The Patient's Question: I'm 42 and I want to change my nose -- it looks like there's a ball attached to the tip. I also want to get my neck and chin area tightened some. My last complaint is that when I am concentrating people often think I look mad or snobby or bitchy. I want my face to look happy.
Nose: Imagine your nose divided into thirds. The upper third is made up of bone and looks fine. The middle third is made up of cartilage, and in your case, it seems a little narrow. This narrowness may be real or the result of the tip of your nose being too wide -- only a physical exam will tell the truth. The lower third of the nose is made up of two mirror image pieces of cartilage that create the shape of the tip and, in your case, the bulbous look. Plastic surgeons can reshape and tighten these cartilages to create a more balanced tip, similar to the computer-generated image seen above. After the tip is reshaped, the surgeon can reevaluate to determine if any widening of the middle third of the nose is indicated. The cost of a rhinoplasty can be from $4,000 to $10,000, depending on the experience of the surgeon and the region of the country you live.
Neck: Your neck has excess skin and fat. Certainly a good exercise regimen and a healthy diet are crucial to looking good, but once those efforts are exhausted you can consider liposuction of the neck, with or without a neck lift. The neck lift would be advisable if there was a lot of excess skin or if the muscles of the neck showed the waddle or turkey gobblers. Your images suggest that liposuction might be enough. Neck liposuction costs $3,000 to $5,000 and has minimal downtime.
Eye area: You have described not looking happy. I prefer to see the problem as having deep-set eyes plus eyebrow sagging. These two factors together make you look unhappy. In your case, I think an eyebrow lift and fat injections to the lower eyelids and cheeks may be all you need to perk up your looks. Of course, the deep-set eyes will not change, but lifting your eyebrows a little will make your eyes look more open and pretty. The cost of a brow lift runs about $3,500.
Robert M. Freund, MD
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.