Description:

Description:

Procedure: Upper lid blepharoplasty, Open Sky Technique

Patients Story

This patient is a young woman who came to know Dr. Weinfeld as a patient undergoing breast reconstruction for breast cancer. Due to her positive interaction Dr. Weinfeld she sought a Cosmetic Surgery consultation for peri-orbital rejuvenation. The patient’s primary goal was to correct excess upper lid skin, known as dermatochalasis. After a discussion it was determined that the best solution would be upper lid blepharoplasty. The result has removed the excess skin and eliminated lateral hooding. This was achieved without hollowing out the upper lid thus leaving her upper lid somewhat full, a characteristic of youthful eyes.

Description:

Upper lid blepharoplasty

Description:

Upper lid blepharoplasty. Short term follow-up (less than one month). Looks refreshed, vibrant, younger and natural.

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, lower eyelid bags, cheek decent with jowls, obtuse angle between face and neck with loose skin.

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

Patient Story:

This patient is a woman in her late fifties who is the wife of a senior hospital administrator in Austin, Texas.  She was interested in comprehensive cosmetic facial rejuvenation.  Following her consultation with Plastic Surgeon Dr. Weinfeld, she felt the best approach for her was two-stage process.  First she underwent an upper and lower blepharoplasty.  The lower blepharoplasty was performed with a subciliary approach permitting septal reset and blending of lid cheek junction.  This advanced approach provides more than just lower lid smoothing.  It permits elevation of the upper cheek, softening of the nasojugal crease, and a decreased vertical dimension of the lower eyelid – all features associated with youth and attractiveness.  Following three months she underwent and facelift and necklift.  In the majority of patients, but especially in patients with full faces and necks, Dr. Weinfeld choices to use direct sculpting of the lower face and neck fat instead of using liposuction which can be less  precise.  The powerful effect of direct sculpting can be seen in her post-operative photos.

Description:

Description:

Improvement Focus: Dorsal Hump / Bump, Tip Shape, Uneven Dorsal Aesthetic Lines

Technique: Open Rhinoplasty

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

Graft Source: Septal Cartilage

Patient Story: This patient had injured his nose playing soccer. He wanted cosmetic improvements to his nose and also needed to breathe more efficiently through his nose. He underwent surgery where both issues were addressed.

Description:

Liposuction and T-Z plasty in 65 year old man

Description:

Description:

Special Note: Cleft Rhinoplasty
Technique:
Stage 1 – Iliac Crest Bone Graft to Pyriform Aperture and Skin Graft to lining of Left Ala (nostril)
Grafts – Pyriform Aperture, Alar Lining
Source – Iliac Crest
Stage 2 – Revision Rhinoplasty with Costal (Rib) Graft
Graft Types – Bilateral Spreader, Columellar Strut , Lower Lateral Crus Batten, Bilateral Alar Rim
Graft Source – Costal Cartilage (Rib)

Patient Story

This patient is a mid-Forties school teacher from Austin Texas who was referred to Dr. Weinfeld by an ENT colleague who refers Dr. Weinfeld patients with complex nasal breathing problems and rhinoplasty challenges. She had difficulty breasting due to collapse of the left side of her nose and septal deviation and desired improvement in the appearance. Her case was complex due to the face that she had a nasal deformity related to her past history of cleft lip and had a prior rhinoplasty by another Plastic Surgeon. Owing to his experience in advanced pediatric and adolescent cleft nose surgery at Dell Children’s Medical Center, Dr. Weinfeld felt that the best a way to achieve the patient’s goals would involve a two stage approach. In the first stage an iliac crest bone graft placed at the left side of the pyriform aperture was used to support the left ala bringing it more forward and a skin graft was placed in the left ala lining to help release the scarred and contracted tissues. In the second stage the patient’s rib own cartilage was used in an open revision rhinoplasty to rebuild the structure of the nose improving the function and appearance. Of special note to restore more normal contours to the cleft (left) side a lower lateral crus batten graft constructed from rib cartilage was used to strengthen the native cartilage that was abnormal due to the cleft and damaged due to the prior rhinoplasty. She has been very happy with her results.

Description:

Description:

Technique: Open Revision / Tertiary Rhinoplasty (3rd)
Graft Types: Bilateral Spreader, Columellar Strut, Bilateral Alar Rim, Dorsal Onlay
Graft Source: Residual Septal Cartilage, Costal (Rib) Cartilage

Patient Story:

This patient is women in her mid-Twenties who suffered significant facial trauma the age of 5 years old when she fell face first only a bleacher seat. She had undergone a rhinoplasty to try to improve hear breathing in her pre-teen years and then a second rhinoplasty in her teenage years to improve her shape. Both of her surgeries were performed in Austin by a different Facial Plastic Surgeon. She was referred to Dr. Weinfeld by her primary care Doctor to discuss a tertiary (3rd) rhinoplasty to improve her breathing and appearance. She underwent a complex revision rhinoplasty with grafts from her own rib cartilage. Dr. Weinfeld believes a patient’s own rib is one of the best graft materials for revision rhinoplasty because of its long term durability. Some patients are initially apprehensive but later comment on the fact that the procedure is associated with much less discomfort than they initially expected. This procedure improved nasal length and projection in addition to refining shape, especially at the tip. Of special note is the use of the dorsal onlay gaft to restore dorsal projection and improve nasal length.