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All About Rhinoplasty

girl touching nose
Rhinoplasty, aka…a nose job, is a plastic surgery procedure for correcting and reconstructing the form, restoring the functions, and aesthetically enhancing the nose- by resolving nasal trauma, defects or respiratory defect, as well as a previous failed primary rhinoplasty. In the surgeries —  a plastic surgeon creates a functional, aesthetic, and facially proportionate nose by separating the nasal skin and the soft tissues from the nasal framework, correcting them as required for form and function, suturing the incisions, and applying either a package or a stent, or both, to immobilize the corrected nose to ensure the proper healing of the surgical incision.
The nose is made up of bone and cartilage. The size and relationship of the bone and cartilage which make up the nose determine the size and shape of the nose.

Nose surgery (rhinoplasty) offers improvement in the appearance in cases in which the nose is cosmetically unappealing. Age may also be a consideration. Many surgeons prefer not to perform cosmetic (elective) rhinoplasties until the growth of the nasal bone is completed (around 14 or 15 for girls, a bit later for boys).

With local anesthesia, the nose and the surrounding area is numbed. The patient will usually be lightly sedated but awake during the surgery, and relaxed and insensitive to pain. The surgery is usually done through the incision inside the nostrils. Instruments inserted through the nostril, are used to reshape the bones which make up the nose.
The results of surgery are variable, depending on the initial shape of the nose, but rhinoplasty offers significant improvement in appearance in most cases.

Rhinoplasty surgery can change:

  • Nose size, in relation to the other facial structures
  • Nose width, at the bridge
  • Nose profile, with visible humps or depressions on the bridge
  • Nasal tip, that is large or bulbous, drooping, or too upturned
  • Nostrils that are large, wide or upturned
  • Nasal asymmetry and deviation

nose profilenose side
Dr. Bishara provides a wide range of cosmetic procedures to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Many of these procedures can be combined in order to achieve your desired appearance.  Please call our office at (817) 473-2120 for more information or visit our website at www.MarkBisharaMD.com.
 
 

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Selfies May Inspire More Americans To Undergo Plastic Surgery

selfie couple
Plastic surgeons are seeing more patients who wish to undergo facial surgery, suggesting social media-posted selfies may be inspiring more Americans to consider plastic surgery.
The growing trend of taking selfies – a type of self-portrait photograph, typically taken at arm’s length with a hand-held digital camera or camera phone – and posting them on Facebook, Twitter,  Snapchat, and Instagram, has been attributed to the increase in nose jobs and other reconstructive facial procedures.
Dr. Edward Farrior, President of the AAFPRS who conducted the research that posed these assertions, states in CBS News:

“Social platforms like Instagram, Snapchat and the iPhone app Selfie.im, which are solely image based, force patients to hold a microscope up to their own image and often look at it with more self-critical eye than ever before. These images are often the first impressions young people put out there to prospective friends, romantic interests and employers, and our patients want to put their best face forward.”

According to an annual survey conducted by the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) of a select group of the organization’s 2,700 members revealed one in three plastic surgeons reported seeing an increase in requests for facial procedures by patients who wanted to look better online.
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Between 2012 and 2013 they saw a 10 percent rise in nose jobs, a seven percent rise in hair transplants and a six percent rise in eyelid surgery, says the NY Daily News. In addition, 58 percent of the doctors surveyed noted having a growing number of patients under 30 seeking out services – in part because of social media images like selfies.
Nose jobs (rhinoplasty) are the most popular elective surgical procedure conducted among those in the under 35 crowd – accounting for 90 percent of women, and 86 percent of men respectfully. And while women account for nearly 80 percent of plastic surgeries for face and eye lifts, men are becoming more determined to keep their hair and combat wrinkles.
This information is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX
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Breast Augmentation Questions

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In consultations, women ask dozens of questions about the safety, durability and longevity of saline and silicone gel implants – the two types that are approved for sale by the U.S. Food and Drug Administration. Here’s a sampling:
Is it normal to have different-sized breasts?
Breasts are sisters, not twins. There’s no such thing as perfectly identical breasts. Most women have breasts that are slightly different sizes. In consultations, when women look at dozens of before-and-after photos, they are surprised and relieved to see that they are not the only ones with different-sized breasts.
The asymmetry can be addressed during surgery, by enlarging breasts with implants of different sizes, augmenting the smaller breast or reducing the larger breast. While surgery cannot transform those sisters into twins, it can make them look like sisters from the same family.
Will I be able to breastfeed if I get implants?
In most cases, breast augmentation surgery does not interfere with breastfeeding, because milk ducts are generally not disturbed during the procedure. When implants are placed through an incision made around the areola, milk ducts are sometimes disrupted, which may affect breastfeeding. However, not all women are naturally able to breastfeed, whether or not they have cosmetic breast surgery.
Do implants get in the way of reading a mammogram?
They can. That’s why technicians routinely ask women if they have breast implants. If so, they will gently displace (push up) the implants and take extra views of each breast. Because of the number of women who have had breast augmentation, radiologists are likely to have experience evaluating breasts with implants.
Can you make me a full C cup?
Women commonly think that being in proportion means wearing a C cup bra. Because there is no standard bra cup-sizing system, and because breast implants are measured in cubic centimeters not cup size, it’s better to refer to proportional as a “C look.” To achieve that, a 5-foot-tall woman with a small frame might end up wearing a B cup bra and a 5’ 8” woman might wear a D.
How soon can I get back to work and to working out?
The former depends on what your job entails. Generally, women who work in an office setting can go back to work on the fifth day after surgery. Those whose jobs entail lifting, pushing or pulling normally return to work at the end of the second week.
Three weeks after surgery is a milestone: That’s when women can run, ride a stationary bike and do lower-body weight training.  It’s also when policewomen or soldiers can put their bulletproof vest back. Women are usually comfortable doing arm exercises (upper-body weights) starting about six weeks after surgery.
Do breast implants have to be replaced every 10 years?
Breast implants don’t have an expiration date. They can handle hundreds of pounds of pressure, which is why a mammogram – which can apply up to 50 pounds – doesn’t harm them.
Through the years, manufacturers have increased the strength of the implant shell. On average, less than 3 percent of implants rupture or deflate.
Will my breast implants melt in a sauna?
Both silicone gel and saline implants have an outer silicone shell, which can melt at temperatures greater than 392 degrees Fahrenheit. A conventional sauna is typically between 150 and 190 degrees. If you were in an environment where your implants would melt, you’d melt too.
Women come in for a consultation to get their questions answered and to make an informed choice. While breast augmentation is not right for everyone, for those who choose it, it can make a life-altering difference.
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This information is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX

