As we age, our bodies undergo numerous changes. Gravity takes hold, and the skin’s elasticity weakens. This can result in drooping, sagging breasts. Over time, a woman’s breasts may lose their perkiness, and can also lose volume. Pregnancy and breastfeeding can exacerbate these effects. The changes in breast appearance can have a tremendous effect on a woman’s self-esteem.
Case 78: A combination approach was used here to create a really meaningful but completely natural transformation. Otoplasty made prominent ears all but disappear from the field of view and no longer distract or draw attention. At the same time, rhinoplasty, chin augmentation, and neck liposuction accomplished were able to remove a nasal hump and overprojection while improving chin and neck laxity to achieve a nice overall balance.

Dr. Miller says it’s also important for patients to have realistic expectations. “It’s not a good idea to take a wide, thick nose and turn it into one that’s thin and tiny,” he says. “But if the steps are done properly, we can make the desired changes.” Thick nasal skin that makes it challenging to refine the nasal tip needs to be thinned out, for example. It’s important to find a board-certified facial plastic surgeon who specializes in ethnic rhinoplasties. 

Case 33: For this young woman, the nose felt boxy and unrefined in comparison to her more defined facial features. Goals of rhinoplasty included lifting and definition of the tip along with subtle hump reduction to create a more sleek and streamlined nasal contour. Achievement of these goals creates a nose that harmonizes rather than dominating other features.
Case 89: This patient had broken her nose with consequent severe loss of tip support, tip rounding, crookedness, and a traumatic bump. In this case, a lateral crural overlay technique was used to reduce and lift the tip along with a septal extension to help with support and straightening which has improved tremendously as seen on the base view. Even though she’s still swollen in these early photos, she already has a great result and it’s only going to get better. 

The surgeon makes incisions in the skin, usually on the crease under the breast, around the areola and along the underside of the breast. After removing excess skin, the doctor will move the areola and nipple to a new, higher position, pull the skin down to reshape the breast, and then stitch the incisions. Usually, the procedure requires general anesthesia. The American Society of Plastic Surgeons[1] provides a detailed description of the surgery.
A rhinoplasty, commonly called a nose job, is a surgical procedure that changes the shape and, often, the size of your nose. If your nose has a prominent bump, crooked bridge, or wide tip, or it seems too big (or even too small) in relation to the rest of your facial features, surgical rhinoplasty could be your best option to correct it. It’s sometimes combined (and often confused) with a septoplasty—the surgical correction of a deviated septum, a condition where the wall between your nasal passages is crooked. A septoplasty is performed to improve breathing, while a rhinoplasty is usually performed for cosmetic enhancement.  Both procedures can be performed simultaneously under one anesthetic, with one recovery period.

