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.
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. 
Case 60: Facial aging can be hard on someone who is naturally thin by creating a more severe and skeletonized appearance as facial fat is lost. A combined approach was used to create a beautiful transformation, including a trichophytic brow lift, lower lid tightening, and facelift along with a conservative rhinoplasty to straighten and balance her nose. Notice how the eyes are opened up and facial hollows are smoothened without the surprised look that can accompany over-aggressive lifts. You’ll also see that incisions are hidden within the hairline and natural skin creases making them almost invisible.
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.
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.
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.
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.

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.


During the course of a woman’s life, the breasts change in appearance and oftentimes sag. Don’t worry, this is NOT an uncommon condition. In fact, the clinical term for female breasts that sag is called ‘breast ptosis.’ There are many causes of breast ptosis including pregnancy, cigarette smoking, high body mass, gravity and the natural aging process. There are also different degrees of ptosis as shown in the illustration below. Fortunately, breast ptosis can easily be treated with breast lift surgery.
Case 38: This beautiful young lady is an early 6 month example of a finesse rhinoplasty. On front view you can see the bridge is narrower and the sense of hang is improved. On profile, the tip looks undone, natural and less projected with correction of the slight hanging columella. The result is a beautiful, natural look that corrects the issues but leaves her looking totally natural and undone.
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