Case 40: Excessive nasal width can cause the nose to dominate other fine, delicate facial features. In Ethnic Rhinoplasty, the key to obtaining a more refined nose is to create a nasal framework upon which the thick skin will wrap around. This pretty young Persian woman wanted to reduce her nasal width, the fullness in her tip, and the sense that her tip was downturned. These six month photos show significant improvements in achieving these goals and her nose will only get better yet.
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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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.
A revision rhinoplasty is a complicated surgery, because the surgeon now has to contend with thick scar tissue—which makes it difficult to raise the skin and soft tissue off the cartilage. “Plus, we often need to reconstruct part of the nose, so we need to take cartilage from other sources,” says Dr. Miller. Surgeons say that the minimum amount of time to wait before you can do revision rhinoplasty, even if there is an obvious problem, is a full year. 
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.
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.
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.
Each year, thousands of women undergo breast lift procedures to restore the shape and volume of their breasts for a more youthful breast contour. Oftentimes breast lifts are combined with other procedures such as breast augmentation or breast reduction. In cases like these, the breasts are lifted as they are increased or decreased in size. The result are breasts that look and feel better!
A: It’s difficult to answer “how much” sensitivity you can expect to lose after breast lift surgery but most patients report that they are able to retain complete or near complete sensation. During the initial postoperative period, there may be a temporary loss or decrease in sensation primarily due to swelling. As the swelling subsides, the sensation will return. There is the potential that you may experience a change in the sensitivity of your nipples and the skin of your breast. On occasion, patients have reported that their nipples are “supersensitive.” In this case desensitization, exercises can be performed to diminish the sensitivity. This involves gently rubbing the nipples with cotton ball and then progressing to a more course material.
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.
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 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.


If you plan to have children in the future you may want to postpone cosmetic breast surgery until after pregnancy and after you are done breast feeding. Pregnancy may stretch the breasts and may reduce the volume of the breasts. Both of these factors may counter the benefits of breast lift surgery. In fact, breast skin ages over time, which may impact breast sagging and the appearance of a breast lift.
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. 

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.


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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.
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.
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.
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