Post Your Face: Wide Nose, Worry Lines & Heavy Eye Lids
Chrissy's Question: My nose is very wide, I wish it was smaller. I have a deep worry line in between my eyes, and my eyelids have heavy flaps.
Before (left) and after (right) alar base reduction to the nose and Dysport/Botox to the forehead. Courtesy Photo
Dr. Freund's Answer: Thank you for your pictures. You describe three concerns; 1) the width of your nose, 2) the worry lines between your eyebrows, and 3) your heavy upper eyelids. I will address the nose first and then the second and third concerns together.
The width of your nose: A simple rule of thumb is that a vertical line drawn from the inner corner of your eye should fall somewhere near the outer edge of the nostril. This can be seen in the photos by the blue lines. In the "Before" photo, the width of the nostrils is much greater than this line. In the "After" photo, these lines are much closer. One note of caution -- anyone rushing to a mirror to determine if their nostrils are too wide should evaluate the width without smiling. As is the case in your photos, smiling will falsely make the nostrils appear wider than they are. Plastic surgeons perform an alar base reduction or ABR, to narrow the width and opening size of the nostrils. By itself, ABR will cost from $2500 to $5000 and can be performed under local anesthesia. Downtime is 2-3 days with the sutures removed on the 5th day.
Your worry lines and heavy upper eyelids: It appears that the heavy upper lids are not so much the result of excess skin but more the result of some forehead and eyebrow sagging, more on the right than on the left. The worry lines are the result of too much frowning or excess facial expression. We could certainly lift the forehead surgically (a.k.a. Browlift), but can also lift the brows and eliminate the worry lines by using a muscle paralyzing agent (Dysport or Botox). These agents will weaken the muscles that make the lines and can also be used elevate the eyebrows. This unique combination of relaxation and lifting requires that the doctor is well-versed on facial anatomy and is experienced with the use of these agents. You can see what this treatment can do for you in the after photographs. These agents will cost around $750/treatment and will need to be performed 2-4 times per year. Downtime is minimal. Many people can return to work on the same day.
Respectfully submitted,
Robert Freund, MD, FACS
The health or medical information in this article is for informational purposes only and is not intended to be used as a substitute for professional medical advice, diagnosis or treatment. Please consult your doctor or a qualified healthcare provider with any questions.
Tags: cosmetic surgery, CosmeticSurgery, Dr. Robert Freund, Dr.RobertFreund, plastic surgery, PlasticSurgery, post your face, PostYourFace






mdennish, 1-11-2010, 6:07AM
Your so vain...You probably think this post is about you!
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