Case 12: One of the things that we love about rhinoplasty is that we can combine dramatic changes such as straightening this patient’s nasal twist, and at the same time create some subtle enhancements such as refining and slightly deprojecting the tip while reducing the sense of columellar show. At 6 months, her nose now balances with her face and really brings out her beautiful eyes.
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.
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.
The closed vs. open rhinoplasty technique concerns only how the surgeon gets inside the nose to make the required changes, not what’s accomplished with the rhinoplasty procedure itself. Reshaping your nose may include breaking and removing bone and cartilage. If cartilage needs to be added, say, to rebuild the tip of the nose, it’s often taken from the septum, the middle portion of the nose—a technique called a cartilage graft. Cartilage may also be taken from other areas of your body, such as your ear. In some cases, a synthetic material, like a silicone implant, is used; but studies have shown that there may be more complications with synthetics. Cartilage grafts, nasal-bone osteotomies (removal of parts of the bone), dorsal-hump removal, and suture techniques applied to the nasal tip cartilages can all be performed with either the closed- or open-approach rhinoplasty.
In addition to a breast lift, many women also consider having other procedures performed at the same time to enhance the overall result. For example, a “mommy makeover” is a combination of different surgical procedures reserved for women who have been pregnant and want to look like they did before the pregnancy. This may include a tummy tuck, liposuction surgery and breast enlargement or breast reduction. There is also a cost savings of having multiple procedures done at the same time.

Tip: Look for a board-certified plastic surgeon with plenty of experience performing breast surgery. The American Society of Plastic Surgeons[2] 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.
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.

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.
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. 

A breast lift usually costs between $3,500 and $6,000, including an anesthesia fee of $1,000 to $1,500, a hospital fee of $500 to $1,500 and a surgeon's fee. The breast lift cost also will vary from patient to patient, and a lift on smaller breasts, which usually require fewer incisions, will be slightly less expensive. For that reason, a doctor will need an in-office consultation to provide an accurate quote.
In addition to a breast lift, many women also consider having other procedures performed at the same time to enhance the overall result. For example, a “mommy makeover” is a combination of different surgical procedures reserved for women who have been pregnant and want to look like they did before the pregnancy. This may include a tummy tuck, liposuction surgery and breast enlargement or breast reduction. There is also a cost savings of having multiple procedures done at the same time.
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 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.
Disclaimer: Please note, any information on this page is provided to you for educational and/or informational purposes only, and should not be construed as an endorsement of any particular procedure, product or treatment. This information is also not a substitute for medical advice, diagnosis, or treatment by a doctor or other qualified health care professional. For medical concerns, including decisions about any procedure, product or treatment, visitors should always consult with their doctor or other qualified health care professional.
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. 

The procedure also does not permanently change the breast shape and firmness. As time marches on, you may expect the effects of aging and gravity to continue. In these cases, a secondary revision surgery may be required. The best candidates for this cosmetic surgery are women who are emotionally well-adjusted, have realistic expectations, and understand the procedure thoroughly.
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