Answer:
Anything placed into the nose after nasal surgery can be considered “packing”. Having said that most horror stories regarding nasal packing refer to the use of long thin nasal packing which was layered into the nose after surgery and which takes a considerable amount of time and patient discomfort to remove. It is for that reason that we do not use this type of packing at our centers. For most patients only silicone splints are inserted which slide out easily one or two days after surgery. These also serve to stabilize the recently straightened septum. Occaisionally we insert a small piece of telfa (the ouchless bandaid) if the patient requires it. Nasal surgery does not need to feared with this type of post operative treatment.

Answer:
The key to effective and pain free laser hair removal is adequate chilling of the skin. All of our lasers are contact cooled that is the tip of the laser is chilled to increase patient comfort during treatment. In addition we use an external chiller which helps to alleviate discomfort during treatment.

Answer:
Juvaderm is a beautiful choice for facial volumizing in all skin tones. Becasue the filler is placed underneath the skin (dermis) the augmentation of nasal creases, wrinkles, and folds is natural. Because the hyaluronic acid is a naturally occuring substance allergies and reactions to the subdermal placement is rare. Juvaderm XC comes with local anesthetic included and is not uncomfortable for most patients even those who fear injections.

Answer:
Depending on the size of the treatment area and the equipment laser hair removal can be completed in a lunch hour. For facial hair removal the treatment times are usually 10 minutes to 20 minutes and for extremities and chest or back 45 minutes or longer depending on the size of the treatment area.

Answer:
What you are describing is known among Rhinoplasty experts as the the “Finesse Rhinoplasty.” For rhinoplasty specialists such as Dr. Gentile the procedure is realistic and the advantage of making a few minor adjustments is the procedure is short and can be frequently performed under local anesthesia. In skilled hands the Finesse Rhinoplasty is a worthwhile intervention for interested patients.

Answer:
Otoplasty numbing shots are typically given behind the ear where there is much less sensitivity. In our centers we will typicall administer an light oral or IV sedation to make these few injection even less comfortable. The shots may pinch like a mosquito bite but as long as the doctor injects the anesthetic slowly the discomfort is minimal.

Do any fillers provide permanent results? Which provide the longest lasting results and what can they be used for?

Answer:

There are several fillers available which are semipermanent and are used in Europe and Canada. In the US Artefill is one of the recently FDA approved fillers to be approved. Artefill has little permanent beads in it and as such can be rejected by the body which would give little mosquito bite like bumps over the “filled areas”. As such and with the negligible complication rates of hyaluronic acid and hydroxyapatite we are awaiting futher safety data before we offer these products to our patients.

How quickly will I see the results of fractional skin rejuvenation, and will there be any redness or swelling after the procedure?

Answer:

Results will be apparent after 4 days but the early results and improvement seen is from the swelling of the skin and is a temporary benefit. As the swelling diminishes cells called fibroblasts migrate to the region and begin producing collagen which produces more of the permanent improvement for wrinkles and scarring. After healing much of the pigmentary problems of the skin improve and this occurs about 1 to 2 weeks following treatment.

The tip of my nose is too round. Can this be corrected with rhinoplasty?

Answer:

Patients with round or bulbous tips are excellent candidates for rhinoplasty especially if the roundness is created by excess or excessively rounded tip cartilages. Occaisionally the roundness is casued by excess fat or tissue in the tip associated with thick skin and this is a problem that should be addressed by a rhinoplasty specialist. In rounded cartilage patients we reshape the cartilage by removing a small portion and then recontouring them with specialized suture techniques. This helps to reduce the roundness or “bulbous” shape of the tip and gives a more natural and aesthetically pleasing triangular tip.

Question:

I’ve been told by a doctor that I have thick nasal skin. How will this impact my rhinoplasty surgery?

Answer:

Thick nasal skin can interfere with an ideal result in rhinoplasty for several reasons. First all the fine and intricate cartilage work done under the skin is frequently covered up by the thick skin thus limiting the final result. Think of someone refining the floor under a thick shag carpeting. The other reason is because  thick skin in noses is heavy and surgeons must be careful not to overdo the cartilage work (removal) or the heavy skin can be too much for the cartilage framework. So a middle ground approach will usually limit the degree of improvement that Rhinoplasty can achieve but not eliminate improvement.  Thick skinned noses can improve but patient’s need to be counseled on what to expect and the degree of improvement that is usual in thick skinned patients.