Case 72: This patient had sustained a nasal fracture that caused a significant deviation of her nose. The fracture was corrected along with a septoplasty to improve breathing. Loss of tip support after the injury made her hump look more prominent and her tip felt more droopy. The bump was smoothened and her tip angulation restored to create the softer, more feminine profile she wanted. At the same time, fat transfer to the cheek and under eye area and subtle neck liposuction substantially improved the flat cheek and mid-face contour that previously made her feel hollowed and tired looking without makeup.


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.

Case 4: 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.
However, it’s not without real risks. A liquid nose job should be done only by a skilled plastic surgeon with extensive knowledge of facial anatomy, using only hyaluronic-acid-based fillers. Misplaced filler can cut off blood flow and cause skin necrosis (tissue death). If it’s caught quickly, the hyaluronic-acid filler can be dissolved by a doctor, using an injection of hyaluronidase. But because this risk is serious, fillers have not been approved by the U.S. Food and Drug Administration for use in the nose. 

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.

If you’re having what’s called an open rhinoplasty, the surgeon will make an incision (about 6 millimeters long) in the skin between the nostrils. “Open rhinoplasty is a very common technique, where the skin is lifted upward like the hood on a car,” says Dr. Ronald Schuster, a Baltimore plastic surgeon, in a RealSelf Q&A about open vs. closed rhinoplasties. If you’re having a closed rhinoplasty, all incisions are placed on the inside of the nose, so there are no external scars.
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.
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.
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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.”
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.

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.
If you’re having what’s called an open rhinoplasty, the surgeon will make an incision (about 6 millimeters long) in the skin between the nostrils. “Open rhinoplasty is a very common technique, where the skin is lifted upward like the hood on a car,” says Dr. Ronald Schuster, a Baltimore plastic surgeon, in a RealSelf Q&A about open vs. closed rhinoplasties. If you’re having a closed rhinoplasty, all incisions are placed on the inside of the nose, so there are no external scars.
Case 25: This patient had what is called a tension nose wherein a convexity on the bridge pushes the tip forward and down. Notice how this also puts tension on the upper lip and appears to tether it from inside. a combination of straightening, improving breathing, removing the hump, and setting the tip appropriately also helps to relax the upper lip and complete the look.
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.
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.
Once your bone and cartilage have been resculpted, your surgeon pulls the skin back down and stitches it along the open-rhinoplasty incision across the columella (the tissue that links the nasal tip to the nasal base). “When done properly, that incision is extremely hard to see, once it’s healed,” says Dr. Miller. With a closed procedure, the incisions are made inside your nostrils, so there’s no visible scarring, and the sutures are usually dissolvable. 

Chances are good that you know at least one person who’s had a nose job. The American Society of Plastic Surgeons says that rhinoplasty is the third most popular cosmetic surgery, with more than 200,000 patients opting for the nose procedure every year. Whether it’s right for you depends on a number of factors, including the cosmetic and structural issues you’re looking to change, your budget, and the amount of time you can take off for recovery.
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.
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