facial cosmetic procedures

NASHVILLE NOSE JOB PROCEDURE

Rhinoplasty

Cosmetic and functional deformities of the nose may be congenital, developmental, or acquired.  Congenital deformities of the nose are present at birth and may be related to genetic abnormalities, such as cleft lip.  Developmental deformities of the nose occur from abnormal growth of bone or cartilage as a person grows.  Acquired deformities of the nose can result from trauma or complications from previous nasal surgery.  Despite the underlying cause, deformities of the bone and cartilage of the nose can result in significant functional problems with nasal breathing or chronic nasal/sinus infections, or undesirable cosmetic appearance of the nose that can make people self-conscious and lead to low self-esteem and depression.

Rhinoplasty is a surgical procedure that corrects deformities of the bone and cartilage of the nose in order to improve nasal function (breathing) and/or aesthetic appearance.  The technique for rhinoplasty can vary considerably depending on the anatomy, concerns, and goals of the patient.  The procedure may include straightening of the nasal septum (wall that divides the two sides of the nose), restructuring of the cartilages of the nasal tip, and fracturing of the nasal bones to restore symmetry and function, and improve aesthetics of the nose.  Some people with significant nasal deformity may require additional cartilage from the ears or a rib to reconstruct the cartilage framework of the nose, while others may require bone grafting or implants when additional structural support is needed.  The techniques required must be individualized to each patient.

Rhinoplasty is typically performed under general anesthesia or deep IV sedation.  The procedure may take 1 – 4 hours or longer in rare cases, depending on the complexity of the procedure.  Most patients can return to normal activities in 1 – 2 weeks, but mild to moderate swelling may take several weeks to resolve.  Rhinoplasty is an art, and requires significant experience and expertise to achieve optimal results, as the nose can change over years following rhinoplasty.

Exact cosmetic results may vary because every patient has their own unique circumstances.

Open Septorhinoplasty

Before & After Gallery

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DR. MICHAEL A. BOGGESS, MD
NASHVILLE, TN

With more than 19 years of experience, and an untarnished safety record, Dr. Boggess is an expert in facial rejuvenation including rejuvenation of the brow, upper and lower eyelids, mid-face, jawline, neck, and skin.

6,500+ procedures performed
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Call 615-942-8016 or complete form to request your COMPLIMENTARY CONSULTATION ($300 value)

FINANCING OPTIONS

If you’re concerned that you won’t be able to afford facial rejuvenation, give us a call. Because we customize each Reflection Lift to suit each patient’s goals, we can and will work with you to get the reflection you want at a budget you can afford.

If you need help with financing, we have several different options.

Frequently asked questions

Call us today to schedule a free consultation where we will answer all of your questions. In the meantime, here are answers to a few of the most commonly asked questions.

What is a Facelift?
As we age, the effects of gravity, midface volume loss, and loss of skin elasticity leads to progressive laxity of the skin and soft tissues of the face, resulting in sagging along the jawline and in the neck, and deepening of the nasolabial folds and marionette lines around the mouth. A facelift, also called a rhytidectomy, is a surgical procedure intended to lift the skin and soft tissues of the face and neck, thereby restoring a more youthful contour to the neck and jawline, and softening the depth of the nasolabial folds and marionette lines. Therefore, a facelift primarily addresses aging changes of the lower face and neck. A facelift is commonly performed in combination with other facial rejuvenation procedures to address aging changes of the forehead, brow, eyes, midface, and skin. However, these additional procedures are not routinely considered part of a facelift.

