attractive neck contours and a well-defined jawline. Thinner patients tend to benefit most from this additional work. Without submandibular gland reduction, patients often retain fullness beneath the mid-mandible that blunts the jawline. She is seen here at four months. This procedure was performed by Dr. Adam Bryce Weinfeld, facial aesthetic plastic surgeon in Austin, Texas.

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This 49-year-old woman is seen five months after a deep plane facelift, deep plane neck lift with submandibular gland reduction and reduction of the anterior belly of the digastric, endoscopic brow lift, upper and lower blepharoplasty, lip lift, and fat grafting. Together these procedures represent comprehensive facial rejuvenation. This patient is a compelling demonstration that a comprehensive approach to facial rejuvenation produces extremely natural results without looking overdone. The meaningful improvements created throughout the face work together synergistically to create a youthful, energetic appearance without distortion. She also represents an important point: performing a facelift at a younger age can have significant benefits. Performed by Adam Bryce Weinfeld, M.D., facial aesthetic plastic surgeon in Austin, Texas.

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This 58-year-old woman underwent a deep plane facelift, deep plane neck lift with submandibular gland reduction and reduction of the anterior belly of the digastric, platysmaplasty, endoscopic brow lift, upper and lower blepharoplasty, upper lip lift, and fat grafting to complement her other procedures. She is seen here at four months. The combination of these procedures not only makes her appear between 10 and 15 years younger, but creates the appearance of significant weight loss — even though her weight has not changed between the two photographs. This procedure was performed by Dr. Adam Bryce Weinfeld, facial aesthetic plastic surgeon in Austin, Texas.

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This 67 year old woman is seen just two and a half months after a secondary facelift. She had her original facelift performed by another surgeon approximately 10 years prior. A deep plane facelift technique and deep plane neck lift technique were used. When performing a secondary facelift, there are times when a deep plane approach is not possible — if the prior facelift significantly altered the anatomy in a way that would make it dangerous. However, in this patient a deep plane facelift was safely performed, and facilitated significant improvement in facial shaping. Her neck lift included submandibular gland reduction, reduction of the anterior belly of the digastric, and platysmaplasty, all of which contributed to further improvement in her contours. This procedure was performed by Dr. Adam Bryce Weinfeld, facial aesthetic plastic surgeon in Austin, Texas.

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48-Year-Old, One Year After Comprehensive Facial Rejuvenation Surgery

This 48-year-old patient was photographed one year after a complete facial rejuvenation, sometimes referred to as age-reversing surgery of the face and neck. Her transformation was achieved through a combination of advanced procedures, including a TriMax deep plane facelift, deep plane neck lift, upper and lower blepharoplasty, and an endoscopic brow lift.

Together, these procedures addressed every layer of facial aging—from the underlying muscle and connective tissue to the delicate skin around the eyes and forehead. The result is a refreshed, natural-looking appearance that restores youthful contours, smooths the neckline, and brightens the eyes—all without an over-tightened or operated look.

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This 55-year-old woman is seen four months after a deep plane facelift and deep plane neck lift. Her neck lift included submandibular gland reduction and reduction of the anterior belly of the digastric — steps that are particularly crucial in thin patients to create appropriate neck contour. She also underwent Aviva laser to facilitate scar management, making her incisions nearly invisible. This patient represents an important and growing category: facelift for patients who have undergone significant weight loss with the assistance of GLP-1 medication. She lost 50 pounds, and that weight loss created significant laxity — particularly in the lower face. The Light-Touch TriMax deep plane facelift technique that I perform is especially well suited for addressing skin excess in these regions.This procedure was performed by Dr. Adam Bryce Weinfeld, facial aesthetic plastic surgeon in Austin, Texas.