Beverly Hills rhinoplasty has different endpoints depending on the gender of the patient.
For female patients, we aim to produce a very gentle slope over the bridge of the nose, ending in a defined tip which is the highpoint on profile. Additionally, the sidewalls of the nose are somewhat narrower in the midsection, producing a subtle curve or “C” shape. Extending this curve into the eyebrow produces a continuous convexity. Furthermore, the angle between the bottom of the nose and the upper lip is greater than 90 degrees or a right angle. In some cases, it may be as large as 105-110 degrees, producing more “nostril show” than we see in a man.
On the other hand, the angle for a man is around 90 degrees. The bridge tends to be straighter, which forms a “T” with the straight eyebrows above it. And we are generally more accepting of slight imperfections and a larger framework in a man.
The term “septorhinoplasty” describes an operation that changes both the midline wall or septum within the nose and the outside structure or appearance of the nose. It implies that the septum is not in the midline, but rather in the direct path of inspired air. The septum is then classified as “deviated” and needs to be surgically corrected to improve airflow. This is called a “septoplasty”.
“Rhinoplasty” is the term we use to describe an operation that changes the appearance of the nose. When used in the context of improving breathing, it suggests a deformity that, by itself, is blocking airflow, as with a collapse of a sidewall or a deformity that contributes to the deviated septum, as may be seen in a nasal injury where deflected nasal bones are holding the septum in a displaced position. Hence, the term “septorhinoplasty”.
For patients who aren’t ready for a facelift or who may never want facial surgery, the Beverly Hills Necklift can give dramatic, rejuvenating results. As the skin loses its elasticity and starts to sag, the neck can suffer the most. Add an accumulation of fat underneath the jawline and laxity of the muscles in the floor of the mouth supporting the salivary glands and a full, sagging neck is the result.
The procedure is generally performed under intravenous sedation or general anesthesia. A small incision is made underneath the chin and incisions are made behind the ears. However, there are some patients with such extreme skin laxity that facelift incisions are also necessary. This is so because the skin has to be pulled superiorly on to the face as well as posteriorly behind the ears to accomplish the desired result. A small drain is usually placed over night and full recovery generally takes one week.
There are many young patients who have never had a right angle under their jawline and would benefit from the Beverly Hills Necklift. Their full neck is primarily related to the orientation of the muscles that form the floor of the mouth and, to a lesser degree, fatty deposits and/or prominent salivary glands or hypertrophied muscle.
To correct this deformity, a combination of several techniques are used. Liposuction, creation of muscle flaps, excision of muscle, transection of muscular attachments, suspension sutures or partial salivary gland resection are the primary approaches. The procedure need not be performed with any additional facial surgery and can have a dramatic effect on the overall appearance.