The Patient's Issue: I think my nose is too fat, and it doesn't have a bridge. My skin has been ravaged by acne. I want plumper lips. I want a better bone structure, and my eyes are too far apart.
Let's start with your lips and eyes. I think most people would be envious of the shape and proportions of your lips. In fact, the two rules plastic surgeons use for evaluating attractive lips are:
1) That the ratio of upper lip height to lower lip height should be about 40:60. You qualify!
2) That the corners of the mouth should be slightly turned up so that a line drawn between the corners will cross through the upper lip (Look at Charlize Theron). You qualify!
In other words, enjoy your beautifully proportioned lips.
Moving on. Even if there was a problem with the width of your eyes, surgery to correct this problem is designed for children with serious craniofacial deformities and the risks are significant. This, however, avoids the fact that your eyes have a beautiful almond shape and a highly desirable slightly upward slant. So forget your concerns and enhance your positives!
As for your acne, most teenagers face these issues, so be assured that they will improve with age and maturity. In the meantime, there are six things that you can do to make it better:
1) Wash your face with a non-foaming cleanser (Cetaphil). Most importantly, do not overwash your face even if you have supe-roily skin. I know you'll feel that by excessively washing your face you can dry the oil, but in many cases it just stimulates more oil production.
2) Twice per week, exfoliate your skin with a mild Buf-Puf. This is a mildly abrasive sponge available at your local pharmacy. Note that after a couple of weeks, dead skin cells will accumulate within the pad so be sure to replace it!
3) Next, Benzoyl Peroxide (available at your local pharmacy) is an antiseptic agent that will also help dry your oil glands. This can help improve the acne, but most people experience an initial honeymoon followed by more acne. It is worth a try this lotion at first and then use it intermittently when flare-ups occur.
4) Facial scrubs with salicylic acid are the next line of defense. Facial scrubs act like the Buf-Puf, so don't use both together. The salicylic acid is an anti-inflammatory agent to help reduce the redness. It also helps to dissolve oil blocking the deeper pores. An inexpensive version of this product is St. Ives Facial Scrub with salicylic acid.
5) Always wear a zinc oxide sunblock. The acne scars can become hyperpigmented (darker) in the sun, so don't let that happen! Elta MD makes a sunblock just for people with acne.
6) If all else fails, consider finding a Board certified dermatologist to prescribe medications like antibiotics, retin-A or Accutane.
As for your nose, I agree that you do have a broad bridge and that your nostrils appear wide. There are procedures that we could perform that would resolve your complaints. The computer images above show what those changes would look like. Just keep in mind that any efforts to narrow your bridge may also make your eyes appear further apart. So look at the images and decide. In any case, rhinoplasty surgery can cost from $4,000 to $7,500.
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.