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Improvement Focus: Dorsal Hump, Dorsal Width, Tip Shape, Nostril Shape
Technique: Open Rhinoplasty
Graft Types: Bilateral Spreader, Columellar Strut, Sub-Domal, Bilateral Alar Rim
Graft Source: Costal Cartilage (Rib)
Patient Story: This patient is a young Woman from north Austin. She had suffered a cheerleading injury that resulted in altered nasal shape and deviated nasal septum. She underwent a septoplasty by prior to coming to see Dr. Weinfeld. While this surgery improved her breathing somewhat, it was not normal and the shape was still problematic. She underwent a rhinoplasty by Dr. Weinfeld. Costal cartilage was used as graft source for the procedure due to the fact that septal cartilage was not available (prior septoplasty). This patient was extremely pleased. It is interesting to note that here recovery was so rapid that she was able to walk as a runway model in a fashion show the day her splint was removed (her brother is a fashion designer and was participating in a charity fashion show). This case highlights the important fact that if you are going to undergo a septoplasty, but believe you may later want to undergo a rhinoplasty, find a surgeon like Dr. Weinfeld who is experienced with both, board certified, a member of the American Society of Plastic Surgeons, a member of the American Society of Aesthetic Plastic Surgeons, and The Rhinonplasty Society.
Eyelid Lift 01
Procedure: Upper Lid Blepharoplasty, Lower Lid Blepharoplasty (Subcilliary Approach with Canthoplasty) – “Quadralateral Blepharoplasty”
This patient knew of Plastic Surgeon Dr. Weinfeld from a relative who was one of his former patients. She visited with him in his office in Austin, Texas. She initially stated that she wanted an “eyelid lift.” After more conversation it became apparent that she wanted to remove the excess skin from her upper eyelids and smooth her lower eyelids. The patient and Dr. Weinfeld decided the best option for her was a combined upper and lower blepharoplasty (four lid blepharoplasty). Due to the laxity of her lower eyelids she required a lower lid canthoplasty (tightening of the lid) to prevent lid malposition post operatively. She recovered well and enjoys the results. Of note is the fact that Dr. Weinfeld recommended as special diet to reduce swelling and bruising and the patient adhered to it indefinitely following the surgery and has sustained weight loss that can be seen in the photographs.
Eyelid Lift 02
Procedure: Endoscopic Browlift (EBL), Upper Lid Blepharoplasty, Lower Lid Blepharoplasty (Subciliary Approach with Canthopexy) – “Upper Face Lift”
This patient is in her mid Forties. She was referred by her husband who is a doctor in Austin, Texas and knew Plastic Surgeon Dr. Weinfeld by reputation. She stated outright that she was interested in a facelift but did not feel she was quite ready. Instead she wanted to focus on her upper face first as the next best thing. She wanted to address upper lid excess skin and lateral hooding. With regard to her eyebrows she emphasized that she did not want a “surprised” look. She was more interested in position stabilization and smoothing of the temples more so than significant elevation and shaping. Her goals for her lower lids were to reduce the fine wrinkles and the appearance of “bags.” Following her surgery she has been very happy with the natural and subtle brow lift in addition to the reduction of excess upper lid skin. Most of all she likes lower lid smoothing and the blending of the lid cheek junction afforded by the septal reset and fat transposition. The subtle elevation of the upper malar (cheek) tissue through the subciliary (open approach) yielded benefits in the midface as well, benefits rarely seen with alternative approaches such as transconjunctival lower lid blepharoplasty. It is for that reason that when performed appropriately, the lower lid subciliary lower lid blepharoplasty inherently contains a natural element of upper cheek lift. The subciliary approach to lowed blepharoplasty involves an incision just below the lower lashes which results in a scar that is difficult to perceive. It is a more complex approach to blepharoplasty with which not all Plastic / Cosmetic Surgeons have experience. However, due additional training and experience in Oculoplastic Surgery, Dr. Weinfeld is well versed in this and other advanced techniques for the eyelids, brows, temples, and upper cheeks.
Eyelid Lift 03
Procedure: Upper Lid Blepharoplasty, Open Sky Technique
This patient is a women in her late fifties who wanted to look more energetic, refreshed, and somewhat younger. She started the consultation with Dr. Weinfeld (Austin, Texas) by stating that she did not feel she was ready for a facelift yet and needed a procedure that allowed for a very quick recovery. She identified her upper eyelids as the area of greatest concern. She elected to undergo an upper lid blepharoplasty (referred to as a “upper lid lift” by the general public) with local anesthesia only. She reported the procedure itself and the recovery had far less discomfort than she expected. Given that the procedure was performed under local anesthesia she had minimal bruising and swelling. She returned to work almost immediately after the procedure.
