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.
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.
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. 

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.
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.
Asian, Latin, and African American rhinoplasties require a special skill set. Surgeons say the challenge lies in reshaping and resizing the nose while retaining its distinct features and keeping it proportional to the face. “Typically, African American, Asian, and Latin noses have flat bridges and wide tips,” says Dr. Miller. “The number-one goal is to create a new tip [through cartilage grafting] that has better support.” Patients also often request a reduction in nostril size. 
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.

We think you shouldn’t have to wait to look better, and more importantly, feel better about yourself. To help our patients afford breast lifts, we offer several financing options. When you apply, we’ll take a look at your credit history to determine your qualification and financing amount. Upon approval, you can book a date for your procedure. Afterward, you’ll make monthly payments. Financing can help you get where you want to be sooner rather than later.
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 with most plastic surgery, getting more than one procedure done at one time can save you money in anesthesia and facility fees. Prices will vary by surgeon, but it is always best to look for the most qualified doctor rather than the lowest price. Also, some doctors will offer discounts to patients who agree to give testimonials or allow the doctor to use their before and after photos.
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. 
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