Case 34: Hispanic Rhinoplasty in this patient meant removal of a high dorsal bump on profile and correction of a droopy-appearing tip. On front view, there is correction of a left nasal bone fracture and refinement of the nasal tip. All of this was done while still maintaining her unique individuality and while bearing in mind the various challenges Rhinoplasty in Latino patients present- thicker skin and softer cartilage.


This procedure is for women who need additional volume as well as a lift. Depending on the placement of the implant, a breast lift can occur as a result for women with a low degree of droop, without the need to make any incisions. For women who have a moderate to severe breast droop, breast lift incisions along with breast implant insertion will be needed to achieve optimal results.
Case 96: To see how well our results last, see these photos of our patient 8 years after rhinoplasty and facial fat transfer! Her rhinoplasty involved softening her look and removing the convexity on the bridge that made her tip look downturned. Fat transfer under the eyes has stood the test of time and really helped to reduce her under eye hollows to noticeably brighten her appearance.
An “Internal” Bra: This is one of the most interesting procedures, as it is a mesh type of bra that is inserted surgically to lift your breasts. The mesh bra provides a little extra structure although over time the mesh is broken down and absorbed by your own tissues. This procedure is called the Breform, and you can expect a surgery of about four hours in the hospital with a few nights in recovery before you are released. The Breform is inserted through a scar in the nipple area or in the crease under the breast.

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A: In general, no plastic surgeon can guarantee that breastfeeding will still be possible after the breast lift surgery. But in most cases, you should be able to breastfeed after a breast lift if the nipple was left intact during the procedure, and was still connected to all the anatomical structures underneath the nipple. However, if you are planning to become pregnant, its recommended that you wait until after your pregnancy to have a breast lift. Reason being, as your breasts enlarge during pregnancy the skin will stretch. Depending on the elasticity of your skin before pregnancy and the degree to which your breasts enlarge during pregnancy, your breast skin may permanently stretch. In this case the results of breast lift surgery performed before pregnancy would be lost. 

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. 


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.”
You’ll be in a recovery room immediately after surgery. When getting ready to leave, a nurse will go over instructions on how to care for the drainage tubes, antibiotic use, and other important information about post-surgical care. She will also discuss symptoms that are commonly felt after surgery as well as the types of complications that could result.
Some might think that this patient had had previous rhinoplasty with tip collapse, but she did not. Occasionally, the shape of the tip cartilages is very vertically-oriented, causing a deep groove in the nostril. She felt this, along with her marked tip crookedness, drew unwanted attention to her nose. Now, her nose is smaller, smoother, more defined, and just blends with the rest of her face.
This procedure is for women who need additional volume as well as a lift. Depending on the placement of the implant, a breast lift can occur as a result for women with a low degree of droop, without the need to make any incisions. For women who have a moderate to severe breast droop, breast lift incisions along with breast implant insertion will be needed to achieve optimal results.

Botox Breast Lift: There are more and more uses of Botox that researchers are finding as time goes on. A Botox Breast Lift is not an approved use of botox by the FDA. Here’s how it works: Botox is injected into your pectoralis muscle. This causes a relaxation of the muscles in the chest and your back muscles then begin to lift your breast. The lifting is not dramatic though and it only lasts about three to four months. The advantage, however, is that there are no scars because surgery was not done. There’s also no recovery time as there is with a breast lift surgery.
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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.
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.

A Bra Lift with Laser (Laser Bra Lift): Some doctors will want to use a laser bra lift as an insurance policy that your breasts won’t sag. It’s actually not really an alternative to breast lift surgery as it is an extra procedure. In the laser bra surgery, the laser is used to create a bra-like effect that protects the surgical results of the breast lift. Laser energy will always stimulate the production of new collagen fibers, which give you more support of any tissues. Always look at the before and after pictures to see whether or not you think there is enough improvement.
Case 29: Major concerns for this patient were widening of the tip with a marked lack of projection which made his nose feel flat and washed out. Nostril thickness and rounding was also something he wanted addressed. In this case, irradiated donor rib cartilage was used to project and support the tip along with alar base reduction removing a significant amount of nostril flare to create a natural tip and nostril contour that is ethnically appropriate. Fat transfer to the cheeks helps to balance out his flat mid-face to strengthen the cheek contour which can be seen nicely on the profile view. 

Case 43: Rhinoplasty in this pretty professional woman was all about removing the bump she had hated for years and correcting the tip droop and asymmetry that had worsened with age. Relatively small changes here have created a real sense of refinement while maintaining her long, elegant profile. A lower face and neck lift along with facial fat transfer helped to round out the enhancements in her already beautiful appearance.
Case 3: A curvature and droopy tip brings undue focus to this young man’s nose. Although there is still some swelling in these early post-operative photos, we can already see a nose that is now straight, has a smooth profile and no longer droops. A sense of length is preserved to match his oval face. More than that, because of these positive changes, he also looks younger.
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.
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.  
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