It is difficult to answer the question about scar revision surgery without first seeing the patient. There are certain types of procedures that can be used to soften the scar which we refer to as laser abrasion or dermabrasion.  For more significant scars, it is important to actually surgically remove the scar first and repair it in a controlled fashion.  Typically the approach that we use on the face is what we refer to as a geometric broken line repair or a z-plasty.  This is a procedure that we have published on and it can be found in the literature.  Essentially the procedure is performed to take control of the scar and hide it in the area where the eye does not expect to see a line.

A flattened bridge is often the result of trauma and it is what we often refer to as a saddle-nose deformity.  It gets t his name because it can resemble a saddle if you were looking at a saddle from the side where it settles in the mid-aspect of the nose.  A closed Rhinoplasty or what we often refer to as an endonasal Rhinoplasty procedure is one approach that is used in Rhinoplasty.  In our practice it happens to be an approach that we use in almost 80% of primary Rhinoplasty.  This is a procedure where all of the incisions are placed on the inside of the nose and has a significantly shorter recovery period with less trauma to the nose and to the patient.  The anesthesia that is used is a twilight anesthesia similar to someone having their wisdom teeth removed or a colonoscopy.  The procedure is performed in our Surgery Center as an outpatient.

I agree, menopause is a natural part of the aging process, and not something to fear.  It is a wonderful transition for women, and most women come out the other side of menopause confident, healthy and feeling well.  However, during the time of perimenopause can be so severe that they will interrupt the quality of your life.  In this case, I think it is important to use natural treatment to help feel the best that you can.  I favor Bio-identical or natural hormone replacement because this is very effective, and has multiple health benefits for women who are lacking hormones.  If that is not something that you would want to do, I would recommend using some vitamins and herbs that can help during the time of menopause such as black cohosh and chaste berry.  These offer help with the mild symptoms of menopause but will not provide the health benefits that Bio-identical hormone replacement does.   Remember, estrogen is your hormone of memory, it is your hormone for vision and heart health.  It helps maintain your bones and helps prevent osteoporosis.  Progesterone helps anxiety, moodiness, depression, dizziness, and testosterone helps muscle tone and sex drive.  These are all important functions that women want to maintain throughout their life.  That is why Bio-identical hormone replacement is a very healthy treatment for perimenopause and beyond.