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The Seattle Facelift Center™
Bill Portuese, M.D.®

Facial Surgery Procedures


Nose Surgery Procedures

Why is my nose distorted when smiling after rhinoplasty?
Little can be done for an animated nose when smiling. The nasal operation is a static operation and it isnít completed for dynamic action with respect to the orbicularis oris muscle pulling only on the nose. It is unlikely that anything can be done about this but, a patient could potentially try to put a very small amount of Botox in the nasofacial junction to see if this possibly reduces the smile muscle strength.


What can be done if the tip of the nose is too big and too hard after rhinoplasty?
Stiffness in the tip is truly dependent on the stage of healing the patient is in after the nasal surgery. Techniques used in cartilage grafts and tip sculpting may contribute to permanent stiffness in the tip, the stiffness may be increased from the preoperative state. Expect the hardness of the tip to remains for upwards of six months prior to it settling down and beginning to and feel normal again.

When is a Radix graft for rhinoplasty?
Radix grafts can be used either in primary or a secondary nasal surgery. These grafts are solely used to build up the top-most portion of the bridge when it is depressed from the removal of too much bone during a previous surgery or a congenitally formed depression. These grafts are recommended and are an outstanding procedure for those who have an indent in the area, and provide the nose a stronger, longer dorsal height.


Dr Portuese and Janet the office manager are reviewing the computer imaging results with a patient which is part of the rhinoplasty consultation. Dr Portuese is examining the nose during a rhinoplasty consultation.
What are the possible long-term effects from arcus marginalis release?
Long-term effects of the arcus marginalis release should not exist providing the brows have been placed up to the new anatomical position. When they have been suspended and sutured in position, the scar tissue will reattach the arcus marginalis at the new permanent level.
Dr William Portuese
Rhinoplasty Surgery
Top Facelift Surgeon
Browlift Surgery
Eyelid Surgery