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Case 92: This procedure was all about correction of a droopy twisted tip. This patient was especially bothered by the tip’s tendency to drop and spread when she smiled, with a twist that made one nostril look higher than the other. After surgery, her nose is about as straight and symmetric as can be and the straighter bridge line makes her look younger.
Case 44: One of the hardest things to accomplish in a nose job is giving a person a smaller version of the same nose. In Los Angeles, where small differences can mean everything, doing Finesse Rhinoplasty is common. Even at 6 months, you can see that, on profile, this patient’s tip is less projected but he still has a strong masculine profile. On base view, you will also notice the deprojection and the fact that alar base reduction can be done with no visible scars and maintenance of the natural nostril curve.
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 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.
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.
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.
Case 60: Facial aging can be hard on someone who is naturally thin by creating a more severe and skeletonized appearance as facial fat is lost. A combined approach was used to create a beautiful transformation, including a trichophytic brow lift, lower lid tightening, and facelift along with a conservative rhinoplasty to straighten and balance her nose. Notice how the eyes are opened up and facial hollows are smoothened without the surprised look that can accompany over-aggressive lifts. You’ll also see that incisions are hidden within the hairline and natural skin creases making them almost invisible.
Some people opt for a temporary nonsurgical nose job—also called a liquid rhinoplasty—with hyaluronic=acid-based injectable fillers, like Voluma or Restylane Lyft. This minimally invasive procedure can camouflage bumps, create more symmetry, or lift and build up the tip of your nose. This approach has its limitations though. “If you have a large nose, it’s not going to get any smaller with fillers,” says Dr. Miller, though changes in proportions can sometimes make it appear smaller. It also can’t fix a crooked nose.
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 26: Narrowing a wide tip can really soften the face. The challenge in Ethnic rhinoplasty is in making a nose smaller while still maintaining good structure and support so that definition is enhanced. In these 15-month photos, you can now see how tip narrowing along with reduction of the bridge convexity has created a very pretty, feminine nose that enhances her beauty.
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 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.
Tip: Look for a board-certified plastic surgeon with plenty of experience performing breast surgery. The American Society of Plastic Surgeons provides a free referral service. When you meet with a surgeon, discuss your expectations to find out whether they are realistic. Also discuss risks and disadvantages. One major disadvantage of the breast lift procedure is that it inevitably leaves scars, which can be red, bumpy and very noticeable. Also, the surgery can cause numbness, tingling and loss of sensation in the breasts and nipples, which usually, but not always, disappear over time.
Case 21: For our patients who are in image-centered occupations such as modeling or acting, nasal refinements often focus on small changes that will enhance the overall look and remove subtle cues about the nose that preoccupy or distract the eye. This successful model had a look that really worked for her but had always felt that her tip and nostrils were too wide, flared, and slightly droopy. Creation of a slightly narrower and more structured tip draws unwanted attention away from her nose and, instead, enhances her overall look.
Case 39: The facial plastic surgeons at PROFILES Beverly Hills tailor every Rhinoplasty to achieve just what you are looking for. Sometimes, the most subtle of changes take just as much effort as the most dramatic ones. This pretty model didn’t want to drastically change her look. Her Los Angeles Finesse Rhinoplasty gave her the refinement she wanted, especially on her front and three-quarter views. Along with fat transfer to the lower eye area, her overall look was softened to make her that much more camera ready.
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 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.