Examples of some of Dr. Scaccia’s surgical results. All photos are untouched and shown with patient’s permission. Disclaimer: Results may vary*
Chin Implant and Neck Tuck*
Chin implant & neck tuck/lipo all through 1 inch incision under chin. 3 weeks postop with swelling. With patient permission.
Rhinoplasty, Neck Lift, Chin Implant and Lip Enhancement*
Three week postoperative view of a young lady who underwent multiple procedures including reconstructive rhinoplasty, septoplasty and adenoidectomy and turbinectomy to improve her breathing, upper lip vermilion border lip lift, chin implant and neck liposuction and submental neck tuck. As can be seen in the preoperative pictures, the patient presented with a markedly deviated nose to the right probably secondary to a prior fracture with a small bony hump and spicules. She also had a depression in the mid vault of her nose on the left side with narrowing of her mid vault region as seen on the three-quarter view. She also had a small upper red mucosa of her lip, elongated white upper lip region between the red lip and the base of her nose. She also had somewhat of a mildly recessed chin and submental neck fat hypertrophy. It was felt that her neck was not only in the subcutaneous compartment but also in the deeper facial planes of the submental area underneath the platysma. For this reason it was felt that both liposuction of the neck and a submental neck tuck with deep fat correction and platysma muscle suturing was necessary. Her rhinoplasty involved correcting a small bony hump and placing a cartilaginous graft over her left mid vault depression. The lip advancement was done by excising 4.5 mm of upper lip skin to make her upper lip more in proportion with her lower lip and the rest of her face. A nice Cupid’s bow was also developed. A small extended prejowl implant was placed through the submental incision and the submental neck tuck as previously described was done. As can be seen in the postoperative pictures, she now has a more pleasing appearance to both her profile and frontal views of her face. Her chin, neck, upper lip and nose have more pleasing contours now and in balance with all three zones of her face. In addition, her breathing is significantly improved after correcting the deviated septum and performing the inferior turbinectomy and adenoidectomy. Her appearance will continue to improve as she is only at a three weeks postop.
Chin Implant and Rhinoplasty*
Before and after photos of a young lady who underwent a correction rhinoplasty and chin augmentation. The patient was also unhappy with her breathing and sinuses and that was corrected at the same time with a very successful outcome. As can be noted on the preoperative exam, especially on the anterior view, you can notice that she had somewhat of a small chin and her face was out of proportion with the lower third of her face being not harmonious with the dimensions of her upper and middle third of her face. Also, the lateral view depicts a weak chin that was mildly behind the ideal projection line which is up to the vermilion border of the lower lip. Her nose had a small dorsal cartilaginous bony hump and bulbosity. She was happy with the angle of her tip and desired to have only minimal elevation of the nasal tip. It was thought that her rhinoplasty would result in greater than desired rotation of her tip upwards unless a septal cartilage tip graft was placed at the end to counteract this. This was done during the surgery which added a slight amount of bulbosity to the tip but yet prevented her from being rotated excessively in the postoperative period. She was very happy with the result. As you can see in the postoperative results, her nose has a more elegant feminine dorsal appearance. The tip is not excessively rotated. It is still somewhat swollen at two months and should continue to improve and now she has harmonious balance between the lower portion of her face, chin/mandible area in relation to her mid-face and forehead because of the chin implant that was placed.
Chin Implant and Neck Lift*
Two-and-a-half month postoperative view of a middle aged man who underwent multiple procedures including a submental neck tuck, chin implant, partial inferior turbinectomy and modified UPPP. In addition to improving his appearance from this surgery, the patient also improved his nasal obstruction by shrinking down his turbinates and also by removing some of the excessive palatal tissue that was causing his snoring. A small wraparound chin implant was placed to enhance his profile but yet to maintain a natural look. A submental platysmal neck tuck and liposuction was then done through a 2 cm incision below his chin that is well hidden and concealed. No incisions around the ear and no facelifting were necessary to achieve this significant improvement in his neck contour. The redraping of the neck skin and the improvement seen in the postoperative pictures is quite impressive despite the fact that his skin laxity for his age and elasticity is not as responsive as younger persons would be but yet he still developed an excellent result and significant improvement in his neck and jaw contour.