Eyelid Lift 04
Procedure: Upper lid blepharoplasty, Open Sky Technique
This patient is a young woman who came to know Dr. Weinfeld as a patient undergoing breast reconstruction for breast cancer. Due to her positive interaction Dr. Weinfeld she sought a Cosmetic Surgery consultation for peri-orbital rejuvenation. The patient’s primary goal was to correct excess upper lid skin, known as dermatochalasis. After a discussion it was determined that the best solution would be upper lid blepharoplasty. The result has removed the excess skin and eliminated lateral hooding. This was achieved without hollowing out the upper lid thus leaving her upper lid somewhat full, a characteristic of youthful eyes.
Neck Contouring 02
Liposuction and T-Z plasty in 65 year old man
Revision Rhinoplasty 02
Special Note: Cleft Rhinoplasty
Stage 1 – Iliac Crest Bone Graft to Pyriform Aperture and Skin Graft to lining of Left Ala (nostril)
Grafts – Pyriform Aperture, Alar Lining
Source – Iliac Crest
Stage 2 – Revision Rhinoplasty with Costal (Rib) Graft
Graft Types – Bilateral Spreader, Columellar Strut , Lower Lateral Crus Batten, Bilateral Alar Rim
Graft Source – Costal Cartilage (Rib)
This patient is a mid-Forties school teacher from Austin Texas who was referred to Dr. Weinfeld by an ENT colleague who refers Dr. Weinfeld patients with complex nasal breathing problems and rhinoplasty challenges. She had difficulty breasting due to collapse of the left side of her nose and septal deviation and desired improvement in the appearance. Her case was complex due to the face that she had a nasal deformity related to her past history of cleft lip and had a prior rhinoplasty by another Plastic Surgeon. Owing to his experience in advanced pediatric and adolescent cleft nose surgery at Dell Children’s Medical Center, Dr. Weinfeld felt that the best a way to achieve the patient’s goals would involve a two stage approach. In the first stage an iliac crest bone graft placed at the left side of the pyriform aperture was used to support the left ala bringing it more forward and a skin graft was placed in the left ala lining to help release the scarred and contracted tissues. In the second stage the patient’s rib own cartilage was used in an open revision rhinoplasty to rebuild the structure of the nose improving the function and appearance. Of special note to restore more normal contours to the cleft (left) side a lower lateral crus batten graft constructed from rib cartilage was used to strengthen the native cartilage that was abnormal due to the cleft and damaged due to the prior rhinoplasty. She has been very happy with her results.
Improvement Focus: Excess upper eyelid skin, lower eyelid bags, cheek decent with jowls, obtuse angle between face and neck with loose skin.
Technique: Cervicofacial Rhytidectomy (Face Lift, Neck Lift), Sub SMAS Dissection and Flap, Platysmaplasty, Upper and Lower Lid Blepharoplasty
This patient is a woman in her late fifties who is the wife of a senior hospital administrator in Austin, Texas. She was interested in comprehensive cosmetic facial rejuvenation. Following her consultation with Plastic Surgeon Dr. Weinfeld, she felt the best approach for her was two-stage process. First she underwent an upper and lower blepharoplasty. The lower blepharoplasty was performed with a subciliary approach permitting septal reset and blending of lid cheek junction. This advanced approach provides more than just lower lid smoothing. It permits elevation of the upper cheek, softening of the nasojugal crease, and a decreased vertical dimension of the lower eyelid – all features associated with youth and attractiveness. Following three months she underwent and facelift and necklift. In the majority of patients, but especially in patients with full faces and necks, Dr. Weinfeld choices to use direct sculpting of the lower face and neck fat instead of using liposuction which can be less precise. The powerful effect of direct sculpting can be seen in her post-operative photos.
Improvement Focus: Dorsal Hump / Bump, Tip Shape, Uneven Dorsal Aesthetic Lines
Technique: Open Rhinoplasty
Graft Types: Bilateral Spreader, Columellar Strut, Sub-Domal, Bilateral Alar Rim
Graft Source: Septal Cartilage
Patient Story: This patient had injured his nose playing soccer. He wanted cosmetic improvements to his nose and also needed to breathe more efficiently through his nose. He underwent surgery where both issues were addressed.
Neck Contouring 03
Neck contouring with liposuction: This woman underwent liposuction of the submental region and neck. The liposuction improved neck contours. In combination with the buccal fat pad reduction the liposuction has created the appearance of weight loss and has improved visualization of the jaw bone contours. Liposuction of the neck can create significant improvements and in younger people may be all that is required to improve the appearance. This woman is an example of how the improvement is profound, however it is not perfect. Some loose skin is visible and there is still some fullness to the overall contours. She is interested in having a neck and facelift in several years, but for now the neck liposuction has brought considerable satisfaction and has deferred those more involved procedures for now.
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This facility is only for cosmetic and non-insurance based procedures. If you seek insurance based treatments or reconstructive procedures, please search for Dr. Weinfeld in his other facility.
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