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Does a Nose Job Affect the Voice?

nose job
NEW YORK (Reuters Health) – People who had rhinoplasty sounded a bit more nasal five months after the surgery, according to a new study from Iran.
The results from 27 surgeries showed that “the voices changed in statistically significant ways, but the changes were subtle,” Dr. Kamran Khazaeni told Reuters Health.
Khazaeni, a surgeon who specializes in ear, nose and throat procedures, worked on the study at Mashhad University of Medical Sciences in Iran.
The 22 female and five male patients “noticed changes, but overall, they were satisfied,” Khazaeni said. Patients ranged in age from 18 to 45 years old.
A team of linguists and speech pathologists detected more pronounced nasal sounds in test words like “man” and “namak” post-surgery after listening to voice recordings of the patients. Persian, the official language of Iran, has no nasal vowels, but does have nasal consonants – like the “m” in “man” and the “n” in “namak” – said Khazaeni, explaining why the group focused on those two words.
The results were confirmed with patient self-assessments and a computer program that analyzes acoustic sounds.
About one in 560 Iranians had cosmetic nose surgery in 2011. By comparison, about one in 1,250 U.S. men and women had the same procedure in 2012, according to national surveys from both countries.
Writing online January 28 in Plastic and Reconstructive Surgery, Khazaeni and his team say that if rhinoplasties can change vocal sounds by narrowing a person’s nasal cavity, people who rely on their voice for professional reasons should be made aware of this possible risk.
But Dr. Steven Pearlman, a facial plastic surgeon based in New York City who was not part of the current research, disagreed, at least in cases where patients are singers.
“The better trained the singer is, the less the nose has to do with it,” Pearlman said.
“I’ve operated on patients who are rock stars, Broadway stars and opera singers,” Pearlman told Reuters Health. “And in the classically trained American style of singing, you sing from the chest and the throat, not the nose,” he said, adding that speaking is different from singing and perhaps Middle Eastern methods of singing rely more on the nasal cavity for sound.
Regarding the study, the idea and goal were good, “but the execution was limited,” Pearlman said.
An important missing element is nasal airflow measurements taken on each patient before and after the surgery in order to detect changes in how air passes through the nose.
“Without this measurement, you may have airflow changes, but you don’t know,” he said.
The study raises interesting questions, such as why these results are being seen in Iran and not in North America, said Dr. Minas Constantinides. Anecdotally, of the more than 2,000 rhinoplasties he has performed, Constantinides said only one patient expressed concerns about more voice nasality after surgery.
Constantinides practices facial plastic surgery in New York City and is secretary of the American Academy of Facial Plastic and Reconstructive Surgery. He was not involved in the new research.
“I don’t think these results can be broadly applied to rhinoplasty,” he said. But, the current study “raises enough questions to bear being repeated” with larger groups of patients at a medical center in the U.S., he said.
“Rhinoplasty is one of the hardest procedures to do in facial plastic surgery,” Constantinides said.
“Patients understand that surgery always has some risk attached to it,” he said. “However, voice change is not something that patients need worry about in competent hands.”

This news is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX

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New wrinkle worry identified: Water bottle mouth

Facial wrinkles occur because people lose skin elasticity as they age, but there are also habits that can contribute to premature signs of aging. For example, forgoing sunscreen can cause sun damage, which leads to lines on the face. Repetitive motions, such as constantly squinting at the sun or sucking on a cigarette, can also make you more likely to develop wrinkles. In a recent article, The Inquisitr identified another potential cause of facial lines: water bottles.
water bottle drink
Think before you drink
If you live in an area that has less-than-stellar tap water, drinking bottled water may seem like a no-brainer. There’s nothing wrong, nutritionally, with drinking H2O from a bottle, but the cosmetic dermatologist told the news source that it’s the repetitive motion that could cause lines to form around the mouth when they otherwise might not.
“We tell our patients, keep on drinking, it’s great for your body, it’s great for your health, it’s great for your skin,” a physician said in the interview. “Unfortunately, over time it either causes these lines or it aggravates them.”
Of course, there are ways to avoid this issue. Water purifiers may do the trick if you’d rather drink from the tap, and this will also save you money in the long run. You can pour your bottled water into a cup or drink through a straw, thus eliminating the lip-pursing motion.
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A cosmetic solution
Unfortunately, for those of us who have been drinking out of water bottles for years, this news may come a bit late in the game. If wrinkles have already formed, you can discuss other options with a plastic surgeon. Facelifts and deep chemical peels offer long-term results that can make you appear younger, while dermal fillers can help fill deep wrinkles and reshape the facial contours.
 

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