Chin Implant and Neck Lift*
Early ten day postoperative result of a 22-year-old man who desired aesthetic improvement of his congenital fat hypertrophy of his neck and small chin. Despite being in good shape and normal weight for his height, the patient had excessive fat collection in his lower neck which has been present since his teen years and has progressively worsened. The patient desired a strong chin and for that reason a customized small wraparound chin implant was placed through an external incision. The apex of the implant was shaved slightly to have it fit more exactly into his profile. Also through the same under the chin incision, liposuction was done throughout his neck; however correction of superficial fat was not sufficient for creating the profile that we desired. It was determined intraoperatively that the patient’s obtuse neck angle and fat hypertrophy was mostly related to deep fat deep to his platysmal. For this reason, sub-platysmal fat was dissected out under direct sharp dissection through the one inch submental incision. His platysmal neck bands were then sutured to help tighten the platysmal and create a nice sharp neck angle. Even at ten days, his incision is barely visible. Over the next few months, the swelling around his chin should subside to produce an even better profile. In addition, the swelling around his mandible and angle of the mandible should subside to produce an even better contour of his jaw and neck. The patient also suffered from nasal obstruction secondary to septal deviation and turbinate hypertrophy and this was corrected simultaneously with an excellent improvement in his nasal air flow.
Chin Implant and Neck Liposuction*
One-month post-operative views of a young man who underwent chin augmentation and neck liposuction. Note that his face is now more proportionately balanced. His newly created jawline is now more defined and angulated.
Chin Implant and Rhinoplasty*
Very early 12-day post-operative result of a young man who underwent reconstructive rhinoplasty and chin augmentation. As can be seen, especially on his lateral views, a large dorsal, bony and cartilaginous hump was excised, excessive nostril show was corrected and a cartilage tip graft was placed to help prevent over-rotation of the tip. In addition, the full nasolabil angle was corrected and brought back to allow for a more pleasing lip/nose junction. An extended medium-sized pre-jowl implant was placed through an external approach to allow for a very subtle but more contoured jawline. “Worm’s-eye” base view demonstrates a more symmetric tip and nostril appearance. The external columella scar which was utilized for this open approach is barely visible even at 12 days. Some residual swelling and echymosis (black and blue) can still be seen around his eyes in these early post-operative views, but should resolve shortly.
Chin Implant and Neck Liposuction*
Nine-day post-operative result demonstrating a patient with a congenitally weak/recessed chin. As demonstrated on the lateral pictures, the patient was also exhibiting early signs of aging/jowl formation along her jaw line. For this reason, augmentation mentoplasty/chin augmention was performed with an extended mandibular contouring chin implant that also added projection to the area right in front of the jowls to diminish the appearance of the jowls while simultaneously adding projection to the chin. As noted on the frontal shots, her face appears more balanced with smoother skin along the chin and jaw line. Liposuction also assisted in allowing for a longer, more youthful jaw line/submental plateau.
Eyelid, Facelift, and Chin Implantation*
Four month postop result of cheek and neck lift, chin augmentation, and upper and lower eyelid tightening. All incisional scars well hidden in natural skin creases. The patient now appears more youthful and balanced. Note that fat bulge under the chin is now corrected with better neck contour. Additional refinements are possible, if the patient desires, with attention to skin care utilizing either chemical peels, laser abrasions and/or Gentlewave LED Photomodulation.
Smile Surgery, Lip Correction, and Chin Implant*
Young patient who underwent multiple procedures to improve the appearance of his smile, lips and recessed chin. Surgery allowed for correction in the amount of gum show with a lowering of the upper lip. Correction in size of both upper and lower lips. Chin implant also placed for better profile.
Chin Augmentation & Neck Liposuction, Rhinoplasty, Cheek Buccal Fat Extraction*
Patient desired more masculine and prominent jaw line with accentuation of cheeks with slight hollowing of mid face. A small pad of fat was taken from inside the mouth to decrease fullness in the lower cheek while simultaneously increasing definition of upper cheek highlights. Chin implant and neck liposuction also performed to allow for better jaw contouring and facial balance.
Nasal Refinement and Chin Augmentation*
Nasal hump corrected and straightening of a crooked nose. No tip work done. Small chin implant placed.
Weekend Neck Lift*
Patient underwent neck liposuction and placement of small chin implant. Very minimal swelling seen at four days after surgery. Often referred to as “weekend neck lift,” since recovery time is usually very quick.
Six month post-op result of neck liposuction and placement of small customized chin implant. All work done through small incision under chin and 1/4 inch incisions behind ears. Facelift will be required in the future to correct mildly sagging jowels and cheeks.