If you want to refine your facial contour to naturally look years younger or correct a past procedure, a consultation with Thomas Romo III, MD, FACS can help you determine if facial plastic surgery is right for you. Dr. Romo III is one of the most respected surgeons

in the world, known nationally and internationally as a "super specialist" in Plastic and Reconstructive Surgery. 

 

There are four primary ways to surgically refine the face: Rhinoplasty, Facial Implants, Fat Repositioning and Removal, and Ear Reconstruction.

 

 

 

Rhinoplasty 

 

Rhinoplasty is most commonly a reductive surgical technique, but may require augmentation and elevation in certain ethnic groups. Dr. Romo utilizes computer imaging to illustrate how a patient’s nasal appearance can be improved with the recommended

rhinoplasty procedure.

 

 

Reduction   (Women- before & after photos)  (Men- before & after photos)

 

Contemporary rhinoplasty or reshaping of the nose has undergone several changes over the last two decades. First, most rhinoplasty procedures are performed upon Caucasian patients who have large noses that they want to look smaller. This is called a reduction rhinoplasty and is accomplished by cutting away cartilage and bone and letting the natural skin shrink-wrap down to the smaller framework. In the past, too much cartilage and bone were removed, which commonly resulted in noses that were too small, upturned, and pinched. To prevent this, Dr. Romo has developed a rhinoplasty technique called Reduction Structured Rhinoplasty™, which creates a natural-looking nose that maintains proper breathing function. The key to this technique is to not over-reduce the nasal architecture and to strengthen the residual support structures with the grafting of septal cartilage or implants.

 

 

Augmentation  (Women- before & after photos)

 

Dr. Romo is an expert in the “aesthetic reconstruction of the platyrrhine or flattened nose”. His augmentation technique utilizes natural tissue and safe porous implants to produce a nose that matches the face and the race of the individual. This rhinoplasty procedure first conceived and published by Dr. Romo in 1992 has its basis in that the flattened or platyrrhine nose requires substantial augmentation to properly support it. The skin of the nose has no shape; it is instead the underlying cartilage and bony architecture, which delineate the shape of the nose. Therefore these noses require the specific placement of grafts and implant materials to produce a more defined and elevated nose.

 

 

Revision  (Women- before & after photos)   (Men- before & after photos)

 

The need for a revision rhinoplasty is usually the result of excess cartilage and bone being removed from the nose during a primary rhinoplasty. As the nose heals following a rhinoplasty, the nasal skin shrink-wraps around the remaining nasal architecture. Because the structure is weakened, the nose often becomes distorted and misshapen with ski-slope bridges, pinched nasal tips, retracted nostrils and compromised nasal breathing capability. Revision rhinoplasty is one of the most difficult operations to perform, and the surgeon must have extensive experience in treating these deformities before operating on patients. Over the last 18 years, Dr. Romo has performed hundreds of successful revision rhinoplasty surgeries using a combination of natural and artificial implant materials.

 

Dr. Romo is an expert in revision rhinoplasty. He has designed and developed many new surgical techniques in this field. Dr. Romo utilizes standard techniques for revision rhinoplasty, but also offers newer alternatives for needed architectural support. This means that natural material, such as ear cartilage and rib cartilage, may be used during the reconstruction. If the patient chooses not to use these donor sites, then safe, porous implant material may be used to support the new rhinoplasty. The latter approach reduces the post-operative healing period because donor site trauma is eliminated.

 

 

 

Facial Implants   

 

 Facial implants can dramatically refine and improve a patient’s facial contour. Although the chin implant is the most frequently requested surgery, Dr. Romo also performs cheek, temple and jaw implants, as needed. Aging results in a downward shifting of the facial fat pads, as well as a loss of facial fat volume. Dr. Romo utilizes fat repositioning, fat grafting and selective liposuction to restore the youthful face.

 

 

Cheek, Chin, Temple, and Jaw Implants  (Women- before & after photos)  (Men- before & after photos)

 

The need for augmentation of the face can be determined by measurements called cephalometrics. Cheek, chin, temple, and jaw implants can be used to enhance a patient’s appearance by filling facial deficiencies and creating a more defined and contoured facial structure. Dr. Romo uses an intraoral approach to place cheek implants, which eliminates visible incision lines. If needed, jaw implants can be added during this procedure or a separate procedure. Temporal implant surgery is usually combined with a temporal lift procedure, and the incision is hidden in the hairline. Chin implant surgery usually requires an external approach involving a small incision hidden below the jaw line. Chin implants are by far the most common implant procedure performed. Using cephalometrics to assess a patient’s facial structure involves visualizing a straight line extending from the forehead to the chin. If the patient's actual chin is tangential to this vertical line, the chin is considered normal.

 

If the patient’s chin is in front of this line, it is called prognathic, more commonly known as “lantern jaw”. The most famous person with this characteristic is Jay Leno. If the patient’s chin is behind this vertical line, it is called retrognathic. These patients are good candidates for chin implant surgery. Chin implant surgery often includes liposuction of the neck to achieve a more defined jawline.

 

 

 

Fat Repositioning and Removal  (Women- before & after photos)  (Men- before & after photos)

 

Like all the facial soft tissues, the fat pads in the face descend and diminish as we age, which results in facial hollows in the cheeks and wrinkles around the mouth. These areas can be filled by elevating and repositioning the fat pads and adding supplemental fat from the abdomen if needed.  Alternatively, there can be an accumulation of fat that develops under the chin as we age, which can be eliminated with micro-liposuction. A combination of strategic fat grafting and targeted liposuction is used to create a younger and more balanced appearance.

 

 

 

Ear Reconstruction

 

Otoplasty    (Women- before & after photos)  (Men- before & after photos)

 

The standard otoplasty technique commences by removing a portion of skin behind the ear and then suturing back the cartilage in a partially blind procedure. Often, this approach causes an overpinning of the ears, which results in ears which are too close to the head. A subsequent effect of overpinning is the flaring of the top and bottom of the ears, also known as a “telephone deformity”.

 

Dr. Romo designed and published a unique otoplasty technique that utilizes a skin flap behind the ear instead of the standard procedure of primary skin removal. This approach allows for complete exposure of the ear cartilage which enables a more predictable result after the needed set-back procedure. At the time of skin closure, the redundant skin is redraped and exactingly removed. This allows for a tension-free closure that prevents deformity in the post-operative ear shape, as the ear heals.

 

 

Microtia

 

Microtia (a smaller than normal, usually misshapen auricle) is one of the more common congenital anomalies of the external ear. It occurs with a frequency of one in every 7,000–8,000 births in the general population. Males and the right ear are most often affected. Bilateral microtia occurs in one in every 12,000 births. The majority of cases have no genetic component, as less than 15% of these patients have a family history of ear anomalies.

 

Dr. Romo is a recognized expert in treating this deformity and has been performing ground-breaking surgical techniques for over 20 years. Creating a new ear structure can be accomplished using rib cartilage or porous implants. Each patient is assessed to determine which method will provide the best result. Microtia is often associated with atresia, which presents as a hearing loss. This is corrected with a bone-anchored hearing aid that is implanted completely under the skin.