What are the different types of facelift, and how do they differ?
This is a complex question, because there are so many different techniques that have been described for facelift, and the terminology is not always consistent in the literature. However, all properly performed facelifts employ some common basic principles. First, a variable length incision is made in the hairline in front of the ear, extending down along the natural creases around the front of the ear, and then possibly extending up along the backside of the ear and down along the hairline behind the ear for a variable length, depending on the needs of each individual patient. A separate small incision may be made in the natural crease under the chin to permit access to the midline of the neck, if needed. The skin of the face and neck is then elevated from the underlying soft tissues, called the SMAS in the face and the platysma muscle in the neck. This deeper layer of fascia and muscle is more resistant to stretch than the skin, and it is this deeper layer that is elevated and secured to re-contour the neck and jawline. Once the SMAS and platysma have been lifted and secured in a more youthful position, the excess redundant skin that comes back with the lift is trimmed along the incision lines and sutured back in place. Depending on the needs of the patient, liposuction of the jawline and neck, and tightening of the platysma muscle in the midline of the neck, may be performed through the incision under the chin for patients with significant fat accumulation or laxity in the neck. The thing that distinguishes different types of facelift procedures is the technique used for management of the SMAS and platysma. A SMAS plication involves folding the SMAS over onto itself as the tissues are lifted and suturing the layers together to support the lift. A SMAS imbrication procedure involves excising or removing a variable width strip of SMAS and platysma around the ear and approximating and securing the free edges together to support the lift. A deep plane facelift involves developing a separate plane of dissection underneath the SMAS layer to allow release of ligamentous attachments along the jawline and in the midface to allow additional mobilization of the SMAS during the lift. This is primarily to allow additional improvement in area of the nasolabial fold and midface. There are other variations related to suturing techniques and vectors of pull that distinguish facelift techniques. There are pros and cons to each facelift techniques, and the choice of facelift technique is dependent on the skill, experience, and preference of the operating surgeon. However, there has been no consistent evidence in the medical literature to demonstrate any advantage of one technique over another, in terms of outcome, complications, or longevity of results. Most experienced facelift surgeons have likely performed all of these techniques and utilize each to some degree based on the anatomy, concerns, and goals of each individual patient.

What is the difference between a mini-lift and a full facelift?
As described in a previous question, a facelift procedure is indicated for addressing aging changes of the lower face and neck. A facelift may be combined with other facial rejuvenation procedures, such as a brow lift or mid-face lift to address aging changes of the upper face and midface. However, these additional procedures are not routinely considered part of a facelift. A mini-lift is a very conservative facelift procedure that is best utilized for younger patients with mild to moderate laxity along the jawline and mild laxity in the neck, or for patient who have had a previous facelift and just need a little tuck-up. This procedure involves lifting a short skin flap around the ear to allow limited mobilization of the SMAS and platysma to tighten the jawline and neck. A full facelift is best utilized for patients with more advanced aging of the face and neck with moderate to severe laxity along the jawline and in the neck. This type of procedure involves more extensive skin flap elevation in the face and neck to allow more aggressive mobilization of the SMAS and platysma resulting in better tightening of the neck and jawline. This may also include liposuction in the neck and tightening of the platysma muscle in the midline of the neck to optimize results.

What is a Reflection Lift?
I am not a believer in a “one procedure fits all” approach to facial rejuvenation. Every patient is unique and different in their anatomy and the effects of aging. I have performed over 3500 facelift procedures, and with that experience I have been able to develop techniques to optimize results for all of my patients. I tailor every procedure to the individual anatomy, concerns, and goals of each patient. The Reflection Lift utilizes my unique approach for lifting and securing the SMAS and platysma to optimize results and achieve a natural, more youthful look for my patients. The Reflection Lift can be performed in an office-based setting using light sedation and local anesthesia, thereby eliminating the risks and cost associated with general anesthesia. A Level I Reflection Lift is a conservative SMAS facelift approach for younger patients with mild to moderate laxity along the jawline and mild sagging in the neck. A Level II Reflection Lift involves a SMAS facelift, in addition to liposuction in the face and neck, to address mild to moderate laxity and fat accumulation in the jowls and neck. A Level III Reflection Lift is a more aggressive facelift approach for patients with moderate to severe laxity in the face and neck. This procedure involves more extensive skin flap elevation in the face and neck to allow tightening of the platysma muscle in the midline of the neck and more aggressive mobilization of the SMAS and platysma with the lift, in order to optimize results.