On average, RealSelf members paid about $7,500 for a rhinoplasty. This includes the cost of the surgeon, anesthesia, and surgery center. Your cost will depend on your surgeon’s geographical location, their expertise level, and the complexity of your surgery. Insurance doesn’t cover rhinoplasty when it’s purely cosmetic, but it can help if you’re looking for structural corrections to alleviate medical problems. “Insurance will typically cover procedures to help improve nasal function [i.e., septoplasty, nasal valve repair, turbinate reduction],” says Dr. Sam Naficy, a Seattle facial plastic surgeon. “The extent of coverage varies, based on the details of the insurance plan.”
If more than one procedure is done at the same time, your total cost may be higher. Combining procedures, such as with a mommy makeover, may be cost-effective in the long run as you only pay one facility and one anesthesia fee (these fees may be higher for longer surgeries). That said, combining plastic surgery procedures can also increase your risks.
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Complications after breast lifts are relatively rare. The main three are bleeding, infection, and scarring. Your surgeon will give you instructions for preparing that will help lower your risk of complications. Those instructions will include such things as not smoking, making sure you are off medications that may make bleeding more likely, and taking antibiotics if necessary.
How much you’ll swell really depends on you and on your surgeon’s technique—not so much the type of rhinoplasty you had. Dr. William Portuese, a facial plastic surgeon in Seattle, says that “The amount of swelling after a rhinoplasty procedure depends upon the type of rhinoplasty performed [open versus closed], the thickness of the skin, the amount of alteration required to the nasal tip, and the patient’s variability with the healing process itself.” He notes that “Some patients require taping and steroid shots in the tip of the nose to reduce swelling in that area for the first several months after the procedure.” According to Dr. Miller, “A very clean open rhinoplasty can result in minimal swelling, while with a closed procedure that isn’t performed in the ideal tissue and cartilage, you can have a lot more swelling. If the dissection travels through soft tissue or muscle on top of the cartilage, more bleeding and swelling will develop.” He notes that most people can also expect some bleeding from days two to five, but it should lessen with each passing day.
Dr. Fouda Neel is one of the leading surgeons in the field of cosmetic surgery. Prior to your procedure he will explain what is involved in your aftercare. It is important that you pick up any prescriptions for pain medication or antibiotics before your surgery. Not all patients require post-surgery antibiotics and Dr. Fouda Neel will discuss this with you during your initial meeting.
A rhinoplasty, commonly called a nose job, is a surgical procedure that changes the shape and, often, the size of your nose. If your nose has a prominent bump, crooked bridge, or wide tip, or it seems too big (or even too small) in relation to the rest of your facial features, surgical rhinoplasty could be your best option to correct it. It’s sometimes combined (and often confused) with a septoplasty—the surgical correction of a deviated septum, a condition where the wall between your nasal passages is crooked. A septoplasty is performed to improve breathing, while a rhinoplasty is usually performed for cosmetic enhancement.  Both procedures can be performed simultaneously under one anesthetic, with one recovery period.
If your doctor recommends breast reduction or breast augmentation, these are additional costs. Average cost of breast reduction is $6,500 to $12,000 while the average cost of surgery for breast augmentation is $5,000 to $10,000. In many cases, if your combining procedures there will be a discounted rate. Remember that the more experienced the plastic surgeon, the more expensive the surgery could be. However, you are investing in yourself by choosing an experienced surgeon.
If your doctor recommends breast reduction or breast augmentation, these are additional costs. Average cost of breast reduction is $6,500 to $12,000 while the average cost of surgery for breast augmentation is $5,000 to $10,000. In many cases, if your combining procedures there will be a discounted rate. Remember that the more experienced the plastic surgeon, the more expensive the surgery could be. However, you are investing in yourself by choosing an experienced surgeon.

The results are usually permanent, aside from normal changes that come with the aging process. If you’re really not happy with your results or have breathing difficulties once your nose has healed, you may be a candidate for a revision rhinoplasty. In many cases, scar tissue is the main culprit. “The force of a scar is very strong,” says Dr. Miller. “It can pull a nose one way or another—push it in, pull it out, turn it.” When this happens, a surgeon has to go back in and tweak the work. 
Case 37: Achieving a beautiful, natural change in an already beautiful woman is one of the great challenges we love in rhinoplasty. In front view you see a beautifully defined, natural change that simply looks great. Then on profile and 3/4 views, you see an elegant change where the tip is deprojected (made smaller) but retains a beautiful, natural aesthetic- this is finesse rhinoplasty.
When performing your breast lift, your surgeon will make every effort to make incisions in easily concealed locations, but scarring is an unavoidable byproduct of any surgery. Breast lift scars do fade over time, but in some cases, will never completely disappear, and may be permanently visible. If scarring is a concern for you, we’ll be happy to discuss scar reduction methods with you.
The surgeon’s fee is the most difficult to predict without first knowing the extent of the procedure and the qualifications of the plastic surgeon. The geographical location of the practice also plays a role in your cost. Surgeons who practice in highly populated urban areas tend to charge more because their overhead is higher and they are in greater demand than their counterparts in rural or suburban areas.
Case 47: This patient’s primary surgery left her with valve collapse, nostril notching, persistent tip rounding and hanging columella. Secondary surgery involved correction of these issues with repositioning and reconstruction of the tip cartilages to improve tip contour. Although she is still a little swollen in the after photos, she is already happy with her new nose.
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We think you shouldn’t have to wait to look better, and more importantly, feel better about yourself. To help our patients afford breast lifts, we offer several financing options. When you apply, we’ll take a look at your credit history to determine your qualification and financing amount. Upon approval, you can book a date for your procedure. Afterward, you’ll make monthly payments. Financing can help you get where you want to be sooner rather than later.
Case 61: The concerns in this case were crookedness and a significant breathing issue due to a severely deviated septum. She also felt her nose was over-projected and a little too big for her face. Here we can see resolution of her crooked septum on base view. The tip has been defined and de-projected and the bump brought down to create a naturally pretty and more balanced contour.
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