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.
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 31: This patient had some typical concerns of feeling washed out from the front with flattening and spreading of her tip. She was very happy with the narrowing and definition achieved for her bridge and tip along with nostril reduction. In addition, chin augmentation increased chin projection to improve the balance of her lower face and jawline.
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.
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