The vertical breast lift, which involves an anchor shaped scar on the breast, is what every plastic surgeon learns to do while training in cosmetic surgery. It's been around for at least 60 years, and hasn't been updated since it was first introduced! No wonder Dr. Kara was never totally comfortable with the technique. Results would not last as long as he thought they should for such extensive scarring. On top of that, there would be no fullness in the upper part of the breast, so as the lifted breasts sagged with time, they would start looking tubular and flat on the bottom. That's why Dr. Kara prefers the BEST for his patients by performing the Bellesoma™ Method!
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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.
An “Internal” Bra: This is one of the most interesting procedures, as it is a mesh type of bra that is inserted surgically to lift your breasts. The mesh bra provides a little extra structure although over time the mesh is broken down and absorbed by your own tissues. This procedure is called the Breform, and you can expect a surgery of about four hours in the hospital with a few nights in recovery before you are released. The Breform is inserted through a scar in the nipple area or in the crease under the breast.

Typically, at our clinic, a breast lift costs $10,500 ($9,500 + $1,000 for general anesthesia) plus tax. The total cost may vary based on your body and desired results, and whether you have any simultaneous procedures. In addition, clinic prices can vary based on factors such as the equipment they use, the clinic's accreditation, the surgical staff's skill levels, and the surgeon's experience.

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. 

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.


Dr. Miller says it’s also important for patients to have realistic expectations. “It’s not a good idea to take a wide, thick nose and turn it into one that’s thin and tiny,” he says. “But if the steps are done properly, we can make the desired changes.” Thick nasal skin that makes it challenging to refine the nasal tip needs to be thinned out, for example. It’s important to find a board-certified facial plastic surgeon who specializes in ethnic rhinoplasties. 
How much you’ll swell really depends on you and on your surgeon’s technique—not so much the type of rhinoplasty you had. Dr. William Portuese, a facial plastic surgeon in Seattle, says that “The amount of swelling after a rhinoplasty procedure depends upon the type of rhinoplasty performed [open versus closed], the thickness of the skin, the amount of alteration required to the nasal tip, and the patient’s variability with the healing process itself.” He notes that “Some patients require taping and steroid shots in the tip of the nose to reduce swelling in that area for the first several months after the procedure.” According to Dr. Miller, “A very clean open rhinoplasty can result in minimal swelling, while with a closed procedure that isn’t performed in the ideal tissue and cartilage, you can have a lot more swelling. If the dissection travels through soft tissue or muscle on top of the cartilage, more bleeding and swelling will develop.” He notes that most people can also expect some bleeding from days two to five, but it should lessen with each passing day.

Case 16: A crooked and overprojected nose draws the eye away from other beautiful features. In this pretty young woman, you can see how rhinoplasty transforms her face. Even at this early 3-month point, we see that her nose is more feminine and no longer dominates her otherwise delicate features. And, at the same time, it is balanced and ethnically-appropriate.
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.
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.

Complications after breast lifts are relatively rare. The main three are bleeding, infection, and scarring. Your surgeon will give you instructions for preparing that will help lower your risk of complications. Those instructions will include such things as not smoking, making sure you are off medications that may make bleeding more likely, and taking antibiotics if necessary.


Case 22: This young woman was happy with her profile but wanted to reduce nasal width, tip boxiness, and nostril flare on front and three-quarter views. The combination of narrowing her bridge, tip refinement, and nostril reduction helped bring her nose into balance. At the same time, fat transfer to the under eye hollows did a fantastic job of brightening her eyes and giving her a more youthful look.

Case 71: Tip and nostril width and overall nasal projection made the nose feel dominant for this young woman. Rhinoplasty involved making her whole nose smaller by deprojecting, refining the tip, and removing some nostril flare. At the same time, a nasal fracture and breathing concerns were addressed. Neck Liposuction also helped to define and re-balance her jawline to create the improved facial proportions that she desired.

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.
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.
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 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.
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 rhinoplasty, commonly called a nose job, is a surgical procedure that changes the shape and, often, the size of your nose. If your nose has a prominent bump, crooked bridge, or wide tip, or it seems too big (or even too small) in relation to the rest of your facial features, surgical rhinoplasty could be your best option to correct it. It’s sometimes combined (and often confused) with a septoplasty—the surgical correction of a deviated septum, a condition where the wall between your nasal passages is crooked. A septoplasty is performed to improve breathing, while a rhinoplasty is usually performed for cosmetic enhancement.  Both procedures can be performed simultaneously under one anesthetic, with one recovery period.
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